Last year when I wrote about our Health Care issues, I was seriously wondering what we (my husband and I) would do. I had no idea that there was a way we could and would be able to pay for the health care under the new and revised plans available through the government marketplace. Our company premiums were prohibitive since the change and the coverages were not any better. So we had no choice but to cancel our company policy and no longer provide health care to our employees.
As I might have mentioned previously (Original Post) for the last 29 years we provided 100% healthcare to our employees, everyone qualified and everyone received it at “no cost” to them. Our company paid all of the premium. Not one employee had to pay one cent for their coverage and we always got the best plan we could afford to cover them.
As the years rolled on, the economy tanked, our employee numbers tumbled, our average age increased, and our premiums increased — we were only able to keep them in check by lessening the coverages overall, for everyone. We got to the point we had $2500 deductibles, and that meant every cent of the first $2500 had to be paid before you were able to even do a co pay or have some help with your tests or medications. It wasn’t ideal, it was the only way we could still provide 100% coverage without asking for a contribution from the employees. None of my employees ever complained about their coverage, even though many of them went from amazingly great coverage to simply adequate coverage over the years.
So the decision was made and the company plan was cancelled. Leaving everyone to fend for themselves.
My husband and I used the government marketplace to find a plan and also check to see if we were eligible for a subsidy. We were! We now both have coverage (because of our subsidy) that costs us a lot less than our coverage with the company plan. The coverage we were able to obtain has a LOW deductible, LOW out of pocket costs, and pays for many standard things with 0% copay as long as you stay in network. We might never had even had a plan this good in all the years of having a company plan — and our out of pocket costs are lots less than before.
I almost hesitated signing up. I mean it was “too good to be true” and you know you should always be careful if something works out that way. But we are now into that new coverage, I have had to use it and it has been amazing.
If I told you the amount we have to pay – you too would be amazed! The amount you pay and the plans you are offered are affected by many factors. The state and the county you live in, the amount of money you make, your ages and other factors all play into what type of subsidy you might get (not everyone qualifies). We happen to hit the sweet spot in all the categories. We are still not planning on making many Dr. visits this year — but at least we know – if we need to, we can afford to get just about anything done we need — as long as we make sure we stay in network.
If you are out there wondering if you would benefit from this … there are rules and qualifications. We had to cancel our company plan before we could even look into this as an alternative for us. So if you have a plan available to you, even though you have to contribute to it, you won’t qualify. If you make too much money, don’t have enough of an offset with dependents, etc. as well as other issues not mentioned here – all of those things can affect your results….. but if you don’t have a plan, you shouldn’t hesitate to go check out your options. You can do it on the government website without actually signing up — there are several “estimators” you can use to check what might be available to you. And don’t forget to check to see if you qualify for a subsidy — for us it really worked out!
Disclosure: I was not paid by anyone to write this article. The information contained here reflects our personal experience and does not presume to know or be able to advise you on yours.