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Health Insurance Question

Discussion in 'General Discussion | Finance' started by haserfauld, Apr 26, 2017.

  1. haserfauld

    haserfauld Level 2 Member

    Hi all,

    I have an interesting situation that just arose, and I'm just looking for some recommendations before I move forward.

    I work for a smaller company, and I'm provided with a partial subsidization for my health insurance. Due to the size of our company, we aren't offered any subsidization for spouse/family. My wife is 24, and she was still on her dad's insurance because she has a sibling her parents wanted to cover anyway, and the family rate was the same. She works as a nanny (full time), but has no insurance from her employer. Here's the interesting situation:

    1) Her father just got laid off yesterday, effectively ending her coverage
    2) My company's insurance renewal date is July 1, although I could add her to mine now because she had a qualifying event
    3) I'm leaving my company at the end of July (wife is ending employment June 15) and we're moving to North Carolina--employment is not yet nailed down, so I don't know what to expect for insurance
    4) If her father finds a new job, he'll probably have the same setup (family coverage so her sibling is included), which means he could include her at no additional cost (for the next 18 months)

    Considering the absolute cluster that is the insurance marketplace, I'm trying to figure out my options here. Adding her to mine is obviously the safest and fastest, but it's also costly ($290 a month for my Silver 70 EPO HealthNet plan with $1800/ind and $3600/fam deductible). It doesn't seem to be that much worse than other plans I found searching the CA marketplace, though.

    For being a 24-year-old, she actually does have more medical costs than average (TMJ, sports-related joint issues, etc), although most are chiropractic/acupuncture, dental, and vision which isn't covered anyway.

    Anyone have any directional guidance or recommendations?

  2. AnyNameYouWish

    AnyNameYouWish Level 2 Member

    What does her father plan to do in the time before he gets a new job as far as the family insurance goes? They qualify for COBRA. Qualified beneficiaries have independent election rights so maybe her individual COBRA costs will be less than adding her to your plan? I have no idea what the new rules are as far as how soon they need coverage to be in compliance with ACA and/or when pre-existing kicks in (if it still even does). I did health insurance work but that was way before ACA.

    eta: I believe they have 30 days to contact her regarding her COBRA coverage and she has approx. 60 days to elect the coverage or not. Don't go 100% by those numbers they are just off the top of my head and I can't promise they are accurate, just don't expect a letter this week from his former insurance company. And you have some time to make the COBRA decision.
  3. BuddyFunJet

    BuddyFunJet Level 2 Member

    You only get the extra time if you don't sign a document declining COBRA coverage. The declination doc is sometimes part of the exit paperwork given to a departing employee.

    Just don't decline until you are sure you have a replacement. Silence is cost free.
  4. This is the kind of situation that ACA was supposed to make a lot simpler: you could move to North Carolina, enroll in Medicaid while you looked for a job, then switch to the exchanges or your workplace insurance after you found one. Unfortunately North Carolina still hasn't expanded Medicaid so that's not an option.

    Due to your wife's health needs you probably do want to be on a North Carolina plan, since a CA plan might not have her new doctors in NC in-network which would raise your costs dramatically. You can check with your insurer though to be sure. If they have NC providers in-network then that's clearly the best way to go.

    Otherwise, my suggestion is that you enroll in the North Carolina marketplace either using your CA income history (presumably you'll be receiving a couple more paychecks after you leave the company in case they need proof of income) or your "estimated" North Carolina income. You can lowball your income in order to trigger a subsidy or you can decline the subsidy (and get it when you file your 2017 taxes, if applicable). Since North Carolina's a non-Medicaid expansion state you won't qualify for the exchanges if you don't have any income (that's what the Medicaid expansion was for), so you'll have to get creative in order to enroll.
  5. traveler

    traveler Level 2 Member

    If she's healthy consider purchasing a HDHP directly from the insurer and max out an HSA. In a family every member can have separate policies - sometimes the "family plan" may not be the best option.

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