health insurance help (how much, house, neighborhood)

[hershey87]

i am posting this on behalf of my parents.

they just moved to cape cod from NH and both have great jobs - except neither have health insurance. my mom's employer does offer it, but it's super expensive and her boss doesn't pay for any of it.

it turns out they are exempt from any tax penalty because what mass. has determined they could afford per month is half the cost of any insurance plan that's offered to them, according to the ma health connector site.

they can only find plans that run around 1k a month and that offer a ton of things they'll never use, like prenatal and diabetes care. they would ideally like insurance that covers catastrophic events, run of the mill physicals, and, hopefully, medications. out of pocket, my step-dad's medications would cost a fortune. they'd be okay with paying out of pocket for appointments, but they're in their 50's and would like some protection in case someone has a heart attack or any other unexpected trauma.

they both make too much to qualify for masshealth and commonwealth care. my mom did try applying to masshealth before her husband had a job, and never heard back.

do you have any ideas of what they can do? where they can turn? is there any way for them to get affordable health insurance?

they have considered having one of them switch to a job that has full benefits, but as you can imagine, jobs on the cape are hard to come by, and they are happy where they are.

forgive me if any of these questions are obvious, as we're all from out of state and aren't familiar with this.

[Jamesnana]

Depending on income, they may be eligible for the Commonhealth Connector, which covers up to 400% of the poverty limit. My best advices is to go to the admitting department of the nearest hospital, and they will be happy to sort it all out for you.

[Beachcomber4]

Part of the problem is living on Cape. My business is off Cape. Our insurance agent inadvertently used our Cape home address for insurance and with Tuft's the cost was $200 more per month- even for my off Cape employees. BC/BS charges outrageous surcharges for services at on Cape hospitals- even with their top plans.

I was recently told that Neighborhood Health Plan is very reasonable. They might have to choose off Cape practitioners but the savings is significant. It might be worth checking out. If they are looking, Altus Dental is also a good, reasonable dental insurance plan that is out of Rhode Island and part of Delta Dental. I'd also suggest calling a local insurance agent or whomever writes their car insurance and homeowners policy. They might be able to put you into a "group" to get a better price.

Good luck. But to be honest, $1,000/ month is pretty average for a couple for health insurance. They also need to look into how much insurance is needed to avoid charges imposed by the state at the end of the year for being uninsured or under-insured.

[hershey87]

jamesnana - thank you. by that do you mean the commonwealth care/choice options? their income is too high for care, and they qualify for a bunch of commonwealth choice options, but they are the ones that are around 1k.

beachcomber4 - i noticed that when viewing the average monthly costs for insurance among the different counties that it's highest at the cape. i have passed on the information to them, thank you. i understand 1k isn't that horrendous, but the cheapest plan offered to them has a $10,000 deductible. with such a high monthly payment and deductible for two healthy people, i don't even think it's worth it.

[Beachcomber4]

Originally Posted by hershey87

beachcomber4 - i noticed that when viewing the average monthly costs for insurance among the different counties that it's highest at the cape. i have passed on the information to them, thank you. i understand 1k isn't that horrendous, but the cheapest plan offered to them has a $10,000 deductible. with such a high monthly payment and deductible for two healthy people, i don't even think it's worth it.

Believe me I feel their pain. But if they don't have insurance they will be assessed (by the state seizing any income tax owed them) half the cost of the least expensive plan available to them, for each month they are not covered. So if they go the entire year, and 1k was the least expensive plan, they are looking at 6k in penalties.

Welcome to Massachusetts.

[hershey87]

that's so crazy. luckily i do believe they are exempt from a tax penalty - there's a way to find out for sure, and i am encouraging them to do that. they may just have to go without insurance for a while and pay out of pocket... i'll keep researching their options.

they didn't know it was this bad in MA. they moved there to escape the property taxes and high costs of running an old house in NH - and now a bunch of their money could be sucked into health insurance anyway.