January 2012 Weddings
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Update!!!!Insurance Stuff... again

Penguin129Penguin129 member
500 Comments 25 Love Its First Anniversary Name Dropper
edited November 2015 in January 2012 Weddings
I want to make the right choice and do the right thing. I am so upset because it shouldn't be this hard. We are stuck. If H's employer didn't offer me coverage we could get the subsidies and afford the premiums and extra cost of having a baby without a problem. An agent from Blue Cross Blue Shield (not the agents from the store) told me last night I could get the subsidies, but everyone else is saying no. The law as it is written says I can't either due to being offered insurance through H's employe( For $740/month H's employer can keep that coverage). So I'm considering 2 options:
Option 1: Buy a Florida Blue Policy  for $277/month. The Deductible is $6,700  with OOP costs of $6850. There's a $50 copay for the Doctor and $85 copay for specialists. We could swing this, but it would be tight and we would most likely have to get a credit card to pay for monthly payments of pre-natal care and do payments after the delivery.

Option 2: Continue without insurance and apply for Pregnancy Medicaid when I do get pregnant. All costs or pregnancy would be covered at no charge to us.

What option would you choose if you were in our situation? 

Thank you for your time and bearing with me while I navigate through this.
Daisypath - (B4ZA)
Lilypie - (V3N1)

Re: Update!!!!Insurance Stuff... again

  • Honestly between those two options, I would pick option 2. 

    We have a higher deductible that I care for (I think most people do) and we have no copays for doctor visits - we cover everything OOP until we meet our deductible.  Unless it's preventative care like a Pap Smear.  So I know next year when we have the baby, we will have to meet our deductible which means we will be making payments to the hospital for awhile.  But for the rest of the year, at least our insurance will cover some stuff.  Compared to nothing this year. 
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  • I really have no advice = (. I'm covered through hubby's insurance and it's really, really good (not to brag). Just wanted to say I hope you get it all figured out soon. I know stuff like this is incredibly overwhelming and frustrating. Thinking of you!

     01.21.2012---> I married a redhead I'm crazy about.

    04.2016: IT'S A BOY! Elias Alan is due!

    WDW trips: 05/14 (1st trip! Art of Animation; Little Mermaid), 05/15 (Pop Century!). DL Trips: 12/15


      

  • I'm not sure either, I'm in too similar of a boat with Amber. My suggestion is make a spreadsheet of the cost. What would it cost you on taxes to not go with the plan? Is it cheaper with the penalty you pay? 
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  • I'm not sure either, I'm in too similar of a boat with Amber. My suggestion is make a spreadsheet of the cost. What would it cost you on taxes to not go with the plan? Is it cheaper with the penalty you pay? 
    It is definitely cheaper to pay the fine/tax penalty. 
    Daisypath - (B4ZA)
    Lilypie - (V3N1)
  • I called and spoke to a representative from healthcare.gov. I was on the phone with him for an hour and a half. He went through the application the Blue Cross Blue Shield agent filled out the other day and updated any information that needed to be changed. After everything was fixed he told me I DID qualify for a tax subsidy and cost sharing. All I have to do is send in H's pay stubs and a letter saying I don't work and H supports our family. I was very clear that I could technically get health insurance from H's employer, about the cost for just my H, and the cost to add me to the plan. I want to believe this representative was telling me the correct information. I mean I went straight to the source.

    I'm going to talk with H about this tonight when he comes home and see what he says. This is the last piece of our TTC puzzle and I really want it to fit. 
    Daisypath - (B4ZA)
    Lilypie - (V3N1)
  • I hope it works out for you. 
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  • It sounds like you've covered all your bases in who you can talk to about this.
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  • We are pretty sure we are going to buy the plan using the subsidy. The only thing is if something happens later and they decided we weren't supposed to get the subsidy we would have to pay the money back. I am praying the information I was given was correct.
    Daisypath - (B4ZA)
    Lilypie - (V3N1)
  • I would definitely get that all in writing. I know it doesn't mean they can't change their minds, but maybe it would keep you from having to pay it back?
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  • shellyamf said:
    I would definitely get that all in writing. I know it doesn't mean they can't change their minds, but maybe it would keep you from having to pay it back?
    It says in my application that I am approved for the subsidy. I told them all the information and they entered in it on their end. I think the agent number is on there. I'm not sure if since I had an agent helping me that would count or what.
    Daisypath - (B4ZA)
    Lilypie - (V3N1)
  • So I called The Marketplace again and told them I wanted to double check the information I was given. It is a good thing I did because when I filled it out it came back that we don't get a subsidy. I am so over this whole thing. GRRR!!!!
    Daisypath - (B4ZA)
    Lilypie - (V3N1)
  • I'm sorry. I completely get it. I've been fighting them too. 
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  • I'm sorry. I completely get it. I've been fighting them too. 
    I'm sorry your are going through a similar thing. It is so frustrating being an adult sometimes.
    Daisypath - (B4ZA)
    Lilypie - (V3N1)
  • I'm sorry. I completely get it. I've been fighting them too. 
    I'm sorry your are going through a similar thing. It is so frustrating being an adult sometimes.
    It really is. My problem is having two insurances, and getting the other insurance to pay stuff. They already messed up my deductable numerous times. 
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  • Adulthood stinks = (. I'm sorry this keeps going back and forth.

    If it helps: I really admire you guys waiting until you get the insurance under control before you TTC. I know of people who don't think about that kind of thing, then get stuck with all sorts of medical expenses and go into massive debt. I know it sucks (we've been there too. Thinking we can go ahead, then something comes up we have to take care of). = )

     01.21.2012---> I married a redhead I'm crazy about.

    04.2016: IT'S A BOY! Elias Alan is due!

    WDW trips: 05/14 (1st trip! Art of Animation; Little Mermaid), 05/15 (Pop Century!). DL Trips: 12/15


      

  • I agree ^^ 

    It does suck that this keeps going back and forth.  While I'm not a fan of our insurance, it's definitely better than a lot of the other options out there.
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  • Adulthood stinks = (. I'm sorry this keeps going back and forth.

    If it helps: I really admire you guys waiting until you get the insurance under control before you TTC. I know of people who don't think about that kind of thing, then get stuck with all sorts of medical expenses and go into massive debt. I know it sucks (we've been there too. Thinking we can go ahead, then something comes up we have to take care of). = )
    Thank you so much for your kind words. It really means a lot. I know we are most likely going to be approved for pregnancy medicaid, but I'm not 100% sure. I think we'll end up buying the insurance policy and then applying for medicaid when I do get pregnant. That way if we don't get approved I'll still be covered. Even if we are going to be really tight.
    Daisypath - (B4ZA)
    Lilypie - (V3N1)
  • The good thing about having the insurance is it's going to allow you to get up to date with the rest of your health this year. And I am going to second Amber on being wise to get everything straightened out first. 
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