Stuck on private health insurance and I'm so lost

amother

Turquoise

Mon, Jul 30 2018, 11:29 am

Neither my husband nor I receive health insurance from work. We might qualify for CHIP or Jersey Care but they require us to be off health insurance for 3 months prior- which I can't do for my kids- AND it's not a guarantee that we'll get on, because my husband made a lot more money on his last tax return, and they refuse to listen to us when we explain that our finances this year will be lower.
So we are STUCK on this horrible plan called omnia silver, which only lets us see New Jersey doctors, AND had high premiums and high deductible! We are being so financially squeezed!!! They only pay 70% of the expenses!!!
So we pay $1000/month in premiums, plus expensive co-pays (my kids are at the doctor quite often), plus an insane deductible. My husband doesn't want to go for some much-needed tests because they'll charge us thousands of dollars! But he needs these tests so we can figure out what's wrong!!!! I'm so angry and overwhelmed and LOST. Can anyone help?
Don't suggest LrRC. They did not help us last time. I live in Lakewood NJ.

amother

Mistyrose

Mon, Jul 30 2018, 11:37 am

I don’t really have advice because half of DH’s salary goes to premiums, deductibles and copays. I have serious neck and back pain and I can’t afford to get help.
I can sympathize with you

das

Mon, Jul 30 2018, 11:44 am

Unfortunately afaik there is nothing you can do. But if you don't have much savings you may be able to have dh check into an ER and have charity care cover the costs.

Your plan actually doesnt sound too bad at all compared to other plans. If you pay only 1,000- in premiums you won't be getting much better. Sad

Health insurance sucks...

amother

Cerulean

Mon, Jul 30 2018, 11:59 am

Ugh I totally hear you it's crazy how expensive the private health insurance went up in the past few years it's killing us and we meet our deductibles easy . State insurance is not easy and most of the specialist my kids see don't take it .and can't play that game off no coverage for 3 months. our helth insurance takes up more of our income then normal I a d at my wit's end I can cut back in many areas but not this .

amother

Beige

Mon, Jul 30 2018, 12:14 pm

You should be able to put your children on the NJ child health plus equivalent without needing them to be off insurance for 3 months. But since you said you're husband's making a nice amount of $ you may have to pay a higher premium.

amother

Turquoise

Mon, Jul 30 2018, 12:41 pm

amother wrote:

Their website says applicants need to have no insurance for three months prior.
And my husband isn't making money; but he made a bit of money last year.

amother

Cerulean

Mon, Jul 30 2018, 1:57 pm

amother wrote:

Nope they need not have insurance for 3 months and even then it can't be a guarantee believe me we tried. My daughter was having medical issues and we had taken out a cheaper insurance ( before everything got bad) and we asked to be switched and they said no you need to be uninsured 3 months

amother

Turquoise

Mon, Jul 30 2018, 2:08 pm

das wrote:

Of course there are many plans. But you can't apply for them until open enrollment.

Like which plans?
I am turning 26 so will have a qualifying life event.

Amarante

Mon, Jul 30 2018, 3:06 pm

amother wrote:

Like which plans?
I am turning 26 so will have a qualifying life event.

It depends on where you are located since plans are geographically based.

You can go to the state site that offers the health insurance plans for your area - you plug in your zip code since costs and plans available differ depending on the area.

You will then see all the plans available in your area and the cost after subsidy - you also plug in your income.

If you aren't eligible for a subsidy, you can still purchase through your state exchange or any other private plan.

The best way to proceed is to find a knowledgable health insurance broker who can advise you on the best plan for your circumstances.

amother

Beige

Mon, Jul 30 2018, 3:11 pm

amother wrote:

Wow. In NY we just had to have a termination letter from the previous insurance. We tried to time it so that there wouldn't be a gap from end of month a to start of month b on new insurance plan.

5S5Sr7z3

Mon, Jul 30 2018, 3:54 pm

I used to be in your situation. I found it cheaper to go without insurance until I was able to get my kids onto child health plus. Doctor visits paid out of pocket are cheaper than deductibles.

amother

Sienna

Mon, Jul 30 2018, 5:12 pm

Why don't you try Liberty Healthshare?
They pay 100% after a $1,000 deductible, and they're very affordable.
If you want to go onto Jersey Care, you can have Liberty Healthshare first. They are not an official insurance company so it's like your uninsured. And you can go to any doctors, as long as the doctor agrees to take it... and if they don't, you pay cash and get reimbursed.

amother

Cerulean

Mon, Jul 30 2018, 6:45 pm

IYamWhoIYam wrote:

I used to be in your situation. I found it cheaper to go without insurance until I was able to get my kids onto child health plus. Doctor visits paid out of pocket are cheaper than deductibles.

It really depends on the situation in my case my kids medicine would cost me over 5 grand a month plus all the doctor's appointments we would need so it wouldnt be worth for me to go without insurance. and then I would need to get my approval for all of their medications and diagnosis with the state insurance the whole thing is crazy and unfair.

amother

Fuchsia

Mon, Jul 30 2018, 6:50 pm

Have you tried going through the exchange marketplace? If your eligible for chip you should be able to get it through the exchange. It may be different in NJ, but in NY if your income changed you allowed to apply at any time and once you are approved coverage begins the first of the next month