10 answers

Can't Afford Health Insurance Through Husband's Employer. What Are My Options?

Hello Mamapedia!
I live in PA. My husband has been in his current job for 4 months.
We were hoping that we'd be able to take advantage of health insurance benefits through his employer. After 90 days, we found out that benefits would cost $500 a month for just the two of us, which we definitely cannot afford. We verified the amounts with his employer and yes, indeed, they are that expensive.

At this point, we are seeking out benefits for just me including womencare/maternity. I also have Plantar fasciitis and have not seen a doctor for it since February. I had state benefits until he started working. The pain is agonizing.

I'm in need of benefits desperately. My husband makes too much money to qualify for state health insurance. I could just pay out of pocket to see the doctor but my condition may require surgery.

Has anyone else been in this type of situation before? Does anyone purchase benefits outside of their employer? HELP!

What can I do next?

So What Happened?™

Just to be clear. I'm not pregnant. Never said I was. It's coverage I'm going to need in the future. Please don't make assumptions.

More Answers

Though I have never personally purchased health insurance outside of an employer, I do know that it is extremely expensive to purchase private insurance individually; it is actually usually cheaper (and you may get better coverage) to go through an employer. You might be able to find individual plans for less, but be sure to check the coverage very carefully to make sure they provide an adequate amount of coverage.

As a healthcare worker, I strongly encourage everyone to have some type of health insurance. The cost of healthcare is astronomical- even without having some type of chronic condition. You never know when something could happen and even just one event or incident (broken bone, infection, car accident, etc.) can be catastrophic and truly bankrupt a family. In the long run it is actually cheaper to have the health insurance- even if it seems to cost a lot every month. Good luck!

I live in Massachusetts and the state offers help with premium payments if you can prove you can't afford the $500. Not sure about PA, but I would contact WIC and go from there. We once paid $800 a month through my hubby's old work - nearly crushed us!

Best of luck!

In addition to the fact that you might not qualify due to your pre-exisiting condition, the costs of health plans not offered through employers are pretty high. I looked into one when my husband was out of work and it was more than $500 with no pre-existing. Also, the coverages are not as good. So you will more than likely pay close to the same as you would through hubby if not more, have your P.F. not covered at all for a certain period of time, and the coverages you would get for the rest of your health care would not be as good. Also, maternity care is usually an extra "add-on" and costs extra.

I would definitely get some quotes though. Check with a broker and they can run a bunch of quotes for you from various companies, and explain the different limitations on each.

Good luck to you, I hope you find something.

I live in PA and we were in this situation at my last employer. Unfortunately until the new healthcare legislation goes into effect you may find that any surgery for a pre-existing condition would not be covered by insurance. When I was at my last job it would have been over $800/month to cover my husband & son on my employer's insurance. So I obtained private insurance for my son when he was born. At that time I had a great plan with Aetna for about $115/month which was about $150-180 cheaper per month than through my employer. My husband was uninsured for a brief time but we were shopping around for private insurance when I got my new job. I found that private insurance would still have been cheaper than through my employer so I would try calling Aetna and Blue Cross (ibx.com) to see what kind of plans they have and what the price would be for the coverage you want. Not sure what other plans are available in PA but I do know both those companies do.

I heard this on the radio this morning about a new plan for people with pre-existing conditions. It's a PA initiative:

We do. We have done it for years. Many companies offer a variety of plans for those who need to insure themselves. We opted for a high deductible plan, our monthly payments are extremely reasonable, but the deductible is very high...so basically we pay monthly to get the insurance negotiated prices. But we have crunched the numbers several times, and this plan works well for us. There are many insurance brokers that can help you. I started with ehealthinsurance.com. It allowed me to see what options were available in my area and compare plans. It offers an estimate so you can see what your monthly plans will most likely be. A word of caution though, they may consider your condition a pre-exhisting condition. For my pre-exhisting condition, they will not cover any of the costs for treating it...in five years this part of my contract will be re-evaluated. I also had to fight for my insurance a bit. I have been declined twice because of a mistake in my medical records. It took some time and some phone calls, but both times the decision was over turned and I got the insurance I was seeking. Even with these issues, we have found private insurance for me and kids a much better deal than signing on with what my husband's work offers.

You can shop around, but until the reform bill kicks in you may have trouble due to your pre-existing condition.

It doesn't hurt to shop, however just know insurance is expensive..I would pay more than that if I had to get insurance through my employer. The other consideration is whether you have pre-existing conditions that may prohibit a carrier from writing you a policy (that's the boat I'm in). My only option is to get coverage through my husband's or my employer.

Good luck!

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