State Insurance or Private Insurance???

Updated on January 11, 2012
C.D. asks from Fort Worth, TX
7 answers

I want opinions on what I should do. We currently have private insurance through my husbands job. We have the policy on the whole family. (me, hubby, son 1 and son 2) We don't make a lot of money right now because my husband is working full time but also in school full time. I stay at home because my youngest son is constantly sick. That being said as of March 1 according to Medicaid my husband will be making too much money so he will be denied medicaid. Unlike Medicaid I can't have CHIP and private insurance, so long story short, what is better for me to do, drop my kids from our private insurance and enroll them in CHIP? Or keep them on our private insurance, we really can't afford that (dr visits will be $25 each, Urgent care is $75, and ER is $235). The only pros I can think of to keep our private insurance is that my son sees a lot of specialists one being an ENT I love, and he doesn't take chips. HELP!!!!

On another question, Son 1 lost his medicaid as of August last year so this year I knew we would being paying for things for him so I had my husband take out $1040 for Flex account, if I should drop the kids from our private insurance should I wait till we use the bulk of our Flex money because I am like 99% sure my husband and I won't use that much?
Thanks for any help!!

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So What Happened?

We don't have the money yet until my husband finishes school and finds a better job, we don't have any other state help just health insurance. It makes me nervous to take them off our private insurance. We have United Health Care though my husbands job.

More Answers


answers from Phoenix on

I'm an insurance agent in AZ. Find a local independent health insurance agent in your area. They know what is available and the pros and cons of each option. Good luck!!!

5 moms found this helpful


answers from Oklahoma City on

In all honesty I would use the state insurance for everyone who can get on it and then drop all the other stuff, use the money for groceries or paying utility bills.

People who are not in these circumstances have no real idea of how hard it is to choose. They would say it's your responsibility to provide for your kids but they have not experienced having to choose to buy food or pay for an office call. I have no insurance at all and if I am sick have to go to the ER for medical treatment. I am unable to pay that bill and have to ask the social workers at the hospital to find funds to pay it or expunge it.

My hubby is on SSDI, we are raising 2 out of 7 of our grandkids, the kiddo's are on medicaid, and we make too much money for me to qualify for the free clinic or medicaid. I go without basic needs being met so the kids can have what they need and some of what they want.

I would talk to the ENT and see if he would consider taking a lesser payment from you if you paid him directly. He might, some doc's will do that if they can possibly afford it. They may seem to make a lot of money too but they do have staff, overhead, surgery staff, supplies, looks might be deceiving, maybe the ENT will be able to still see him though.

4 moms found this helpful


answers from Killeen on

You might check into getting your insurance through the college your husband is attending. My husband is working full time and going to school but he doesn't get any benefits from his job. The insurance through his school is great insurance and cheaper than anywhere else we could find it. Take advantage of it while you can.

And doctors, clinics and hospitals have a cash price that is often 50% of what they would charge the insurance company. All you have to do is ask about their cash price. You will be surprised what kind of discounts you will get paying in cash. Better and cheaper than taking someone to the ER for something that is not an emergency, then not being able to pay that bill. Clinic may be $60 vs. ER @ $900.

Check into the insurance through the school though. I never knew about it until a friend told me and was glad she did!

2 moms found this helpful


answers from Washington DC on

I would go with the policy that allows me to keep the doctors I know and trust.

You are most likely going to get a lot of feedback on this one.

I will admit I'm confused. You say you have a private policy but you have medicaid - which in my book is government do you have a private policy or medicaid/state/federal health care?

I would find out why my son is sick all the time. That would bug me to no end.

Sorry - if you have the funds - YOU pay for your insurance. that's my thought.

2 moms found this helpful


answers from Louisville on

Can you talk to a social worker about the medically dependent children's waiver program? It's for children who have chronic health problems/needs but whose parents make too much money for Medicaid. This waiver would allow your son with issues to get back on Medicaid despite your income. Find a social worker (available at any hospital - call any of dfw's children's hospitals & ask to speak to someone in social work); he/she can then help you determine if you're eligible for the waiver & if you are, help you fill out the forms.

Good luck.

2 moms found this helpful


answers from Portland on

There is an income cut off for being eligible for state insurance. Also, if the child has access to private insurance and the family has income above a certain level the child would not be eligible for state insurance. Check with the state to find out the requirements.

It's my impression that in Oregon if the child can be covered by their parents' insurance thru work, they are not eligible for state coverage. Every state has their own policy.

If they're eligible then compare the coverage. Choose the one that has the best coverage for your needs. I think that state coverage would be adequate and would go with that if I were eligible but I'd look into it to be sure.

2 moms found this helpful


answers from Dallas on

I would have your ent recommend someone that does take CHIP and put the kids on it. It's way more economical all the way around. Lower dr visits, no copays, deep discount on prescriptions, premiums drastically lower. Be sure you can find CHIP drs to handle your specialties. Otherwise I''d Go CHIP with a vengeance!

1 mom found this helpful
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