Author Topic: Am I doing it wrong? Health insurance question  (Read 1037 times)

We be free if we try

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Am I doing it wrong? Health insurance question
« on: June 09, 2018, 07:49:23 PM »
Been lurking about 6 months, first post! It took me a month to successfully register, because my 2 primary email addresses kept block the activation emails...

Family of 2 parents (48/51 years old) plus 2 teens in very HCOL Bay Area. We're both self-employed / own business / freelance professionals. Our Kaiser health insurance premiums run $1,740/month, or $20,800 / year, unsubsidized (AGI around $190k in 2017, but less this year.) This was a higher-cost plan, because younger dd has some health issues (mostly I'm anti-risk.) Where did we go wrong? We don't have a HDHP / HSA - yet. Should we?

lhamo

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Re: Am I doing it wrong? Health insurance question
« Reply #1 on: June 09, 2018, 08:13:09 PM »
Nothing wrong, necessarily -- once you fall off the subsidy cliff ACA insurance is indeed very expensive.

HSAs are good if you have minimal health care expenses, or choose not to use the money you put in the HSA for current costs and let it serve as another route for tax deferred savings -- might make sense given your high income, as long as meeting the high deductibles/OOP limits are not an issue.  You won't save a ton on the premiums, though -- I found the HSA plans to be almost as expensive as the non-HSA silver plans, but with much higher deductible/OOP limits.

Cranky

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Re: Am I doing it wrong? Health insurance question
« Reply #2 on: June 09, 2018, 08:39:52 PM »
Honestly, that sounds about right. We have insurance through dhs job, and between what they pay and what we pay, well, it adds up to more than $20k/year, and we hardly ever get sick.

But you only have to be in the hospital once to see why it costs that much.

geekette

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Re: Am I doing it wrong? Health insurance question
« Reply #3 on: June 09, 2018, 08:44:02 PM »
Yeah, it's expensive.  Two mid-50's adults in NC, $2,200/month (but we do qualify for subsidies).

MDM

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Re: Am I doing it wrong? Health insurance question
« Reply #4 on: June 09, 2018, 08:51:31 PM »
If you have both HDHP and non-HDHP options, consider putting those numbers into a couple of comparison tools, e.g., Health Savings Account (HSA) vs. Traditional Health Plan and the 'HDHP Analysis' tab of the case study spreadsheet.

We be free if we try

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Re: Am I doing it wrong? Health insurance question
« Reply #5 on: June 09, 2018, 09:33:39 PM »
Ok, thanks everyone! When we get to enrollment season, I'll take a hard look at whether we're better off switching plans or staying put. Since we don't (yet) max our SEP-IRA's, the HSA isn't necessarily helpful from a tax standpoint.

MDM

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Re: Am I doing it wrong? Health insurance question
« Reply #6 on: June 09, 2018, 09:40:09 PM »
Since we don't (yet) max our SEP-IRA's, the HSA isn't necessarily helpful from a tax standpoint.
The HSA money, if spent on medical expenses, is not taxed at all.  A SEP-IRA is taxed at withdrawal.

If you expect to use the HSA money for medical expenses, either now or in the future, it will be more helpful than the SEP-IRA.

cchrissyy

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Re: Am I doing it wrong? Health insurance question
« Reply #7 on: June 09, 2018, 09:41:18 PM »
without subsidies, that sounds like a fair price for 2 adults your age and 2 teens in this area

wawot1

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Re: Am I doing it wrong? Health insurance question
« Reply #8 on: June 10, 2018, 07:51:33 PM »
I think that if you don't have chronic health problems, and don't anticipate a planned expensive procedure (back surgery or having a baby or something) a high deductible plan is usually the way to go.    You can save and invest the money that you would otherwise be paying towards a higher premium for a traditional HMO and then use that money and any investment proceeds towards medical expenses in the future without paying taxes.   Of course, you need to make sure that you could handle the max out of pocket costs if the worst happens and you get hit by a bus and land in the ICU for 3 months....

Acastus

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Re: Am I doing it wrong? Health insurance question
« Reply #9 on: June 11, 2018, 09:04:54 AM »
I signed up for ACA in NY last month, and your cost looks comparable to the family plans I reviewed. Our kid qualifies for CHIP, so we can use a plan for a couple and save $500/mo vs. your plan. Your income would have to be less than 1/2 what you stated, so unfortunately that will not work for you. Family plans at silver level had about $4000 deductible, and were 1600-1900/mo depending on the pool of doctors in the plan.

My company claims my current family plan costs $14.5k overall, and it is terrible. We have a deductible of $7200, though we get an HSA. I expect lower insurance cost overall when I leave.

Sibley

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Re: Am I doing it wrong? Health insurance question
« Reply #10 on: June 11, 2018, 07:55:58 PM »
I think that if you don't have chronic health problems, and don't anticipate a planned expensive procedure (back surgery or having a baby or something) a high deductible plan is usually the way to go.    You can save and invest the money that you would otherwise be paying towards a higher premium for a traditional HMO and then use that money and any investment proceeds towards medical expenses in the future without paying taxes.   Of course, you need to make sure that you could handle the max out of pocket costs if the worst happens and you get hit by a bus and land in the ICU for 3 months....

The funny thing is, if you're going to hit the OOP max, then sometimes the HDHP is a better choice because of lower premiums.

jezebel

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Re: Am I doing it wrong? Health insurance question
« Reply #11 on: June 11, 2018, 08:31:56 PM »
I think that if you don't have chronic health problems, and don't anticipate a planned expensive procedure (back surgery or having a baby or something) a high deductible plan is usually the way to go.    You can save and invest the money that you would otherwise be paying towards a higher premium for a traditional HMO and then use that money and any investment proceeds towards medical expenses in the future without paying taxes.   Of course, you need to make sure that you could handle the max out of pocket costs if the worst happens and you get hit by a bus and land in the ICU for 3 months....

The funny thing is, if you're going to hit the OOP max, then sometimes the HDHP is a better choice because of lower premiums.

Exactly. An HDHP/HSA can be great if you have high  health care costs or low costs.  But it's so specific to regions and plans that you can't make general recommendations without considering the individual plan and circumstances.

For example, we have (a) much lower premium family plan HDHP than we would for a regular hmo here and (b) burn through our 3k deductible by may due to a chronic condition. So we save a lot of money with a HDHP.
« Last Edit: June 11, 2018, 08:40:49 PM by jezebel »

slappy

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Re: Am I doing it wrong? Health insurance question
« Reply #12 on: June 13, 2018, 06:17:47 AM »
I think that if you don't have chronic health problems, and don't anticipate a planned expensive procedure (back surgery or having a baby or something) a high deductible plan is usually the way to go.    You can save and invest the money that you would otherwise be paying towards a higher premium for a traditional HMO and then use that money and any investment proceeds towards medical expenses in the future without paying taxes.   Of course, you need to make sure that you could handle the max out of pocket costs if the worst happens and you get hit by a bus and land in the ICU for 3 months....

The funny thing is, if you're going to hit the OOP max, then sometimes the HDHP is a better choice because of lower premiums.

Exactly. An HDHP/HSA can be great if you have high  health care costs or low costs.  But it's so specific to regions and plans that you can't make general recommendations without considering the individual plan and circumstances.

For example, we have (a) much lower premium family plan HDHP than we would for a regular hmo here and (b) burn through our 3k deductible by may due to a chronic condition. So we save a lot of money with a HDHP.

I have a HDHP with a fairly low OOP max ($4K). This year we blew through it on Jan 1st with an emergency room visit. (I can't believe how expensive IV fluids and anti-nauseau meds are!) Then we had our son hospitalized for four days in January. We are also having a baby next month and then we will have DH get a vasectomy before the end of the year, so we are certainly winning with the HDHP this year!