So this is the first time I plan on getting i surance as it’s always been so expensive for my family, but recently my wife found a knot inside her belly which the doctor believes it’s a hernia and might require surgery.
I looked into healthcare.gov and found out (through a phone agent and local broker) that I do qualify for subsidies and have until the end of the week to enroll. It’s odd for me because I was always told that as long as my employer offered the minimum it meant I didn’t qualify for any subsidies (even the website told me so) until the local broker accessed it and updated it changing the prices; so hopefully that’s right.
So I see that most plans have a really high OOP (like 5-8k) even with high or $0 deductibles. They seem good but the copays are high, between 35-40% for doctors and ER visits depending on the plan.
I did find a plan that doesn’t cover anything until I hit my deductible which would be like $1,400 for ind or $2,800 for family, which sounds good?
Knowing that my wife will most likely need surgery, what things do I need to know before signing up; any issues if it’s pre-existingn? How do I make sure that everything eould be covered by the insurance? Also does she have to meet the family ded or just the ind if only she uses it, but we’re both in the plan? What would count towards my oop/ded if there are no copays? And finally does it make sense to choose the second plan I mentioned or the regular ones that do copays and high oop?
submitted by /u/Unknown0521
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So this is the first time I plan on getting i surance as it’s always been so expensive for my family, but recently my wife found a knot inside her belly which the doctor believes it’s a hernia and might require surgery. I looked into healthcare.gov and found out (through a phone agent and local broker) that I do qualify for subsidies and have until the end of the week to enroll. It’s odd for me because I was always told that as long as my employer offered the minimum it meant I didn’t qualify for any subsidies (even the website told me so) until the local broker accessed it and updated it changing the prices; so hopefully that’s right. So I see that most plans have a really high OOP (like 5-8k) even with high or $0 deductibles. They seem good but the copays are high, between 35-40% for doctors and ER visits depending on the plan. I did find a plan that doesn’t cover anything until I hit my deductible which would be like $1,400 for ind or $2,800 for family, which sounds good? Knowing that my wife will most likely need surgery, what things do I need to know before signing up; any issues if it’s pre-existingn? How do I make sure that everything eould be covered by the insurance? Also does she have to meet the family ded or just the ind if only she uses it, but we’re both in the plan? What would count towards my oop/ded if there are no copays? And finally does it make sense to choose the second plan I mentioned or the regular ones that do copays and high oop?
submitted by /u/Unknown0521 [link] [comments]Read Morer/HealthInsurance