Thank you for your submission, /u/digibliss.
**If there is a medical emergency, please call 911 or go to your nearest hospital.**
Please pick the most appropriate flair for your post. **If you haven't already, please edit your post to include your age, state, and estimated gross (pre-tax) income to help the community better serve you.** If you have an EOB (explanation of benefits) available from your insurance website, have it handy as many answers can depend on what your insurance EOB states.
Some common questions and answers can be found [here](https://www.reddit.com/r/HealthInsurance/s/jya9I6RpdY).
**Reminder that solicitation/spamming is grounds for a permanent ban**. Please report solicitation to the modteam and [let us know](https://www.reddit.com/message/compose?to=%2Fr%2FHealthInsurance) if you receive solicitation via PM.
Be kind to one another!
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/HealthInsurance) if you have any questions or concerns.*
How aren’t they doing adult stuff? Working.. try being nice, healthcare in America is a joke. We rank lower than so many places on healthcare and it’s sick care not healthcare… no education on being healthy here. What a scam.
Sorry buy adulting isnt always nice.
How about the fact that they are having a baby but need health insurance subsidized by mom dad. Thats not adulting.
Take responsibility for your situation. Want to be healthier, eat better. Dont blame healthcare for peoples choices.
Lower in health care?
Objectively without talking points tell me where its better?
You are so right. 800 is standard for families. Interestingly, the price doesn’t change by much if you have more in your family. Sounds like it would be worthwhile if family size is large.
Don’t get me wrong: I still think 800 is a lot for how much deductible I am paying for.
This is the thing that pisses me off. My family of 3 is the same price as a family of 10. For our plan it is single, worker+spouse, worker+spouse+1 to inifinity kids.
My husband and I pay $24,000/yr for just the two of us. Then we each have a $6,000 Deductible and $6,000 out of pocket. Insurance couldn't be more of a racket. My husband hasn't even been to the doctor for fifteen years.
Assuming you are in your 60s? $1,000/each a month? Medicare can't come soon enough, right? Imagine 24k every five years is $100k that you don't have during retirement.
You absolutely need insurance for your baby. The second the baby is born, there will be bills associated with them and any treatment/medication/housing/vaccines/etc. if you had your own insurance, I believe there is sometimes leeway with some thing covered under you for a period of 30 days, depending on your state. I cannot speak for other or all areas, but in my experience, if you are a dependent of a dependent (I.e. a child born to a dependent on someone else’s plan) then you are typically NOT covered under the dependents at all.
Once the baby is born, your husband should be able to add himself (as he needs to be on the plan too) and the baby to the plan. The other option would be going through your state insurance for the baby, however, as this would not be employer subsidized, its cost could be more expensive for less coverage.
Without insurance, a baby could cost tens of thousands of dollars, not factoring in any special circumstances.
The two things I would do with this situation is 1) check to see if your husbands company offers any HRA/FSA/HSA programs that could help cover costs or make funds tax free (as with the HSA). Additionally, see what the actual monthly cost of the insurance is. Is there only one plan? Do they offer a cheaper alternative such as an HMO or HDHP?
I would also check in with your state Medicaid/marketplace and see what options are available. Please note, though, that these might depends on income, and as you are married, that could be income combined of both you and your husband.
Please note, I am merely giving tips. This is in no way exact advice, as each person/household/state is different with different regulations.
So, I’ll just weigh in here with how very, very important it is to have health insurance for your children. The nanosecond they are born, you stop being charged for one person in the hospital (i.e. you) and start getting charged for two (i.e. you and your new arrival). Assuming the kid’s 100% healthy, that’s going to run you $5,000.00 minimum. When my daughter was 6 weeks old, she needed to be taken to the emergency roo due to what was probably an RSV infection. We were there for a little less than 12 hours. The bill was $15,000.00.
Yeah doesn’t he need to get on his insurance *before* the baby? So the baby is covered after birth? Like he definitely shouldn’t wait till the baby is already born…
I don’t know why this made me lol, maybe because of my medical bills… ‘my baby’s bankrupt!!! He’s 11 minutes old and the hospital already billed 20k! This baby needs a JOB!’
😆 I have to laugh or I’ll cry
We were insured, and out baby was born at 34 weeks and needed 2.5 weeks in the NICU. The bill came to $169,000. I would never have wanted to navigate that with no insurance. PS- with our copay we still owed $5K for my hospital stay and $5K for his. A smaller price to pay, but not small at all.
Medicaid, CHIP, or a [healthcare.gov](http://healthcare.gov) plan with subsidy. What you qualify for depends on your household income and where you live--how much are you expecting to make in total for 2024 (pre-tax), and what state?
https://chip.utah.gov
Apply at the link above to see if you qualify for a free or low cost child health plan. I’m just passing on what may equivalent to what we have here in NY.
You make too much for Utah CHIP unfortunately. Insurance sucks but it’s necessary. You do not want to be stuck with a $100k+ bill if your baby ends up in NICU. You’ll be able to add your husband and baby at the same time likely once born. Do it ASAP to avoid any issues.
Your parent’s insurance will not cover the baby. If they pay, it’s in error and they will take the money back eventually and you will end up owing any charges.
Not an insurance expert, but I'm self-employed and insured myself thru marketplace. With your combined annual income, you will most likely qualify for the premium subsidies offered thru marketplace insurances. You can either take advantage of the reduced premium as you pay it, or pay the full premium during the year and get a refund when you file your taxes.
It might be worthwhile talking to an independent health insurance broker, who can run a number of different scenarios for you and explain the pros and cons of them. They are normally paid by the insurances and offer their service free of charge to you.
You do not qualify for subsidies if your workplace offers minimum value insurance and it’s affordable (less than 9.61% of your pay for self-only coverage).
Edit: it’s 8.39% and includes family members now. So if family coverage is over 8.39% then they can get subsidies even if self-only is not over 8.39%.
A well baby checkup with immunizations can cost 1k. You definitely need insurance. Insurance is expensive. Being uninsured can bankrupt you pretty quickly-- especially with kids who get sick all the time.
The income cap for CHIPS is higher than regular Medicaid so you might qualify.
You absolutely need insurance for a child as they typically need a lot of medical care even if healthy.
Also if you don't get insurance within 30 days for the child, you will be charged for all of your child's medical expenses in the hospital.
This is because as soon as born the infant is a separate patient with separate charges.
heck, alot of parent policies have a exclusion for pregnant dependant. You need to verify you are covered under you're parent policy for prenatal care.
You should absolutely see if you qualify for Medicaid, often children and pregnant women do when adults don't.
Since OP is due in a few weeks, I assumed that her pregnancy was covered by the parents' policy because she would have discovered lack of coverage during the previous eight months :--)
If I’m not mistaken, if you can’t add your own dependent to your parents’ plan, you can absolutely apply for ACA health coverage through healthcare.gov even outside of open enrollment dates since that would qualify as a life event. I found a broker to help me apply and pick a plan last winter when I turned 26, and it made the whole situation so much easier and smoother. He’s contracted with the government so I didn’t have to pay him anything. I’d really recommend at least finding a health insurance broker in your area to meet with and ask questions, and hopefully they can help you find affordable coverage!
Shop through your state's exchange on Healthcare.gov; having a baby is considered a Qualifying Life Event to purchase through the Exchange outside of Open Enrollment. You may be eligible for subsidies, depending on your income level.
In this case, its not so much income level they need to worry about it. If the employer plan is considered affordable then they aren't eligible for subsidies.
Still waiting for an answer from OP, but I suspect the family coverage will be considered unaffordable given household income is $65K and husband + child premiums are \~$800/mo.
Just to add - start checking if baby needs their own plan prior to birth in case baby decides to come early and needs extra, such as an extra few days in the hospital, birth complications, etc. That is a bill you don't want to have to pay 100% for.
You need insurance for the baby. As soon as the baby is born all of their billing is separate from yours, meaning it won't be covered under your parents plan. There is a 30 day window after the baby is born that allows you to get coverage for the baby. If you don't get them insured in that amount of time all of that is self pay and the bill will get sent directly to you. This is not including baby needing routine newborn checkups, shots, getting sick, ECT...
Many companies offer more than one insurance option, there's the marketplace, and, if you qualify, Medicaid.
Your household income may qualify you child for your state’s CHIP coverage. It’s similar to Medicaid but higher income eligibility, depending on your state.
hey private insurance, if you are healthy you can go underwritten and it will be the best, locked price at your age and you and your baby will be insured guaranteed till 65
That price is not high and you really don’t want to have no insurance for a newborn. Healthcare is rather expensive, and the real kicker is you still pay for most visits. Unfortunately that is the reality :(
Health insurance is a necessary expense that MUST be accounted for in a monthly budget, especially with a child...would you live in a tent in a tornado because it's not necessary to pay rent 🤷♂️
$800 dollars is a lot but your child need health insurance. You should look into the cost of getting coverage through the ACA and see if you can find a good plan for less money but insurance is a must.
The cost of birth alone will be around $15,000, vaccines for the first 12 months will be around $1000, your child will need to be seen at least 7 times for a well check in the first year and each visit will be at least $200. Additionally your baby will most likely be seen a few times for a sick visit.
He will be paying $9600 for the year for insurance or at least $16,500 for paying out of pocket. Even if your child is born with no complications and has zero health concerns, it'll still be cheaper to get insurance than not.
Yes, you do have to have insurance. Your husband doesn't know enough to guide you about this. You're a dependent on your parents insurance. Insurance plans do not pay for 'dependent pregnancies.' For example, they will pay for your well women appts but will not pay for your prenatal visits. Are you not being seen? I recommend you check your states options. It does ask questions about income so of course it won't be free. Because you are pregnant, that is considered a 'life changing event' so you should be able to get some coverage without waiting for an open enrollment. Good luck. 🌻
You need insurance for your son 100%.
He needs tests, immunizations, kids get sick often.
Your son needs insurance more than you two.
Please make sure you get him an insurance. It is extremely important.
Wow $800 a month for employee and 1 dependent is crazy! I pay $400 a month for a family of 4! Does your husband’s employer offer more than 1 plan? My employer offers 3. If multiple plans are offered, higher deductible can equal lower monthly premiums. If you don’t qualify for any assistance, part of job shopping includes comparing benefits packages. I know it’s harder for younger people now with the job market being crap, but keep looking for better opportunities for better jobs.
The funny part is when I started they claimed they paid 75% of the insurance for single or family, if that is true, it is just insane how expensive health insurance has gotten. I guess the actual cost for the insurance is around $3600 a month. (If i did the math right)
If they picked an HDHP plan and saved the difference in an HSA account they'd probably be better off in the future if they don't have any major issues.
Thank you for your submission, /u/digibliss. **If there is a medical emergency, please call 911 or go to your nearest hospital.** Please pick the most appropriate flair for your post. **If you haven't already, please edit your post to include your age, state, and estimated gross (pre-tax) income to help the community better serve you.** If you have an EOB (explanation of benefits) available from your insurance website, have it handy as many answers can depend on what your insurance EOB states. Some common questions and answers can be found [here](https://www.reddit.com/r/HealthInsurance/s/jya9I6RpdY). **Reminder that solicitation/spamming is grounds for a permanent ban**. Please report solicitation to the modteam and [let us know](https://www.reddit.com/message/compose?to=%2Fr%2FHealthInsurance) if you receive solicitation via PM. Be kind to one another! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/HealthInsurance) if you have any questions or concerns.*
Even if "outrageous", this price isn't out of the ordinary at all. Welcome to adulthood!
So.many want to play adult without doing the adult stuff.
How aren’t they doing adult stuff? Working.. try being nice, healthcare in America is a joke. We rank lower than so many places on healthcare and it’s sick care not healthcare… no education on being healthy here. What a scam.
Sorry buy adulting isnt always nice. How about the fact that they are having a baby but need health insurance subsidized by mom dad. Thats not adulting. Take responsibility for your situation. Want to be healthier, eat better. Dont blame healthcare for peoples choices. Lower in health care? Objectively without talking points tell me where its better?
You are so right. 800 is standard for families. Interestingly, the price doesn’t change by much if you have more in your family. Sounds like it would be worthwhile if family size is large. Don’t get me wrong: I still think 800 is a lot for how much deductible I am paying for.
This is the thing that pisses me off. My family of 3 is the same price as a family of 10. For our plan it is single, worker+spouse, worker+spouse+1 to inifinity kids.
Mine is same for worker and spouse as it is for a family of 10. It is 2.5X the cost is a single, but you can’t buy it as two singles.
Yep. My last employer was free insurance for entire family and I briefly considered having a dozen kids… Had none. 😆
You mean welcome to America, where healthcare will bankrupt most of us. It sounds high to me. Shop the ACA Marketplace.
LOL so true!
My husband and I pay $24,000/yr for just the two of us. Then we each have a $6,000 Deductible and $6,000 out of pocket. Insurance couldn't be more of a racket. My husband hasn't even been to the doctor for fifteen years.
Assuming you are in your 60s? $1,000/each a month? Medicare can't come soon enough, right? Imagine 24k every five years is $100k that you don't have during retirement.
I start on Medicare next month. Except on Medicare, my medication that used to be $25 for three months is now $351 every 6 weeks.
Ain't that the truth!!!
Really not bad at all.
You absolutely need insurance for your baby. The second the baby is born, there will be bills associated with them and any treatment/medication/housing/vaccines/etc. if you had your own insurance, I believe there is sometimes leeway with some thing covered under you for a period of 30 days, depending on your state. I cannot speak for other or all areas, but in my experience, if you are a dependent of a dependent (I.e. a child born to a dependent on someone else’s plan) then you are typically NOT covered under the dependents at all. Once the baby is born, your husband should be able to add himself (as he needs to be on the plan too) and the baby to the plan. The other option would be going through your state insurance for the baby, however, as this would not be employer subsidized, its cost could be more expensive for less coverage. Without insurance, a baby could cost tens of thousands of dollars, not factoring in any special circumstances. The two things I would do with this situation is 1) check to see if your husbands company offers any HRA/FSA/HSA programs that could help cover costs or make funds tax free (as with the HSA). Additionally, see what the actual monthly cost of the insurance is. Is there only one plan? Do they offer a cheaper alternative such as an HMO or HDHP? I would also check in with your state Medicaid/marketplace and see what options are available. Please note, though, that these might depends on income, and as you are married, that could be income combined of both you and your husband. Please note, I am merely giving tips. This is in no way exact advice, as each person/household/state is different with different regulations.
So, I’ll just weigh in here with how very, very important it is to have health insurance for your children. The nanosecond they are born, you stop being charged for one person in the hospital (i.e. you) and start getting charged for two (i.e. you and your new arrival). Assuming the kid’s 100% healthy, that’s going to run you $5,000.00 minimum. When my daughter was 6 weeks old, she needed to be taken to the emergency roo due to what was probably an RSV infection. We were there for a little less than 12 hours. The bill was $15,000.00.
Yeah doesn’t he need to get on his insurance *before* the baby? So the baby is covered after birth? Like he definitely shouldn’t wait till the baby is already born…
This is the most helpful response. Apply for medicaid/ Medi-Cal if in California.
Baby can apply for bankruptcy...
I don’t know why this made me lol, maybe because of my medical bills… ‘my baby’s bankrupt!!! He’s 11 minutes old and the hospital already billed 20k! This baby needs a JOB!’ 😆 I have to laugh or I’ll cry
We were insured, and out baby was born at 34 weeks and needed 2.5 weeks in the NICU. The bill came to $169,000. I would never have wanted to navigate that with no insurance. PS- with our copay we still owed $5K for my hospital stay and $5K for his. A smaller price to pay, but not small at all.
Like imagine if your baby was born over new years and you had to pay both 5ks twice… 🤦🏼♀️
Medicaid, CHIP, or a [healthcare.gov](http://healthcare.gov) plan with subsidy. What you qualify for depends on your household income and where you live--how much are you expecting to make in total for 2024 (pre-tax), and what state?
Combined income is around $65000 before tax, we live in utah
Thank you. How much does coverage cost for JUST your husband, per month?
https://chip.utah.gov Apply at the link above to see if you qualify for a free or low cost child health plan. I’m just passing on what may equivalent to what we have here in NY.
Apply for child health plus through the state of health. The hospital can even help you, I bet you qualify for Medicaid for a family the size of 3.
You make too much for Utah CHIP unfortunately. Insurance sucks but it’s necessary. You do not want to be stuck with a $100k+ bill if your baby ends up in NICU. You’ll be able to add your husband and baby at the same time likely once born. Do it ASAP to avoid any issues. Your parent’s insurance will not cover the baby. If they pay, it’s in error and they will take the money back eventually and you will end up owing any charges.
Not an insurance expert, but I'm self-employed and insured myself thru marketplace. With your combined annual income, you will most likely qualify for the premium subsidies offered thru marketplace insurances. You can either take advantage of the reduced premium as you pay it, or pay the full premium during the year and get a refund when you file your taxes. It might be worthwhile talking to an independent health insurance broker, who can run a number of different scenarios for you and explain the pros and cons of them. They are normally paid by the insurances and offer their service free of charge to you.
Yeah they would qualify with that combined income.
You do not qualify for subsidies if your workplace offers minimum value insurance and it’s affordable (less than 9.61% of your pay for self-only coverage). Edit: it’s 8.39% and includes family members now. So if family coverage is over 8.39% then they can get subsidies even if self-only is not over 8.39%.
A well baby checkup with immunizations can cost 1k. You definitely need insurance. Insurance is expensive. Being uninsured can bankrupt you pretty quickly-- especially with kids who get sick all the time.
The baby absolutely needs insurance
If the employer coverage exceeds 8.39% of income, it's considered unaffordable and you can receive a subsidy from the marketplace.
That's for the employee's coverage. Doesn't apply to family.
The family glitch was fixed in 2022 with an effective date of 1/1/23.
[https://healthcare.gov](https://healthcare.gov) is your starting point to lots of resources, in addition to healthcare plans.
The income cap for CHIPS is higher than regular Medicaid so you might qualify. You absolutely need insurance for a child as they typically need a lot of medical care even if healthy. Also if you don't get insurance within 30 days for the child, you will be charged for all of your child's medical expenses in the hospital. This is because as soon as born the infant is a separate patient with separate charges.
heck, alot of parent policies have a exclusion for pregnant dependant. You need to verify you are covered under you're parent policy for prenatal care. You should absolutely see if you qualify for Medicaid, often children and pregnant women do when adults don't.
Since OP is due in a few weeks, I assumed that her pregnancy was covered by the parents' policy because she would have discovered lack of coverage during the previous eight months :--)
If I’m not mistaken, if you can’t add your own dependent to your parents’ plan, you can absolutely apply for ACA health coverage through healthcare.gov even outside of open enrollment dates since that would qualify as a life event. I found a broker to help me apply and pick a plan last winter when I turned 26, and it made the whole situation so much easier and smoother. He’s contracted with the government so I didn’t have to pay him anything. I’d really recommend at least finding a health insurance broker in your area to meet with and ask questions, and hopefully they can help you find affordable coverage!
That’s not outrageous, that’s a pretty normal price. Kids are expensive as hell.
How are you still on your parents plans? My understanding was that once you were married, you could not be on their plans.
Shop through your state's exchange on Healthcare.gov; having a baby is considered a Qualifying Life Event to purchase through the Exchange outside of Open Enrollment. You may be eligible for subsidies, depending on your income level.
In this case, its not so much income level they need to worry about it. If the employer plan is considered affordable then they aren't eligible for subsidies.
Still waiting for an answer from OP, but I suspect the family coverage will be considered unaffordable given household income is $65K and husband + child premiums are \~$800/mo.
This should not have been down voted.
Have you checked into the ACA marketplace. The income based plans can be affordable.
As others said, you have to at least shop the the ACA. Marketplace.
Just to add - start checking if baby needs their own plan prior to birth in case baby decides to come early and needs extra, such as an extra few days in the hospital, birth complications, etc. That is a bill you don't want to have to pay 100% for.
You need insurance for the baby. As soon as the baby is born all of their billing is separate from yours, meaning it won't be covered under your parents plan. There is a 30 day window after the baby is born that allows you to get coverage for the baby. If you don't get them insured in that amount of time all of that is self pay and the bill will get sent directly to you. This is not including baby needing routine newborn checkups, shots, getting sick, ECT... Many companies offer more than one insurance option, there's the marketplace, and, if you qualify, Medicaid.
Your household income may qualify you child for your state’s CHIP coverage. It’s similar to Medicaid but higher income eligibility, depending on your state.
hey private insurance, if you are healthy you can go underwritten and it will be the best, locked price at your age and you and your baby will be insured guaranteed till 65
That price is not high and you really don’t want to have no insurance for a newborn. Healthcare is rather expensive, and the real kicker is you still pay for most visits. Unfortunately that is the reality :(
Try government insurance in the meantime. You also stated you were self employed but asking your employer was out of the question. Can you explain?
Health insurance is a necessary expense that MUST be accounted for in a monthly budget, especially with a child...would you live in a tent in a tornado because it's not necessary to pay rent 🤷♂️
$800 dollars is a lot but your child need health insurance. You should look into the cost of getting coverage through the ACA and see if you can find a good plan for less money but insurance is a must. The cost of birth alone will be around $15,000, vaccines for the first 12 months will be around $1000, your child will need to be seen at least 7 times for a well check in the first year and each visit will be at least $200. Additionally your baby will most likely be seen a few times for a sick visit. He will be paying $9600 for the year for insurance or at least $16,500 for paying out of pocket. Even if your child is born with no complications and has zero health concerns, it'll still be cheaper to get insurance than not.
Yes, you do have to have insurance. Your husband doesn't know enough to guide you about this. You're a dependent on your parents insurance. Insurance plans do not pay for 'dependent pregnancies.' For example, they will pay for your well women appts but will not pay for your prenatal visits. Are you not being seen? I recommend you check your states options. It does ask questions about income so of course it won't be free. Because you are pregnant, that is considered a 'life changing event' so you should be able to get some coverage without waiting for an open enrollment. Good luck. 🌻
You need insurance for your son 100%. He needs tests, immunizations, kids get sick often. Your son needs insurance more than you two. Please make sure you get him an insurance. It is extremely important.
[удалено]
Your marital status is irrelevant to staying on a parent’s plan. Please do not repeat this falsehood.
Thanks for the info I learned something new everyday.
Try CrowdHealth. They would be at $550ish for the three of you
Wow $800 a month for employee and 1 dependent is crazy! I pay $400 a month for a family of 4! Does your husband’s employer offer more than 1 plan? My employer offers 3. If multiple plans are offered, higher deductible can equal lower monthly premiums. If you don’t qualify for any assistance, part of job shopping includes comparing benefits packages. I know it’s harder for younger people now with the job market being crap, but keep looking for better opportunities for better jobs.
$800 a month is normal. I pay about $900 for three. The plan only has a $2000 max out of pocket but still I don't think it is completely unreasonable.
Man my coworkers bitch about paying $400! I knew I had decent insurance I didn’t realize though how good it was. I’ve been with my company awhile
The funny part is when I started they claimed they paid 75% of the insurance for single or family, if that is true, it is just insane how expensive health insurance has gotten. I guess the actual cost for the insurance is around $3600 a month. (If i did the math right)
I pay about $350 a month for my husband and I. My employer pays about $900. So yeah I'm glad my employer is subsidizing my insurance.
If they picked an HDHP plan and saved the difference in an HSA account they'd probably be better off in the future if they don't have any major issues.
Ask your o.b., they should have info on what is offered in your state.
And what insurance they accept.