Health Care Policies in/for CA?

[Freedom2016]

Hi all,

We live in Boston and have health care through my husband's job.

My job has thrown us a fun twist, in that we will be temporarily moving to California so I can be close to a major piece of client work over the next year. This will be a pretty lucrative gig and it will allow hubby to leave his job (which he doesn't like) and be stay-at-home dad for a year. We should be able to sock away a lot of cash over the next year.

BUT we will lose hubby's health care.

My firm - teeny tiny consulting firm - offers a BCBS health care plan but, if I'm understanding it correctly, we would have to sign up for the PPO while living in California, which costs $1975 A MONTH. If we lived in Boston, we could sign up for the HMO which costs roughly half that.

So naturally I am trying to explore our health care options while we live in CA, and I don't know enough about California to know where/how to start -- beyond having learned that the CA Exchange isn't operational yet.

BTW we are hoping to get pregnant again in the next few months so I'd definitely need maternal coverage.

Tips? Ideas?

Thanks, all!
 

[Left]

what about a cobas plan to carry the current plan through for the year? It's expensive though, don't know how much though

If you aren't traveling, could you ask local offices what their costs for cash payers are? It's been a growing trend here and they discount it quite a lot. Also groupon has deals for dental/vision too, so you'd just be looking at the medical/maternity coverage unless something happens that you need more work on teeth/eyes. For prescription coverage, programs like Medication Card http://www.medicationcard.org/ (there are others too but this one is easy for me to remember name) that might give enough discount that you won't need as much prescription coverage.

Could he work at a local hospital? They generally have good coverage, at least ones I've been at, about $400/month (for family where I am but I'm sure Cali would be more expensive) for 100% coverage if performed at the hospital (or their affiliates), or standard 80/20 split if "in network". Since it doesn't sound like he would need it for money (if the alternative is him being at home?). At least here part-timers getting 20 hours/2 weeks are able to qualify for coverage. This would take time away from baby/might increase childcare. I work with a few on night shift where the dad/mom stays at home with baby when they all sleep, and the spouse works 1 or 2 nights a week and they are home with kids during the day (rest of week)

edit: thx footenote, I misspelt cobra plan :D

[footenote]

Agree with eyem that you should see what COBRA would cost (continue your husband's plan) through year-end. (You pay for the entire cost, so it will be much higher than your current deductible alone.)

Check out California heathcare exchange news: http://www.kaiserhealthnews.org/stories/2013/may/24/calif-health-insurance-exchange-marketplace.aspx

Exchanges will be open for inspection in October. In general, CA rates are coming in lower than expected. I don't know how that might compare to your CA PPO cost (they will vary by region of CA).

Great news for you: maternity coverage is required of all plans after the Affordable Care Act goes live Jan 2014. Let us know what your research turns up...

[cdub]

We have Kaiser and like them... $1900 a month seems ridiculous - I've seen estimates of around $500-600 for a family of 4 on the exchange but I could be wrong.

I think (hope) people are going to be pleasantly surprised when the ACA goes into full effect.

[Another Reader]

You may want to try using this calculator to see what insurance purchased through Covered California (the exchange for individual buyers) would cost roughly. 

http://www.coveredca.com/calculating_the_cost.html

This chart lays out the tax credit subsidies.

http://www.cahba.com/covered-california/premium-subsidy.htm

Several of the major companies have decided to pick up their marbles and go home, so the choices are limited. 

You will probably be stuck with COBRA until January 2014.

[Freedom2016]

Thanks for the ideas!

eyem, I didn't know that about working in hospitals. I'll float the idea with my husband, though our plan had been that he be stay-at-home dad (thus not needing day care) while he figures out his next professional move.

In the meantime, I'll have him research COBRA costs. Until Jan 2014 this might be our best bet, although it's possible that only emergency care in California will be covered under it. This might be OK, though, since we'll be traveling back to Boston frequently during the fall and can schedule regular check-ups and such for when we're back in town. We'll just cross our fingers for no emergencies.

I was pleasantly surprised by the CoveredCA calculator's results - which showed a $736/mo premium which is much more affordable than my work options, and almost certainly better than what COBRA will cost.

I know compared to MMM's $200-something per month premium, this cost seems outrageous. But I'm not quite ready to consider going very-high-deductible the way his family has. I think I need to crunch more numbers before doing so... particularly if we're going to have another baby.

PS: I am a great example of someone who will benefit from Obamacare: I had cancer in 2010 (considered 'cured' today) and am grateful that I can't be denied for a pre-existing condition, nor can our rates be jacked up unreasonably because of it.

[footenote]

You will receive a COBRA notice some time after your husband's last day. It will include costs, blah, blah, blah.

Congratulations on being someone who is healthy, alive-and-with-us post-cancer! And, yes, it's awesome that pre-existing conditions are no longer a bar to getting healthcare insurance.  - #pre-ex-cond-sisterhood

[Another Reader]

High deductible, HSA compatible policies are being phased out.  Covered California will offer no policies that are HSA compatible.  Healthy people over 30 will no longer be able to avoid subsidizing unhealthy people.

I know a number of people that kept jobs they hated for many years, sometimes until they reached 65 and became eligible for Medicare, because they had pre-existing conditions and could not get coverage.  Solving that dilemma is the one positive accomplishment for Obamacare I can see.

[cdub]

Several of the major companies have decided to pick up their marbles and go home, so the choices are limited. 

Two have - but the good ones... like Kaiser and Blue Cross are in it and that's all that really matters in my opinion.

[cdub]

High deductible, HSA compatible policies are being phased out.  Covered California will offer no policies that are HSA compatible.  Healthy people over 30 will no longer be able to avoid subsidizing unhealthy people.

They're being phased out because a lot (not all) of those plans were junk plans that would find something in the fine print to not cover you in the event of a "catastrophic" health insurance event. There was a good Fresh Air interview on this subject:

http://www.npr.org/2013/07/11/200443445/former-insurance-exec-offers-an-insiders-look-at-obamacare

"There are junk plans that are out there today, and some of the biggest insurance companies sell them, and they're very profitable for insurance companies. And a lot of people don't know they're in junk plans until they get sick or injured. And they find out at a time when it's really — quite frankly — too late, that they're not adequately covered. And some [plans] have lifetime or annual caps on how much the insurance companies will pay. And, increasingly, plans have very high deductibles. Insurance companies in these cases don't pay anything for coverage until you've paid quite a bit of money out of your own pocket. That's not a big deal for people who are quite wealthy or healthy or don't really need insurance, but for the rest of us — for folks who get sick occasionally, or get very sick, or injured, or who are not as young and healthy as we once were — these plans are not necessarily the best things since sliced bread."

I know a number of people that kept jobs they hated for many years, sometimes until they reached 65 and became eligible for Medicare, because they had pre-existing conditions and could not get coverage.  Solving that dilemma is the one positive accomplishment for Obamacare I can see.

Well this I can speak to - I'm self-employed and my wife was a 6th grade teacher at a local school for the past 10 years. She grew to absolutely hate the job. 36 kids where the majority always yelled and were disrespectful, parents who would back their kids up and claim that there kids were angels and thus not enforce punishments at home, an clueless administration... many nights she'd be in tears from the stress of it all and plus raising 2 kids at home.

The main reason she stayed was for health care - it was just too cost prohibitive for me to find health care on the individual market. She was kept at a school/job she hated for probably 4 years longer than she needed to.

Now with the ACA we have the freedom to buy affordable good insurance... and so we've decided to have her stay home with our 3rd child. This wouldn't have been such an easy decision if the ACA didn't pass.

I think people are going to be pleasantly surprised with the results - there was just way too much misinformation out there.

[Another Reader]

I will reserve judgement until I see what is covered and how.   Based on who is selling insurance in this exchange, you will probably have few choices of doctors or hospitals, and great difficulty in getting care approved.  You may pay less, but you will get much less in quantity and quality.  It's much better than nothing for folks with pre-existing conditions, but giving the health care system to insurance companies to run is not the solution.

[cdub]

but giving the health care system to insurance companies to run is not the solution.

Giving? They run it now. With Obamacare there are tons of new rules and regulations that look out for the "consumer" so they are not screwed over by the insurance industry. No more lifetime caps, no more pre-existing conditions, no more paying extra for maternity and preventive care, no more junk plans... there's quite a bit of awesomeness in this bill if people take a moment to realize what the bill actually does.

[footenote]

but giving the health care system to insurance companies to run is not the solution.

Giving? They run it now. With Obamacare there are tons of new rules and regulations that look out for the "consumer" so they are not screwed over by the insurance industry. No more lifetime caps, no more pre-existing conditions, no more paying extra for maternity and preventive care, no more junk plans... there's quite a bit of awesomeness in this bill if people take a moment to realize what the bill actually does.

+1

[Freedom2016]

I will reserve judgement until I see what is covered and how.   Based on who is selling insurance in this exchange, you will probably have few choices of doctors or hospitals, and great difficulty in getting care approved.  You may pay less, but you will get much less in quantity and quality.  It's much better than nothing for folks with pre-existing conditions, but giving the health care system to insurance companies to run is not the solution.

As you probably know, Massachusetts was a pioneer in health care (mandating coverage starting in 2007); they've had an exchange for six years now. I actually purchased an individual policy via the exchange about a year before I got married (when I switched to my husband's) and it was a perfectly good policy, in fact with better coverages than I could get through work... and cheaper.

Who knows what it will look like in other states...I'll cross my fingers.