What's happening? Why is insurance getting so expensive?
Everyone's talking about health insurance getting more expensive, but why does it seem so bad for couples and families?
If you rely on getting insurance from one spouse's company, you're likely seeing your health insurance premiums skyrocket. There's a growing trend among businesses that are cutting back on how much they pay for spouse and family health coverage. By law, companies offering health insurance have to pay a minimum of 50% of a health plan premium's for the employee-only. Although they "offer" coverage for spouses and kids, they are contributing less towards it or in some cases, no longer contributing at all.
Insurance premiums have been rising steadily--about 8% a year in Texas--but now families are having to pay a larger percentage of their premiums as companies cut back...this is a double whammy for families.
One of our clients, Natalie, had her family premiums jump from about $500 a month to over $1100 in one year! You can see her story in our testimonial video here:
What can we do?
You have have more options than you think! You should explore putting your family on a separate plan.
It used to be true that getting your family on a group plan (through a company) was the way to go. But that's no longer the case. The reality is that plan for your spouse's company was designed for a company, not for a family. There are dozens of plans in your area--on and off the exchange--that were designed for individuals and families. You'll almost certainly find one that fits you better, provides great coverage, for much much much less.
In summary, leave your spouse on the company plan (where they help pay for it), and put you and your kids on a private plan. Below are some frequently asked questions we get about this setup:
What kind of plans are available?
- It depends where you live, but most people are surprised at all of the options. We'll help you quickly search plans from major carriers like Blue Cross, Aetna, Humana, Cigna, and others on and off the exchange. We even have some new carriers like Oscar that offer free phone calls to doctors (perfect if you have kids) and faith-based sharing plans like Medi-Share.
What about my doctors?
- Choosing a plan that has your doctors and your kids' pediatrician will be key to saving money. It's getting too expensive to pay "out of network" anymore. We have a pretty cool tool (first of it's kind, we believe) that lets you search for your preferred doctors and hospitals and then we'll tell you which plans they accept. Way easier than trying to search every plan site yourself!
When can I move my family from to a private plan?
- You can enroll your family in a private plan during Open Enrollment which starts on November 1st, 2015 and runs through January 31st, 2016. For coverage to start on January 1st, 2016 you have to enroll by the December 15th deadline.
- If you already renewed your coverage on the work plan because you didn't know about your options, you can drop it at anytime (the catch is you can only sign up during your company's open enrollment season or with a special enrollment event)
Am I eligible for a tax credit?
- Unfortunately you're not eligible for federal tax credits (subsidies) because you or your spouse technically get "affordable" coverage from work (even if the company isn't helping you pay for spouse or family coverage). Even so, most people can still save significant amounts of money even without a tax credit.
If we split plans, aren't we just doubling our deductible and max out of pocket amounts? Sounds risky...
- In the past, yes, but not anymore. For family or group plans, the deductible and max out of pockets are handled at the individual level. The family max only kicks in if two or more people have catastrophic injuries. For example, if both your new plan and your spouse's work plan have a max limit of $5,000 for the individual and $10,000 for a family, it doesn’t matter which plan your family members are on. If one person gets seriously hurt or sick, the max will be $5,000. If two people get hurt, it would either be $10,000 on the new plan or $5,000 on the new plan and $5,000 on the work plan. Same thing for deductibles. It's possible you could trigger both max out of pockets and pay a little more, but highly unlikely. Your biggest risk is just having to carry around two insurance cards.
You don't know what saving opportunities are out there until you try! We recommend leaving your spouse on his or her work plan and then searching for a new plan for you and your kids. We make it really easy to see all your options and make sure you can find a plan with your doctors and coverage for your medications and health needs.
Ready to find a great and much more affordable plan for your spouse and/or children? Take Command Health is here to help!