Exactly HOW does this count as health insurance??

Just when it seemed like things were going ok…

Recently I’ve been working on our finances a lot.  I’ve started using You Need A Budget and it’s FABULOUS.  I’ll probably do a whole post about it.  And due to getting severance pay from Justin’s old job and him immediately starting a new job, we have extra money to pay off some bills, get ahead a month, and buy things we want/need.

Until the other shoe dropped.  On Monday I got the first written documentation of our new insurance plan in the mail.  Justin’s new employer is a small individual owned company, and there is only one option for insurance.  Well no one felt the need to tell him, even when he asked about it, that this is basically a castastrophic only plan.  The deductibles are $5000 and $10,000 and apply to everything, meaning we were out of pocket for the first $10,000.  Well we both have chronic conditions (collections of them, in fact) and take lots of meds.  Yeah, this is not flying.  The cost for one of my husband’s medications is $1400 (for a three month supply or $600/month).  That’s an amazingly huge chunk of our monthly income.  

So I freaked the fuck out for a day and a half and then I settled down to be a grown-up and figure out an alternative.  I went through the ACA and found us a plan that will cost us a little more in premiums, but which will give us much better care.  I could have gotten an HMO plan for what we’re currently paying in premiums, but none of our doctors were included in it, so I had to go with a more expensive PPO plan.  

Needless to say, I’ve learned a LOT about the ACA in the last 4 days.  Many people think they can’t use the marketplace if they have employer coverage.  That’s not true.  Anyone can buy insurance through it, but you won’t get any government funded assistance if you have access to “minimum quality plans” through your employer.  The catch is that no one is really sure what minimum quality plans looks like.  Justin’s employer claimed this plan meets the criteria, though I am skeptical.  The qualifications is that it has to meet 60% of health care costs of the average plan subscriber, and can’t exceed 9.5% of your income in cost.  The problem is that I can’t find anything about deductible cost.  And this only applies to the employee, not the family.  So while Justin’s plan is pretty cheap, my plan is outrageous.  And the latter isn’t taken into consideration.  Hopefully this gets tweaked to be more fair in the future, but it’s the government, so no breath-holding.

So I’m not getting any cost assistance with my plan, but it’s still a better option than what we had otherwise.  But it means our financial situation isn’t looking NEARLY as bright as it was 5 days ago.  *sigh*






One thought on “Exactly HOW does this count as health insurance??

  1. thetexturedknitter says:

    A lot of weirdness goes on with small companies. Apparently the cap for contributing to a 401k isn’t REALLY the cap, there’s a penalty where “highly compensated employees” can’t contribute the max unless the sum total participation of employees meets a certain benchmark. I guess it’s meant to keep executive/owners from fully funding their 401k while employees can’t afford to contribute, but we got stuck with that a couple years in a row because his company was rapidly expanding, so lots of employees were on the books who hadn’t yet set up their own 401ks.

    Even only considering Justin, though, I don’t see how that insurance could possibly meet the intended standards.

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