marketplace madness

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6 Responses

  1. Jenni says:

    Have you considered buying an off-marketplace individual plan? That’s what I did for me and my kiddos and it sounds like it was infinitely easier than the mess you are dealing with! I have a BCBS plan starting 1/1 (with maternity, hooray!) and because I got a Platinum level plan, it has a good network and great benefits, while still costing less than the plan I had the last time I was pregnant. I am certainly not an expert (unless you count switching plans 6 times in 5 years an expert) but after getting denied for my “plan A” group plan and finding myself pregnant without insurance, once my agent figured out from the insurance companies what was going on, I’m happy with my “plan B.” Just thought I would mention it just in case you hadn’t already considered it. (My only frustration has been the mandatory “qualified” pediatric dental, which we decided to ignore until someone could define “qualified” a bit better, and went ahead and purchased a plan for the three of us that cost less than the qualified plan for just my two kiddos.) Good luck!

    • John says:

      I’m confused; a Platinum plan *is* a marketplace plan. I think you mean, have I considered just buying it direct from BCBS and not worrying about the subsidies. I have. But that’s crazy expensive ($1328/mo. for Platinum, $770/mo. for the cheapest Bronze, compared to $330/mo. I pay now) Plus I’ve gamed my income through tax deferrals to be at 239% of FPL where I should qualify for not just premium subsidies but cost sharing subsidies, which bring down the deductibles and max out of pocket for Silver plans.

  2. Lisa says:

    Elections definitely have consequences.

  3. IrishRed says:

    I’m so terribly sorry to hear all you’re having to go through on this, on top of all the other recent losses and difficulties.

    Is any of this impacted by N. Carolina’s refusal to expand Medicaid? Here in Texas, that’s certainly impacting my sister-in-law and her husband and 3 children. They both work full time with overtime whenever they can get it but still only earn about 125% of the poverty level. She was just told by a benefit coordinator where she works that they won’t qualify for EITHER Medicaid or subsidies on the ACA premiums/deductibles!!

    Without subsidies they simply can’t afford any plan and will continue to go forward without insurance at all, she guesses. Thank goodness the family has been very healthy so the risk is relatively low. Still, there’s the occasional problem. Her oldest had a nasty abscess in his ear last August which needed anti-biotics. The trip to the Emergency Room to get a prescription cost $981 which they are still paying off.

    Is there any chance your employer will offer health care? Our UHC work plan has steadily increased in cost over the years but is still much less expensive than the individual policy alternatives I saw for our family on ehealthinsurance.com

    It’s a mess and I hope your family is able to navigate through it safely.

    • John says:

      No, none our difficulties have anything to do with NC not expanding Medicaid; we shouldn’t be qualifying for Medicaid expanded or not.

      As far as your sister-in-law, please direct her to the video in this post. At 125% of FPL, if she is able to buy insurance on the new exchanges, their family would get the highest premium credits and cost sharing subsidies. I have a feeling the benefits coordinator gave bad advice.

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