Health Insurance | Imamother

amother

Green

Fri, Jan 06 2017, 11:40 am

so it seems IYH we are going to be ineligible for medicaid very soon.

medicaid is the only insurance dh and I have been on, so this is a new world for us.

I really need help about the different options.

im not going to say I dont know the first thing, because I did try to do research (thanks googe) but im pretty confused.

I know if I ask without giving specifics, ill get answers that it depends, (which is true) so here are some specifics let me know if you need more to help Smile

Number of adults - 2
state - NY
county - Kings

I looked on nys of health,(is that the only place to look?) but I dont know the first things about deductibles (what ARE deductibles?) and what I need to have coverage for?

Thank You !!

im not asking to be spoonfed I really need help

eta: also, anything you can tell me about coverage through the employer? how do u choose which insurance to get then?

amother

Green

Fri, Jan 06 2017, 11:59 am

chocolatecake wrote:

If you are just getting kicked off Medicaid unless you are probably eligible fore the essential plan which is the same United Healthcare Community plan but you pay in like 20 a month. Call up Yeled Vyalda they deal with this and are extremely helpful and the service is free of charge.

I dont think we will be eligible for the essential plan. (the info I read is that the you have to make less than $32,040 for a household of 2)

I will reach out to yeled vyalda. do they make you come in or can they help me on the phone?

amother

Lawngreen

Fri, Jan 06 2017, 12:59 pm

amother wrote:

They mainly work by appointment only.
For your questions in the op:
[list] a deductible is a named $ amount that you will be responsible to cover in medical expenses before the insurance will cover anything. So for ex., if you have a $2,000 ded., you will be paying the first $2,000 of medical bills on your own. Note that some plans do cover certain things before you reach your deductible, like a annual visit etc. It varies plan to plan.
Employer insurance is not through the marketplace. Usually you will get a choice (you may not) of a few plans to choose from. The employer sponsors some of the premium, and you will have to pay the rest + deductible. Comparing to Obamacare, private insurance is usually better and more universally accepted by doctors and hospitals (but it does vary), and also way more expensive (which also depends how much your employer sponsors).
Also, depending on your income, you may be eligible for some subsidy with Obamacare.

For my family, we have 3 different plans. My son is covered through child health plus (almost like Medicaid, but have to pay $45/mo, that's it). For myself I have through my employer, Oxford, which I pay approx. $360/mo premium, +2,000 ded. For my husband, we felt he bh does not need the best insurance (since he's bh healthy, and not getting pregnant Wink

), we took through the marketplace. Since we are not eligible for any subsidy, we chose a catastrophe plan, which is low premium/high ded - $175/$7,000. And lots of doctors don't accept it...sigh.

Good luck! It ain't easy!!

amother

Green

Sun, Jan 08 2017, 10:32 am

amother wrote:

thanks. ideally I would like to get insurance through employer, but I was asked which insurance I want, and I dont know the answer! could yeled vyalda help with that, too?

Amarante

Sun, Jan 08 2017, 3:21 pm

If you get insurance through your employer, then you will be presented with specific options. If you look over the options and post, the deductibles and co-pays and whether it is an HMO or PPO, people can advise.

If you don't get insurance through your employer, you are best off getting insurance through the exchange. With your income, you would probably qualify for a large subsidy towards the premiums. You might also be eligible for assistance with co-pays and deductibles with a silver plan. You should use a broker who is familiar with insurance who can help you decide which plan is best for you.

amother

Green

Mon, Jan 09 2017, 11:14 am

Amarante wrote:

thanks, I didnt get any options yet.. im the type that likes to be prepared. now im gonna google hmo vs ppo..

amother

Green

Mon, Jan 09 2017, 11:15 am

Amarante wrote:

With your income, you would probably qualify for a large subsidy towards the premiums. You might also be eligible for assistance with co-pays and deductibles with a silver plan. You should use a broker who is familiar with insurance who can help you decide which plan is best for you.

"with my income" where did I write my income?
also, whats a silver plan?

and lastly, how do I find a broker?

Amarante

Mon, Jan 09 2017, 11:46 am

amother wrote:

"with my income" where did I write my income?
also, whats a silver plan?

and lastly, how do I find a broker?

I assumed that since yu were just coming off Medicaid, your income was still within the range which qualifies for a subsidy. The amount scales up to abut $96,0000 I think.

But if you get through your employer, it's moot.

HonesttoGod

Mon, Jan 09 2017, 12:12 pm

Definitely go to Yeled Vyalda they are very very good and helpful.

In general with obamacare (if you don't qualify for family health plus) works according to how much you earn. You get x amount discount.
You pay $x per month and on top of that you have co pays (paid at each dr visit) and deductible (the first $xxx of medical expenses you have to pay out of pocket).