Health insurance for families - how do people afford it?

[RUSSandRACHEL 3]

Hi there everyone,

I haven't been on here in a while and was hoping for some helpful advice. I'm a permanent resident and moved from the UK to the US in May 2010. Next summer, I'll be applying to Remove Conditions. My husband (the USC) and I have been married for 16 months now and we are starting to think about having a family but don't know where to begin about health insurance. We live in NJ and wouldn't qualify for medicaid, nor can we afford to pay $600+ a month for the the absolute cheapest private healthcare plan that we can find. And thats before a baby comes along... what then? Horizon Blue Cross Blue Shield have quoted us $850+ a month for full family coverage which we could never afford...

I have my own business and work part time and my husband is the manager of a retail store and makes $45k a year. A health package he was recently offered through his employer required him to pay a $4,000 deductible, up front, before any coverage was put in place - therefore we couldn't take it.

We earn above the poverty line yet the jump up to private health care seems completely out of our reach. My husband has had insurance usually through his employer off and on throughout his life but has never had children and therefore neither of us know who to approach for advice. We also don't have many friends to ask for advice, where we live. Can anyone recommend some health insurance companies or organizations that can point us in the right direction?

(With other reasons aswell) things have got so bad that we've even considered moving back to the UK to have a family.

Please don't be mean with responses and also forgive my ignorance on the situation, but being from the UK, this has never been a concern to me before. Many couples in the US seems to be bringing up families and getting along fine. I can't understand what the big mystery is and how they are doing it. Help!

Thank you!

Edited October 21, 2011 by RUSSandRACHEL

[milimelo 4,481]

We had one of those High Deductible plans at my last work - we had to pony up $6150 before insurance would cover anything except for preventive care. Only now are we all done with payments to doctors - took a while. Also taught me to only pick PPO and never again HD plan. The HD plan works if no one in your family has any medical issues - I know people who are on it for years and have thousands saved up both in HSA and through lower per-month premiums.

For child planning, I'd get a new job with an employer that offers good medical plan and only then start thinking about it. We're couple of years away from it as I'll be going overseas for work and anti-malaria pills plus pregnancy do not work so it's on the back burner.

Hope you find something soon!

Edited October 21, 2011 by milimelo

[JoannaV 174]

One answer is that people afford it because they have to. It's obviously harder to do if it's not already in your budget and then you have to somehow squeeze it in. But if it's one of the initial most basic parts of your budget then the answer is, you just pay it and if you have any money left you buy food.

Is that really the cheapest quote you could find? Was that quote higher after they'd questioned you and based it on your medical conditions/weight/whatevers(/hair colour)? If the latter then all I can say is how sucky it is that it works that way :-( But if that's the normal cheapest option for a couple your age then that double sucks! You can find cheaper options than that here in Virginia.

We have a similar income to you guys, pay a similar amount for healthcare as what you were quoted, and will very soon be providing for a baby on that income. So it's possible. Easier in some places than others, based on living costs. But possible. Whether it's worth it to you is another matter. I do often mourn not having the NHS. It's nice to know that what you pay towards your health insurance (ie in taxes) insures you for life, not just that particular month, especially as it's easier to afford health insurance when you are healthy and don't need it so much...

[Boiler 45,522]

I have my own business and work part time and my husband is the manager of a retail store and makes $45k a year. A health package he was recently offered through his employer required him to pay a $4,000 deductible, up front, before any coverage was put in place - therefore we couldn't take it.

A higher deductible will not reduce the premium by very much.

$5,000 seems the sweet spot.

[Brother Hesekiel 2,236]

I am 53, healthy as an ox, and pay $2,400 per month.

Yep, Americans get shafted because they know no better.

I would take $7.50-per gallon gas and amnesty for illegal aliens any day if the package would include UK-style government-run healthcare!

[Boiler 45,522]

Be careful of what you wish for!

[Kirsten UK 2]

I know you run your own business but one option would be to take a job at a healthcare facility...generally speaking the coverage is very good and slightly cheaper.....I work for a healthcare provider and pay about $480 every 4 weeks for family health and dental. Having said that I would still be faced with a whopping bill at the end of a pregnancy as i'm responsible for 20% of the bill. You could also consider being 'self pay', alot of OB/GYN practices offer a slight discount for this and you may be able to set up a payment plan through their business office.

I too was struck by how expensive healthcare is generally when I first moved here and still to this day can't fathom how working families afford to have children. Having said that though, when I look back and remember how much I used to pay in National Insurance contributions I'm really no worse off at all but I am in the fortunate position of having a job with great health insurance. I hope you can work something out, having a baby is the most wonderful thing ever!

[Rebecca Jo 1,962]

You aren't going to find low cost coverage with a low deductible on the open marketplace. That's just not the way the insurance industry works.

Most self employed people have plans with a high deductible because that makes the premium more affordable. Some of those plans have what is called a health savings account, wherein you put money to cover the deductible if you ever need to use the insurance. In essence these folks are still paying a high monthly cost (because they are paying the monthly insurance premium PLUS putting money in the healthcare savings account) but the difference is the money in the savings account is not used until there is a claim.

The only way you get low cost insurance coverage in the US is through a good job with a large employer. Small employers cannot afford to offer exceptional insurance to their staff because their insurance "group" is small. Insurance companies offer lower rates to employers with big groups. By way of example, my husband used to work for a company with over 4000 employees nationwide. His insurance cost for both of us was about $45 every two weeks. Through his present employer (about 450 employees) that same coverage would cost $160 every two weeks.

If you and your husband are going to continue to live in the US, you will just have to buck up and learn to live with the expense. It's not going to get any cheaper and the US will not go to a single payer system before you are out of your child bearing years.

Rachel, this next comment is not meant to be "mean". You are already in the US (like my husband) so we made the same decision you and your husband did. But six years later, I can't say strongly enough to UK/US couples that the cost of healthcare should be ONE OF THE TOP DECIDING FACTORS in where you will make your life. If one (or both) of you is a high-earner, you will be able to live with the US system and just get use to the costs. If you know honestly that you will both have modest jobs, you need to take a long hard look at living in the US. Having a baby and raising a family is just a minor health care concern. Getting older, needing medications, and growing old without fear of losing your dignity through health care is a very devastating place to be.

Edited October 22, 2011 by Rebecca Jo

[Rebecca Jo 1,962]

PS - I wouldn't look at it as things being "so bad that we've considered moving back to the UK". "Bad" would be moving to the middle of the Rain Forest. Great Britain is a lovely place.

Edited October 22, 2011 by Rebecca Jo

[momof1 205]

I work for a hospital system that employs 22,000 people in our state. They pay 80% of my healthcare premiums which amounts to $511 every two weeks. I end up paying out of my paycheck close to $5200 per year in premiums plus 10% on most care that isn't preventative or maternity based. In addition, I have a $1200 family deductible. A $5000 deductible doesn't seem so bad if you break it down per month if you regularly deposit money into a special account. It would help even further if he had a portion of his paycheck($250) deposited directly into a special account for healthcare expenses. If you don't see the money then you never have the chance to miss it. Deductibles don't require you to put out the deductible amount right away. If you have a doctors visit and the cost is $200 then you pay the full amount. You will continue to do this for care until you reach your deductible. Most of those plans then cover 100% after the deductible is met. Well, I should say that's the way it works for high deductible plans for my insurance. If you have a bill that is too much for you to pay at once hospitals and clinics will work out payment plans for you. If you take the money you have put away into your account each month you should be covered. It can be done if you want to do it. I know it's hard to think about going from paying nothing to paying something. I have a child with a genetic heart condition and I would rather pay a high amount each month than get stuck with a $70k hospital bill. It all depends what kind of risk you're willing to take for your long-term future.

[Chicagoguy 2 27]

This is a huge problem in the U.S. I have free medical coverage but my new Russian wife has none. For doctor visits I pay with charge card and get a 50% reduction. When there is a big bill coming my wife has and will go back to Russia. I pray there in never a big emergency.

A little over 4 years ago my wife died of Lukemia. Her bill was 1.2 million $. How would you like to open that envelope. Lucky for us she had full insurance as a teacher and I paid nothing. Government jobs seem to have better insurance.

[clarence954 20]

I am 53, healthy as an ox, and pay $2,400 per month.

Yep, Americans get shafted because they know no better.

I would take $7.50-per gallon gas and amnesty for illegal aliens any day if the package would include UK-style government-run healthcare!

holy #######! I thought I was getting screwed at 70 a month.

[james&olya 1,121]

Consider my situation. Just 36 hours after my fiancee arrived here with her two children, her 2 y/o daughter developed seizures! We had NO insurance for her. Because I have fairly good group coverage through my employer we married the following day, right there in the hospital room! Even doing that we still have a bill for over $10,000.00!! The good news is that the seizures turned out not likely to be an on-going problem. But nothing is more important than your families' health and I would gladly spend my last dollar to protect them.

Health insurance here is a huge problem for too many people and is only going to get worse, especially if the 'tea-party' has its way! The solution is single-payer government health insurance, 'Medicare-for-all', either federal or at the state level. I am guessing that those of you from Western Europe would be in agreement for the most part. Unfortunately our president squandered an opportunity to get this by trying to compromise with the GOP. The public supports single-payer and would have responded favorably to a simple 'Medicare-for-all' kind of plan. Obamacare with its huge giveaways to the private insurance companies is an easy target and has dragged his poll numbers down rather than boosting them the way a good program could have. I hope a way can be found to move forward on this. I think that the answer may be in state-run programs like the ones being developed in Vermont and Montana. If those are successful people in other states will demand that their legislators enact the same.

I hope you soon find a solution to your immediate problem. The best bet might be looking for a job where you get decent coverage through a new employer.

[Alex & Rachel 78]

A high deductible is not so bad if after meeting it you are covered 100%. Considering that even relatively minor complaints can easily cost into the thousands of dollars, I'd rather have my $4,000 deductible plan than a PPO plan that only covers me 80% or 90%. And, as has been pointed out, a Health Savings Account (which you qualify for with a high deductible plan) is a very useful thing indeed.

But as for how people afford it? Most people will rely on obtaining insurance through their employer and having their employer pay the majority of the cost. My plan costs $750 a month but I only have to pay $160 of that. It is not an inconsiderable expense, and I do miss the NHS, but I also have to consider that here I earn more than three times what I earned in the UK, so overall I am still better off living here (that is, so long as I stay employed!). As JoannaV says, people afford it because they have to.

My recommendation would be to re-examine the high deductible plan your husband's company offers. How much of the premium would they pay? If you only paid a portion of the premium, and were able to put $300 or so a month into an HSA, this may end up being the most cost-effective option.

[Boiler 45,522]

We seem to have lost the OP.