Healthcare exchange and employee provided medical insurance question

[FiguringItOut]

I should probably google this myself, but I am in a bad place right now, so if anyone knows the answer I'd appreciate.  It's been a really crazy week for me which involved unexpected job interview, extensive dental work, and crazy work project deadline.  And today the week culminated in yet another twist.

My ex-h was laid off today, second time since November.  This last job he's been at since March. When he started there we put our kids on his medical insurance because that job fairly good coverage.

At my current employer healthcare is very expensive.  He's trying to get himself onto the exchange and when he applied today he applied for himself and kids.  I'm concerned that kids may not be eligible since technically my employer provides health insurance (crappy as it is) and they would be required to be added to my insurance.
So the question is - can they get insurance through exchange or am I required to add them to my insurance?

And second question - what is the best option from available at my employer?
Option 1: $993/month, no deductible, no coinsurance, $30/$50 copays.
Option 2: $632/month, $3,750 deductible, 20% coinsurance, $30/$50 copays.
Option 3: is ridiculous at $1,565/month
Option 4: HDHP with HSA, $715/month, $4,000 deductible, 10% consurance, no copays.
All of these are for employee plus children.
Right now I have HDHP just for myself at $189/month.
Our insurance year runs from June 1st to May 31st.
I max out HSA.

I need to find a good physiologist for one of the kids and possibly a psychiatrist too in the fall when we all are back from summer vacations.  But because of how the insurance year falls all those visits will be out of pocket to the full extent of deductibles and that's a huge expense too.

I think HDHP is still the best option even with kids.  But it will be huge chunk of my paycheck, which are not much since I am maxing out 401k and HSA.  Plus I won't be getting child support while he's unemployed.  He will most likely pay me back missed child support, but he can't pay it while he's on unemployment.  He has no money, no emergency fund, and unemployment will barely cover his rent.

May paychecks alone, without child support, do not cover my monthly expenses (see maxing out 401k and HSA and IRA), but I have a healthy emergency fund (about 6-7 months).  So I'll be ok, but I am still very stressed right now.

[vivian]

I don't know the answer to the first question. In terms of choosing the best option if you have to add them to your plan is to get your best estimate of medical expenses for the year, and then run it through each option. You know you need a psychiatrist and physiologist. What did they cost last year? Any other known or chronic conditions? If the total estimate of yearly costs is, say, $10K, see which plan will be less out of your pocket.  Usually there is some break even point where costs under make sense to go with low premium but high deductible, and above makes sense to go with high premiums but low deductible. I'm sure there is a way to turn this into algebra to find the break even point.


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[FiguringItOut]

I don't know the answer to the first question. In terms of choosing the best option if you have to add them to your plan is to get your best estimate of medical expenses for the year, and then run it through each option. You know you need a psychiatrist and physiologist. What did they cost last year? Any other known or chronic conditions? If the total estimate of yearly costs is, say, $10K, see which plan will be less out of your pocket.  Usually there is some break even point where costs under make sense to go with low premium but high deductible, and above makes sense to go with high premiums but low deductible. I'm sure there is a way to turn this into algebra to find the break even point.


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I have no idea how much these services for my kid would cost as it would new for us. I'm trying to do some research now.

I also spend all morning trying to figure out the answer to my first questions on whether kids can go on exchange with their dad while I am covered and work and I can't seem to find any information regarding this situation.

So frustrating.

 

[Gin1984]

If they have the ability to get coverage via a parent's insurance, they cannot get a subsidy on the exchange.  They can still be on it, just not with the subsidy which means it won't be cheaper unless your income is such that they are eligible for CHIP.  CHIP rules vary by state.

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[FiguringItOut]

If they have the ability to get coverage via a parent's insurance, they cannot get a subsidy on the exchange.  They can still be on it, just not with the subsidy which means it won't be cheaper unless your income is such that they are eligible for CHIP.  CHIP rules vary by state.

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Thank you. 

This basically means that I am screwed.

[Blonde Lawyer]

I'd go with option 1 I think.  You would pay $3,336 more per year but that amount wouldn't even be enough to hit your deductible under your current plan.  So to get any coverage under you current plan, you'd have to pay even more.  Does your employer contribute to the HSA? That would have to factor into the equation too.  Personally, I always avoid high deductible plans because I take expensive medication and have regular testing for a medical condition.

[FiguringItOut]

I'd go with option 1 I think.  You would pay $3,336 more per year but that amount wouldn't even be enough to hit your deductible under your current plan.  So to get any coverage under you current plan, you'd have to pay even more.  Does your employer contribute to the HSA? That would have to factor into the equation too.  Personally, I always avoid high deductible plans because I take expensive medication and have regular testing for a medical condition.

No, no employer contributions.
But my ex is supposed to reimburse me 50% of all out of pocket medical costs gor kids plus 50% of difference between my self only coverage and self plus children. And for myself I right now pay  $190 per month.
So I think HSA plan may be better. He won't be able to reimburse me until he finds a new job but typically he's good for money.