Insurance questions

[P938LVR]

My DH and I are planning on having a baby in the next year. We don't have any insurance and it's not offered at either of our jobs. We make too much to qualify for state assistance but not enough to pay out of pocket for everything. I want to be prepared for this pregnancy but I also don't want to pay 30K plus for doc visits, hospital bills and the c section that I plan on having. I have called around and there are discounts for self pay but again it would be over 30K and we just can't afford that. Any advice?

[beltim]

Get a marketplace insurance plan: https://www.healthcare.gov/

[P938LVR]

I've heard horror stories about obamacare. And I can't afford $300 plus a month in insurance. We dont really use it but obviously we will when I get pregnant. :)

[beltim]

If you want to wait until pregnancy, that's your choice, but if you make too much to qualify for state assistance than you should make enough to afford an ACA plan, especially if you're going to be pregnant!

Just make sure that you enroll in time – pregnancy is not considered a "qualifying event," so you need to enroll during open enrollment unless you have something else that qualifies you to sign up at another time.

[Cathy]

You could always move to a Canadian province to give birth. Some provinces allow persons who are neither Canadian citizens nor permanent residents to receive government health insurance for free or at low cost. For example, in British Columbia, government health care coverage is generally available to foreign students, subject to certain conditions. Medical and Health Care Services Regulation, BC Reg 426/97, § 2(a) (authorised by the Medicare Protection Act, RSBC 1996, c 286, § 51). As an added bonus, the child will be a Canadian citizen. Citizenship Act, RSC 1985, c C-29, § 3(1)(a).

Note that you do need to obtain government health insurance before receiving the healthcare; otherwise, you may have to pay out of pocket.

[geekette]

You can't afford $300/month for insurance and you want to add a baby?

I don't know what horror stories you've heard, but we have a health plan through healthcare.gov, and it's working just fine. 

[Altons Bobs]

If you can't afford $300/month for insurance, you cannot afford to have a baby, you should not try to get pregnant.  Since you only want to sign up for insurance in order for insurance to pay for your pregnancy, you're actually wanting someone else to pay for your pregnancy, insurance is NOT what you're looking for, you should be looking for charity that will help you pay for your pregnancy.

[protostache]

Another thing you might not be aware of: if you don't have insurance in 2015 you'll see a fee on your 2015 tax return in April 2016. This fee is the greater of 1% of household income greater than $10,150, or $325 per person. In 2016 this goes to 2.5% and $695 per person. The maximum fee is capped at the national average for a Bronze-level plan.

https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/

Have you actually looked at healthcare.gov to see what plans are available and what your subsidies would be? If your family is making less than 400% of Federal poverty level ($63,720 in 2015) you have access to a sliding scale of tax credits, and if you make less than 250% of FPL you have access to cost sharing reduction subsidies (a different type of credit).

You should really think about how much risk you're able to tolerate. Health insurance is a waste of money until suddenly it's the only thing standing between you and losing your entire stash to medical debt. I was almost perfectly healthy until one day I found out I had cancer. Thankfully it was a very treatable form, but even so it would have cost us $80k and counting if we had paid for it all out of pocket. Instead, we pay a relatively small amount every month to cap our downside risk.

If you can't tolerate $30k of medical expenses you need insurance.

[ShoulderThingThatGoesUp]

Is this a troll? If you can't afford health insurance, don't have a baby. And why are you planning a c-section before you're pregnant?

[bobechs]

Is this a troll? If you can't afford health insurance, don't have a baby. And why are you planning a c-section before you're pregnant?

I think the only way trolls can deliver is to hack the little troll out of their gnarly wombs.

[nereo]

Is this a troll? If you can't afford health insurance, don't have a baby. And why are you planning a c-section before you're pregnant?

I think the only way trolls can deliver is to hack the little troll out of their gnarly wombs.

hahahahah!

But seriously, if you make too much to qualify for incentives but can't afford $3600/year there is something very wrong there. 
To the OP:  Have you gotten quotes from healthcare.gov (including available subsidies)?  What is your plan now should you or your husband become sick or injured?  It seems to me you are already just a small step away from financial quicksand.

[thd7t]

I've heard horror stories about obamacare. And I can't afford $300 plus a month in insurance. We dont really use it but obviously we will when I get pregnant. :)

Hearing horror stories is irrelevant.  You have to look into it yourself.  However, if you can't afford $300/month in insurance, you should probably post a case study.  People will try to help you either find the money or find a way to get some incentives.

[MissStache]

If you won't pay for insurance and you can't afford to pay out of pocket then you only have two choices:

1.  Don't have a baby
2.  Have a home birth and hope to hell that nothing goes wrong that requires emergency medical intervention

If those aren't acceptable to you, then you need to find a way to pay for health insurance or for the out of pocket expenses. 

[P938LVR]

That was a typo I meant to say $700/mo is what I can't afford. No, I'm not a troll. I have posted here before (although it has been a while).

We don't make a lot of money and I was just wondering what is the best option for someone with no insurance. Surely, I thought the frugal people here would have some good suggestions on what they do to save money on insurance or how they save money on doctors visits, hospital visits, etc. Does anyone have any suggestions that way? I've never really had insurance before so I am fairly new to all of this.

[Spork]

That was a typo I meant to say $700/mo is what I can't afford. No, I'm not a troll. I have posted here before (although it has been a while).

Try raising your deductible. 

Personally, what I always want is the highest deductible offered.  I can afford to pay for checkups and minor maladies.  What I can't afford to pay for is 5 years of chemo or the cost of getting hit by a bus.

While ACA *did* raise our rates significantly, we are still paying much less than $700 a month (even before subsidies).... though coverage costs *will* vary significantly by state.

As to how to save money on a Doctor...  Tell them up front you are paying out of pocket and want to do what you can to reduce costs.  In the US they've become used to "medicine at any expense" because that is what people have come to want/expect.... and that's really not a good plan for anyone involved.

[BarkyardBQ]

I have posted here before (although it has been a while).

Just scanned through your old posts. Starting last year you were fighting your father for a raise, and trying to run a business with debt.

I think before any of us can help, you should do a case study thread so we can see the big picture and see if there's savings that could be redirected toward child care/health insurance.

http://forum.mrmoneymustache.com/ask-a-mustachian/how-to-write-a-'case-study'-topic/

[thd7t]

The most your out-of-pocket maximum under an insurance plan can be is currently $6600.  For one year of insurance you'd pay $8400.  This comes to $15k, which is half of what you're concerned about.  It's the most that going with an insurance plan could cost you.  Depending on the coverage, your out-of-pocket portion could be lower.

  However, with some research, you can probably find a less expensive plan, if it's just covering you.

[ShoulderThingThatGoesUp]

For my daughter's birth and subsequent care, when we had no indication anything would be wrong, pre-insurance bills were like $20,000. All sorts of weird crap can go wrong with newborns who will later be perfectly healthy if they get prompt medical attention. Home birth is not a responsible idea.

[P938LVR]

I'm worried about getting insurance before I get pregnant. It used to be that insurance companies would not take you if you had a preexisting condition (I.E. pregnancy, etc.) or that you would have to pay an outrageous amount each week to keep insurance. Is this still the case? And I don't really want to pay for insurance if I can't get pregnant within the next year or so because there's a possibility that I might not. I want to make sure that I allocate my money to the right places not just throw money at an insurance policy that I might not really need right away.

[bobechs]

Home birth is not a responsible idea.

Unless you are a troll.

[rubybeth]

I'm worried about getting insurance before I get pregnant. It used to be that insurance companies would not take you if you had a preexisting condition (I.E. pregnancy, etc.) or that you would have to pay an outrageous amount each week to keep insurance. Is this still the case? And I don't really want to pay for insurance if I can't get pregnant within the next year or so because there's a possibility that I might not. I want to make sure that I allocate my money to the right places not just throw money at an insurance policy that I might not really need right away.

Insurance companies can't deny you based on pre-existing conditions (like pregnancy) but you still need to enroll during open enrollment or another qualifying event (job loss, divorce, etc.) and your situation of just not having coverage won't be a qualifying event.

You will need to go to to healthcare.gov or your state's exchange to look at actual prices. $700/mo for what kind of coverage?

I also agree that it seems financially irresponsible to have a child if you can't afford insurance--you never know what kind of issues your baby might have. Premature births can be incredibly expensive, an optional c-section won't be cheap, and you don't know that your baby will be healthy from the start. And kids get sick with normal kid stuff all the time and as a a first time parent, you'll probably want to take them to the doctor when they get sick.

I agree that a case study might be especially helpful for you.

[jorjor]

I'm worried about getting insurance before I get pregnant. It used to be that insurance companies would not take you if you had a preexisting condition (I.E. pregnancy, etc.) or that you would have to pay an outrageous amount each week to keep insurance. Is this still the case? And I don't really want to pay for insurance if I can't get pregnant within the next year or so because there's a possibility that I might not. I want to make sure that I allocate my money to the right places not just throw money at an insurance policy that I might not really need right away.

If you're signing up for a plan through the Exchange, you have to sign up during the open enrollment period. If you sign up during an open enrollment period, then an insurance company cannot deny you for pre-existing conditions nor can they rate you higher based on those conditions. If you don't sign up during the open enrollment period, you have to wait a year.

[Sibley]

OP, based on your posts, a large part of your problem is ignorance. I'm not saying this to be mean. I'm saying it because you're asking about exclusions for pre-existing conditions. That's been gone for years. So, first and foremost, you need to learn about ACA. If your information source calls it Obamacare, then you need to go somewhere else.

Once you've done your research into ACA and insurance in general, then you'll be much better prepared to make a decision about what to do.

[thd7t]

I'm worried about getting insurance before I get pregnant. It used to be that insurance companies would not take you if you had a preexisting condition (I.E. pregnancy, etc.) or that you would have to pay an outrageous amount each week to keep insurance. Is this still the case? And I don't really want to pay for insurance if I can't get pregnant within the next year or so because there's a possibility that I might not. I want to make sure that I allocate my money to the right places not just throw money at an insurance policy that I might not really need right away.

This sounds like a fundamental misunderstanding of what insurance is.  It's not meant to be something that you buy in advance of an event to save money.  There are insurances that you can use that way (we purchased short term disability insurance prior to both of my wife's pregnancies), but if you plan on doing that, you should do a break even analysis.  At this point, insurance for three years is still competitive with $30k.  However, with health insurance, you are typically insuring against unplanned expenses, which would bankrupt you.

[Axecleaver]

You should go to healthcare.gov today, and fill out the information requested along with your income. You can do "anonymous shopping" to compare plans and costs. For a two-person household, 138% of FPL (the threshold for Medicaid coverage) is $21,938. If you are below this, you qualify for free coverage already (assuming you're in a Medicaid expansion state). Even if you're not, pregnant women are eligible in non-expansion states.

If you are between 138% and 400% of FPL (which for two people is $63,720) you qualify for subsidies. The best deals are typically silver plans, which qualify you for cost sharing. $700 is not a realistic number for insurance; even in NYS, which is among the highest in the country, a platinum plan with $5 copays is $414-538 a month. Silver plans are much less. You'll need to allocate money for the baby's insurance too, but not until it's born (which is a qualifying event).

Resources:
FPL chart
http://www.medicaid.gov/medicaid-chip-program-information/by-topics/eligibility/downloads/2015-federal-poverty-level-charts.pdf
Healthcare.gov
http:///www.healthcare.gov
Medicaid expansion by state
http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/