Health insurance in NYC

amother

Aquamarine

Tue, Apr 10 2018, 8:37 pm

Can anyone help me with health insurance agent in NYC? I don't qualify for low income subsidized healthcare plans. Until now had from dh job. But not anymore. But need insurance for a family of 3 children and pregnant with a fourth Iyh. Any leads, ideas companies not crazy expensive you can recommend would be really appreciated! Or do all of u pay through the roof? Im desperate.
TIA

amother

Aquamarine

Tue, Apr 10 2018, 10:11 pm

YES, I can get child health plus for 250$ per child = $700. However, I still need for me and my husband insurance as well.
Liberty health I looked into but does not cover pregnancy. So, it's not an option as of now.

Amarante

Wed, Apr 11 2018, 10:42 am

If your husband lost a job, it is a qualifying event so you can get insurance.

It is likely you are eligible for some kind of subsidy through Obamacare. New York State has a website and it provides you with all options including the cost after subsidy - the subsidy depends on your income and the number of people in your family.

Private health insurance, as you are discovering, is expensive.

wow

Wed, Apr 11 2018, 6:13 pm

If you had health insurance through a job, then you are eligible for Cobra. Find out how much the premium would be should you elect to stay on your plan through Cobra. After you know the price on that, you can compare it to the marketplace plans. I have done the most extensive research and there are literally almost no options for anyone who doesn't get insurance through an employer. Liberty Health Share is what I ended up with, but since it's not relevant to you, I would suggest you stay on Cobra until after you have your baby.
Perhaps only your husband and you can stay on that insurance and your kids can go on child health plus, though you will have to do the calculations once you get your cobra rate.

Just to add - not sure when you lost your insurance but move fast, because you can only elect cobra coverage for 60 days after your termination date. Once on Cobra, I believe you would be allowed to stay on it for 18 months.

amother

Aquamarine

Wed, Apr 11 2018, 6:21 pm

My dh did not lose his job and can still have insurance through work but until now it was mostly paid by employer, now it's all our responsibility. The premiums are very expensive and deductible is 10,000$. Basically. It did not make sense. So everyone is getting into liberty share or Obamacare. Both are not good for me.

amother

Amethyst

Wed, Apr 11 2018, 6:36 pm

Prenatal care is not subject to the deductible on most plans. You can verify this on the plans summary of benefits. Your deductible would kick in when you actually give birth, and then you would get a big hospital bill. However, there are many hospitals that have financial assistance programs where they would waive the bill. Which hospital does your doctor deliver at? I had a 5k copay at my most recent birth and the hospital waived it completely after I completed their financial assistance form. The income limits are super high, for example, a family of four can make up to about 200k and get a 100% discount (in that particular hospital).

Another note though - sonograms and lab work are usually subject to the deductible, but if you're going to a regular doctor, they usually don't take that many tests.

Whichever way you swing it , unless you're on medicaid or a great employer sponsored plan, coverage is super expensive, and until you're done having your baby, you'll have to just pay the $$$! Unless someone here has a suggestion that I have never heard of yet!

wow

Wed, Apr 11 2018, 6:38 pm

amother wrote:

Why isn't obamacare an option? If it's because of the cost, then trust me, you can't find cheaper anywhere else anyway.

thunderstorm

Wed, Apr 11 2018, 8:30 pm

amother wrote:

Just curious. Through a regular obgyn how much would I cost to deliver a baby and hospital stay without insurance?

My OB/GYN charges $3500 for the entire pregnancy including delivery if it's out of pocket. But that does not include the hospital . I think the hospital would be about $20,000 at least and that is just for the stay, not including any other specialists , anesthesia (epidural) etc.

Amarante

Wed, Apr 11 2018, 8:31 pm

There is no such thing as "Obamacare"

If you don't get health insurance through your employer, then you have to purchase insurance on the private market which is costly. Unfortunately health insurance is expensive - people who receive health insurance through a large employer don't realize how expensive it really is until they are put in a position - for whatever reason - of having to pay for it themselves. The benefit for health insurance through a large corporate employer is that everyone is pooled together so the healthy or the young cost the same for the employer as older or sicker employees. If you work for a small employer, THEIR cost for health insurance is high and each employee is rated individually - I.e. the employer will have to pay more for an older employee than a younger employee.

If you are eligible for a subsidy because of income, you buy through the marketplace.

However, it does not appear that you would be eligible for a subsidy regardless of your income because you have the option to purchase insurance for the family through your employer which makes you ineligible for any subsidy. This is a stupid aspect of the law which should have been corrected but the Republicans were more interested in killing the Affordable Health Care Act than in working together to make it better for the middle class.

wow

Wed, Apr 11 2018, 8:38 pm

Amarante wrote:

However, it does not appear that you would be eligible for a subsidy regardless of your income because you have the option to purchase insurance for the family through your employer which makes you ineligible for any subsidy. This is a stupid aspect of the law which should have been corrected but the Republicans were more interested in killing the Affordable Health Care Act than in working together to make it better for the middle class.

If purchasing insurance through your employer would cost you more than a certain percent of your income, then you sure are eligible for subsidies. OP said that insurance through her employer is very costly, so she very likely will fall into that category.

amother

Bisque

Wed, Apr 11 2018, 8:57 pm

wow wrote:

This.

OP, I had a similar dilemma. My employer does not contribute at all to my premium, so I would still be eligible for a subsidy, as my employers plan is not considered "affordable" under the ACA (it's more than a certain percentage of my salary). However, I chose to go with my employers plan and not a subsidized obamacare plan, because I have a health condition that is treated by top specialists in Manhattan who do not accept any obamacare plans. But, if you are healthy and just need a general obgyn, you should be able to find a decent one with Obamacare.