Obamacare/employer insurance confusion (NY)

amother

Saddlebrown

Wed, Jan 11 2017, 10:04 pm

I'm finding bits and scraps of info online and I know I really need to call the State of Health helpline myself but want to ask anyway meanwhile -

DH just got a new job. Until now neither of us qualified for employer-sponsored health insurance. Now, DH is able to receive health insurance from his job and the rest of us have an option of getting health insurance through his job but we'd have to pay in. A lot.

For reference, until he got eligible for job benefits we were paying about $30 a month for Obamacare insurance for adults, and that was only because I upgraded to dental, it would have been less without that. The kids would probably pay less but I didn't get to the exact number yet because we were in middle of transitioning them from medicaid to state of health due to increased income, when this became available so the whole question changed.

Now I still didn't catch the numbers but it sounded like the employer "sponsored" health insurance would be $250 per child and more for me. There might have been a better rate for all of us together than for each of us separately added up, but it was still many times more than what we pay now.

Even with DH's new job we are far from rich and I really can't see how we're going to afford that. I feel like we're being doubly punished for this new job - we're all working harder to support his increased hours and pressure, and going to come home with significantly less money at the end of the month, when the whole reason he was looking for a job upgrade was because we didn't have enough money to get through the month!

But my understanding from what I've googled is that if you even have an option of paying into employer coverage, even if you'd have to pay, then you can't get any government subsidy for any health insurance.

Please please please please please please say it ain't so! And then tell me how!

amother

Powderblue

Wed, Jan 11 2017, 10:41 pm

I don't know if this helps you, but I live in NY and I pay for a plan for myself through my employer. I could add my kids to that plan but it would be extremely expensive so they are instead on Child Health Plus for $30 each per month. (I am divorced so it's just me and my children.) They were already on CHP before Obamacare - don't know if that makes a difference.

Amarante

Thu, Jan 12 2017, 12:37 am

It is correct that if you can get health insurance through your employer, you can not purchase through the exchange and get a subsidy.

However, you can still purchase health insurance privately and it is entirely possible that you can get a lower rate for your children as $250 per month per child seems high.

Depending on the insurance coverage and your age, $250 or even more, is not a bad rate for health insurance. However, you can of course check to see if you can do better on the private market.

You are only prevented from receiving a premium subsidy since you are eligible for purchasing insurance through an employer. This is something the Democrats wanted to clean up but were stopped from doing so by the Republicans who did not want to do anything to improve the ACA.

I have no knowledge as to whether your children might qualify for a state health care program of some kind.

amother

Beige

Thu, Jan 12 2017, 4:36 am

amother wrote:

They said there's no more Child Health Plus, if you earn too much for medicaid then you need to go to obamacare. I didn't finish making the switch when DH got this job. I don't know what we're going to do if this is true, it's so expensive!

I applied through the market place when we were kicked off medicaid. My kids are chp and pay minimally each month. My dh have the essential plan.

amother

Amethyst

Thu, Jan 12 2017, 5:32 am

You will probably need to take the insurance for you and your dh through his employer (unless you find a cheaper price privately which isn't likely) but you can still apply for child health plus for the children. The cost for that is based on your income. We have child health plus for our kids and pay the full premium but it sounds like you wouldn't have to pay as much.

amother

Saddlebrown

Thu, Jan 12 2017, 5:54 am

Can someone please provide more info on how to apply for these things because I was told over and over that Child Health Plus and Healthy NY were cancelled due to Obamacare.

Nice of you to say 250 is not a lot for insurance but I can't afford it. And I also can't afford to have a crummy plan because one of my children has a health condition that sends us to the doctor very often. And I'm assuming that the pay-a-lot plans have significant copays as well which means it will end up costing even more. Exploding anger

Rosemarie

Thu, Jan 12 2017, 6:50 am

esuss wrote:

If you live in Monsey area the community outreach center and refuah health center have someone who could help you with this. In Brooklyn I heard that yelled vyalda could help.

Call one of these places, depending where you live. They are meant for that. Yeled vyalda has a whole facilitated enrollment department just for this. And they know all the details, how much you earn to qualify for each type of insurance...

And child health plus definitely still does exist. I just signed my kids up for that. My husband and I don't qualify so for us we had to buy private. But we still qualifies for the kids.

Rosemarie

Thu, Jan 12 2017, 6:54 am

amother wrote:

Thanks. I'm in neither one of those places but the right state so I'll call and see if they can help me.

Deep breaths.

It will be OK.

Ugh.

Williamsburg also has a place like this, I just don't know the name. Possibly crown heights does too. But regardless, they know the ins and outs of the programs. They should be able to help you over the phone.

amother

Saddlebrown

Wed, Feb 22 2017, 6:17 pm

I called NY State of Health and they said I can decline the employer's offer and still get state assistance based on my income. I'm not sure how that works because it sounds the opposite of the rules I saw online but ok... so I put through an application for the kids on State of Health and it turns out the state requirements for medicaid are different than the city's ones and now the kids are qualified to go back on medicaid through state of health instead of through HRA like they had before. Go figure.

I'm still not convinced until I see their new insurance cards in the mail. So I'm going to have to do a little more phone work to figure out why I haven't heard from anyone yet and I am still getting reminders to renew when I am quite sure I did already. Confused