Getting screwed by high health insurance costs?

[Kyrene]

Can you help a fellow mustachian?

The Situation

Married with no kids in Texas. I have full health insurance through my work. Wife is a non-smoking, healthy, about-to-be-30 lady who works independently part time, and enrolled in the spring through Healthcare.gov into a Humana "silver" plan.

We pay about $180 a month just for her. This seems high to me. (Maybe it's not...enlighten me if this is normal.)

We are extremely dissatisfied with Humana's service and wish to change providers to get better service and save some green.

Here's the issue. My wife is not qualified for special enrollment and open enrollment is closed until mid November. Would rather not stick with what feels like a poorly serviced and over priced plan if we can help it.

Any tips to help my mustache grow a little longer? 

[Paul der Krake]

That's not bad at all. I'm mid-twenties and pay $137 for a catastrophic plan in NC. Considering that your wife is in prime baby-poppin age and therefore risky to insurers, you're getting great value for the money. Is that after subsidy, if any?

[Jack]

Can you help a fellow mustachian?

The Situation

Married with no kids in Texas. I have full health insurance through my work. Wife is a non-smoking, healthy, about-to-be-30 lady who works independently part time, and enrolled in the spring through Healthcare.gov into a Humana "silver" plan.

We pay about $180 a month just for her. This seems high to me. (Maybe it's not...enlighten me if this is normal.)

My circumstances are similar, except I'm locked into paying a similar amount through my employer's group plan (probably equivalent to an ACA "gold" plan) per 2-week pay period (so closer to $400/month!). The damn [employer] open enrollment occurred while the ACA website was still fucked up, so I couldn't comparison shop, and my employer only offers one plan...

[Kyrene]

That's not bad at all. I'm mid-twenties and pay $137 for a catastrophic plan in NC. Considering that your wife is in prime baby-poppin age and therefore risky to insurers, you're getting great value for the money. Is that after subsidy, if any?

No subsidy for some reason. I was shocked as she should have qualified. Hopefully that gets sorted out properly when tax season comes around again. =/

[TheDude]

Will your work cover you wife? If so you will not qualify for a subsidy. Since they cover you 100% it doesnt even matter what it costs you will not qualify. Pretty crappy but that's the family loop hole.

$180 really doesn't sound that bad. Health insurance unfortunately is just really stupid expensive.  I get a decent subsidiary at work but I know the total cost is $750/month. Im 33 and have two kids. The deductible is 9000 and opm is 12700. In other words between my employer and I we pay the first 18000 before insurance even kicks in. Awesome!

[El Marinero]

I suspect that most folks who have shopped for an individual policy would find $180 a month quite low.

Especially if they are a few decades older. Rates go up considerably in your 40s and 50s.

[MayDay]

Sounds super cheap to me. 

We paid 1500$ a month for a family cobra plan.  And theoretically kids are cheaper to insure than adults. 

[randymarsh]

Price sounds right to me based on what I've seen on the exchange and heard from other people.

[Another Reader]

Good luck getting better service and a choice of decent providers with most of these companies.  And you are stuck until the next open enrollment unless she has a "qualifying event."

What other insurance companies can she select during open enrollment?  By then there should be a lot of reviews on the various companies she can research.  Overall, the BCBS folks are generally ranked a little higher.  United Health Care did not participate in the first go around, but you may want to consider them in the fall if they decide to participate.  Whatever you do, be sure the list of doctors and hospitals includes the ones she would actually want to use.  Insurance that gives only the low ranking providers isn't worth much.

[geekette]

$180 really doesn't sound that bad. Health insurance unfortunately is just really stupid expensive.  I get a decent subsidiary at work but I know the total cost is $750/month. Im 33 and have two kids. The deductible is 9000 and opm is 12700. In other words between my employer and I we pay the first 18000 before insurance even kicks in. Awesome!

I keep seeing people post stuff like this, but it's not exactly true.  You each get an annual physical, including appropriate labs "free" (no deductible, no copay). 

The insurance company may not pay, but if you need to go for other things, you'll get the insurance company's negotiated rate instead of list price.  Shockingly, that reduced my labs (not associated with a physical) by about 90%.

It may not be a bargain unless one of your kids gets a brain tumor (as happened to my nephew), but boy is it worth it then.

[soccerluvof4]

2100$ for a family of 6 (4 healthy kids knock on wood) so you have it good! if you ask me! ACA was the same for a bronze. We have high deductible program as well.

[Daleth]

$180 really doesn't sound that bad. Health insurance unfortunately is just really stupid expensive.  I get a decent subsidiary at work but I know the total cost is $750/month. Im 33 and have two kids. The deductible is 9000 and opm is 12700. In other words between my employer and I we pay the first 18000 before insurance even kicks in. Awesome!

I keep seeing people post stuff like this, but it's not exactly true.  You each get an annual physical, including appropriate labs "free" (no deductible, no copay). 

The insurance company may not pay, but if you need to go for other things, you'll get the insurance company's negotiated rate instead of list price.  Shockingly, that reduced my labs (not associated with a physical) by about 90%.

It may not be a bargain unless one of your kids gets a brain tumor (as happened to my nephew), but boy is it worth it then.

You also get free vaccines (the standard ones are free, but not the exotic ones required for travel to certain parts of the world), among other things. But yeah, the biggest savings for folks with high deductibles is like you said--the fact that you will be charged the insurance company's negotiated rate instead of the full price.

[HoneyBadger]

If I could purchase health insurance for $180 a month, I'd feel like I'd won the lottery!  I pay more than $600, albeit for a very good plan.  Next year I'll have to switch plans.

[Kyrene]

If I could purchase health insurance for $180 a month, I'd feel like I'd won the lottery!  I pay more than $600, albeit for a very good plan.  Next year I'll have to switch plans.

Yeah, i'm definitely blessed to have full coverage for myself through my employer. Unfortunately because it's a small organization and many of the spouses have had severe health issues in the recent past it would cost around $600 a month for my wife to get plan through them.

Guess i'll be spending the next couple months researching to see if there a better rate on comparable coverage from other providers in my region. Cutting health insurance costs from $180 to something like $150 would be a big win in my book.

[Daleth]

If I could purchase health insurance for $180 a month, I'd feel like I'd won the lottery!  I pay more than $600, albeit for a very good plan.  Next year I'll have to switch plans.

Yeah, i'm definitely blessed to have full coverage for myself through my employer. Unfortunately because it's a small organization and many of the spouses have had severe health issues in the recent past it would cost around $600 a month for my wife to get plan through them.

Guess i'll be spending the next couple months researching to see if there a better rate on comparable coverage from other providers in my region. Cutting health insurance costs from $180 to something like $150 would be a big win in my book.

Do you have no better way of saving $30/month? I'm just wondering, because with this plan you can't save a dime until open enrollment starts again in December, and it will require a fair amount of time to compare plans and really be sure you actually are saving money (instead of just saving on your monthly payment and then losing that money and more when you have to pay extra copays, deductibles, etc. if she gets sick or injured or pregnant).

There has to be a more straightforward and reliable way you could save $30/mo or increase your income by $30/mo.

[Sdsailing]

 It is not clear why you chose aca to begin with instead of using your work policy.

[Cpa Cat]

Insurance companies start pricing pregnancy into women's health insurance at 26 or 27. Your wife is just the right age to see her premiums sky-rocket. Back before ACA, I was able to opt out of pregnancy coverage to lower my premium, but I don't know if you're allowed to do that anymore.

Even despite that, that premium seems reasonable.

[Gin1984]

Insurance companies start pricing pregnancy into women's health insurance at 26 or 27. Your wife is just the right age to see her premiums sky-rocket. Back before ACA, I was able to opt out of pregnancy coverage to lower my premium, but I don't know if you're allowed to do that anymore.

Even despite that, that premium seems reasonable.

You are not.

[Big Boots Buddha]

If I could purchase health insurance for $180 a month, I'd feel like I'd won the lottery!  I pay more than $600, albeit for a very good plan.  Next year I'll have to switch plans.

You spend 7200 after tax dollars on health insurance a year? Holy snap! What do you get for that? 10 dollar co-pay on anything including heart surgery?

[Another Reader]

I recently read that in the California exchange, failure of the insurer to provide an accurate list of plan providers might constitute a qualifying event that could allow you to change plans.  If one of the carriers presented its entire provider list to you, you signed up for their policy, and then found out your doctor was on that list but not on the plan list, you could change policies.  Since several insurers were guilty of that, lots of folks are eligible to change plans.  However, I'm not sure how the federal exchange or the other state exchanges are handling the issue.

[Gin1984]

If I could purchase health insurance for $180 a month, I'd feel like I'd won the lottery!  I pay more than $600, albeit for a very good plan.  Next year I'll have to switch plans.

You spend 7200 after tax dollars on health insurance a year? Holy snap! What do you get for that? 10 dollar co-pay on anything including heart surgery?

My mom is on COBRA right now (well Cal-COBRA) and is paying a little over $500 for her plan.  She had no copays for ANYTHING.  Everything other than massage was covered 100%, durable medical equipment, PT, meds, regular and specialists, as well as ER and urgent care.