Washington State Health Insurance : School Me

[Buster Highmen]

I'm running out of my COBRA health insurance.

I have a wife and 2 teenagers, some need for nontraditional coverage (wandering eye/tracking).

A broker we found wants $200 to start a survey for plans. That seems a little weird.

Do any WA state others have suggestions or constructive experience to share?

[Conundrum]

Find a new broker. They get paid after they sell you something. Maybe WA is different.

[BeardedClam]

Apple health is pretty baller if you have kids. Medical/dental for free. SO has had 3 free major surgeries with doctors of their choosing. All you gotta do is be close to 'federal poverty' for a little while. Pretty wild to think that a system so socialist works so well for those in the leisure class on the lower end of the economic spectrum.


I don't know what to tell you if you're more of a NORP and are actually trying to pay into the broken system

[Buster Highmen]

Find a new broker. They get paid after they sell you something. Maybe WA is different.

Yeah, the $200 up front to navigate the system seems a little odd.

Apple health is pretty baller if you have kids. Medical/dental for free. SO has had 3 free major surgeries with doctors of their choosing. All you gotta do is be close to 'federal poverty' for a little while. Pretty wild to think that a system so socialist works so well for those in the leisure class on the lower end of the economic spectrum.


I don't know what to tell you if you're more of a NORP and are actually trying to pay into the broken system

We're in an odd financial frame and may qualify for apple this year. Last year, not so much.
NORP requires respectable, right? You should know better.

[GeezerSteve]

For the times you're not covered by Apple Care, you might want to check out Costco Health Insurance Marketplace (administered by CBC). I know several self-employed people who are happy with the plans they got through Costco HIM.

[Cono Este]

If your cobra runs out you qualify for a special enrollment period outside of open enrollment. If you end cobra early, you do not. So don’t end it prematurely, or enroll in the new plan in the up coming open enrollment.

Fuck paying that idiot 200. Open an acct on the aca website, you can enter drugs and doctors and do your own research. But before you enroll, call your doctors to verify they are in network and check and expensive drugs on the formulary.

Then enroll.


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[oftpiste]

subscribed.....

[shroom]

get a job at boeing

[BeardedClam]

I always thought the r was responsible but either way, this ain't the place.

I forget how old your groms are but when median age is 17, that's the best time for you to be in poverty if theyre applying to colleges. FAFSA eats that shit up, Pell Grants out the ying-yang. Don't jump the boat early

Either way I have nothing more of value for the conversation based on demographics.

[snoqpass]

get a job at boeing

Mrs Snoqpass works at Trader Joe’s their insurance is top notch

[liv2ski]

So for laughs I went to Cover CA to see what a no deductible plan would cost for a 63 & 61 year old couple. Ready? $2,150 per month and $30 co pay per office visit and $15 co pay for generic drugs. No dental, vision, etc.
Fucking unreal. I hope you guys can do much better than that in WA.

[KQ]

Shoppers may face hard choices again on health marketplaces

[Buster Highmen]

Our COBRA has cost $1600/month. From looking online, we're fucked for decent coverage.

[liv2ski]

Our COBRA has cost $1600/month. From looking online, we're fucked for decent coverage.

Looking at the COBRA rules, it would appear if my wife voluntarily retires from teaching at 63 she is not eligible for COBRA coverage.
For $2,200 a month in coverage, I wonder if I can talk her into moving to Canada for awhile

[yeahman]

It pays to be poor these days when it comes to health insurance.

[Conundrum]

Looking at the COBRA rules, it would appear if my wife voluntarily retires from teaching at 63 she is not eligible for COBRA coverage.
For $2,200 a month in coverage, I wonder if I can talk her into moving to Canada for awhile

You might put more research into that. CA has weird rules but she should either be offered a retiree program through age 65 or 18 months of COBRA coverage.

[liv2ski]

You might put more research into that. CA has weird rules but she should either be offered a retiree program through age 65 or 18 months of COBRA coverage.

Thanks for the hint Conundrum. I found the retirement package info and sent it to my wife as a FYI. Saves us $1k a month compared to the BS I saw on Covered CA.

Buster, I hope you find something you can live with too.

[Buster Highmen]

A more general question: what is co-insurance?
If a plan states that there's a 20% coinsurance for hospital stays for example, does that mean insurance covers 20% after the deductible is reached?

Why do cheaper plans have all hospital care covered after deductible is payed, but more expensive plans have these coinsurance percentages between 20% and 30%?

All we really want is some catastrophic insurance for hospital stays and serious illness.

[mtngirl79]

Co insurance is fucking annoying. I have to pay 10% of everything (prescriptions are separate) after my 250 dollar deductible up to the 2500 out of pocket limit.

Sometimes it's less than the 20 dollar copay I use to have but I have to wait for a bill to come in the mail. I use a flexible spending account credit card to pay and multiple times sending the paper with the card number written in hasn't worked so I get another bill. I have resorted to going in in person to pay but that's annoying.

Eta.. co insurance is what you pay.. I pay 10% they pay 90.

[billyk]

Coinsurance usually means the same thing as ‘copay”, eg what you pay is 20% and the insurance pays 80%. Usually there will also be an out of pocket maximum, after which the insurance picks up the whole tab.

[Buster Highmen]

So co insurance is tied to the deductible and is a percentage of what the user has to pay whereas a copay is a flat fee independent of deductible.

[mtngirl79]

I don't think coinsurance and copay are different in relation to the deductible.

With both you have to meet the deductible before the insurance kicks in. Once deductible is met, co insurance is like copay only it's a percentage rather than a flat rate.

[billyk]

I think we need to have Flo translate these terms. You pay for everything until you satisfy the deductible. Yeah, I think some plans have a flat fee for the copay after that, and other plans it is a percentage (coinsurance). The terms get mixed pretty often, though.

[Buster Highmen]

I don't think coinsurance and copay are different in relation to the deductible.

With both you have to meet the deductible before the insurance kicks in. Once deductible is met, co insurance is like copay only it's a percentage rather than a flat rate.

The way I read stuff is that one always pays the copay, but a coinsurance kicks in only after the deductible has been met, so one is on the hook 100% on those items listed as coinsured until the deductible is met.

[AK47bp]

So co insurance is tied to the deductible and is a percentage of what the user has to pay whereas a copay is a flat fee independent of deductible.

If you are on a 80/20 plan then after the deductible is satisfied insurance pays 80% and you pay 20% of the remainder of calendar year expenses capped at your out of pocket maximum for the year. Any expense after you hit the out of pocket max is 100% covered.

Office visit Copays are separate if your plan has them. Copay expenses count toward your out of pocket maximum but not your deductible


If you have a high deductible plan those usually don't have copays, just 100% out of pocket until you hit the deductible.