This dummy needs help choosing medical insurance

amother

Thu, Aug 14 2014, 1:47 pm

So here's the story. My dh gets medical insurance through work, but we pay a fortune towards it. We just found out that in September, they will be raising it by 26%. He's been making peanuts until now, and the insurance company can't take away our peanuts from us.

We have a few options, but I am clueless about what is best for us. We have a few kids and we see specialists often.

The first option is a free HIP HMO. Right now we have HIP but we pay for it. There are many doctors who don't take it. With the free plan, we would need referrals each time we see a specialist, which would drive me crazy. We would also have higher copays I think.

We are eligible for Medicaid. I don't know much about it, but our pediatrician takes it.

I know nothing about Obamacare. Is it the same thing as medicaid? Anything worth looking into there?

If there's anyone here who can help this dummy learn a bit about her options, it would be greatly appreciated.

Thu, Aug 14 2014, 2:00 pm

I don't know your options and think you'd be best speaking to a broker.

I DO know that "obamacare" is not the same as medicaid - obamacare offers subsidies towards your health insurance based on your family size and income. That being said, if you ARE eligible to medicaid, obamacare will give you NOTHING towards a subsidy since you have a different option. (Let's not talk about if that's fair or not.)

suzyq

Thu, Aug 14 2014, 2:06 pm

kb wrote:

How could it possibly not be fair? Medicaid is FREE health insurance. Why would anyone need a subsidy if they qualify for Medicaid?

amother

Thu, Aug 14 2014, 2:14 pm

Use a broker, they're free.

I have a medical background and found choosing one of the exchange plans one of the most taxing chores I've tackled. You're not alone

Scrabble123

Thu, Aug 14 2014, 2:22 pm

suzyq wrote:

How could it possibly not be fair? Medicaid is FREE health insurance. Why would anyone need a subsidy if they qualify for Medicaid?

I think she was meaning to say that if someone qualifies for Medicaid, but would want a different insurance for another reason (Pregnant and want to be with a specific doctor), Obamacare will not offer them a subsidy because they qualify for Medicaid.

suzyq

Thu, Aug 14 2014, 2:28 pm

kb wrote:

Suzyq, not all doctors take medicaid, and depending on someone's medical condition they may be better off with private insurance instead.

Not all doctors take my insurance that I pay an arm and leg for either. Nor do many doctor's take the Obamacare plans - those plans are notorious for having very small networks of doctors and no out of network benefits. That's life. If someone needs private insurance, then they may have to actually pay for it.

Basya

Thu, Aug 14 2014, 2:37 pm

In my experience, brokers DO NOT want you going through Obamacare and will probably try to talk you out of it. Find a broker who you TRUST. I'm not sure if they make any commission if you go with Obamacare.

Thu, Aug 14 2014, 2:55 pm

I used a broker and got a plan through obamacare, so I assume he got a commission. I am paying extra every month for a broader network of doctors and hospitals. I have not yet found a doctor that does not take my insurance.

That being said, the deductible (which is relatively low) is insane, and can sometimes ending up costing us more than our monthly premium!

I didn't even KNOW there was real private insurance anymore! Who sells private insurance nowadays?

amother

Thu, Aug 14 2014, 3:04 pm

Op here.

Thanks for all the responses.

How do I find a broker?

If I get Medicaid, will I still be able to give birth in the hospital of my choice? It seems to me like Medicaid may be my best option, because the pediatrician takes it and some of our specialists didn't take our old insurance either. Even if I have to pay for those visits, I'll still be saving money by not paying anything for the insurance.

Thu, Aug 14 2014, 3:05 pm

I believe ALL hospitals MUST take medicaid. So if your doctor does, you're fine.

Broker...? It would probably help to say where you live, as different states have different policies at the moment.