Desperately looking for guidance for Health Insurance

I work at an employer in Florida that has always had expensive insurance. I make $85k a year and my wife work PRN and makes about 55k a year. Since she's PRN, she can't get health insurance through her work. For the past few years, my kids and I have been on my insurance plan through work, and my wife had a plan from healthcare.gov. We've always paid AT LEAST $1000 a month for health insurance which just seems incredibly high. Last year my kids and I paid $578 per month for insurance and my wife plan through healtcare.gov was $475 per month so $1,053 total for the family.

Well, last year, my wife was pregnant with our 5th child, and we were encouraged by multiple people (friends and family), including my employer, to sign my wife up to my works family HMO plan, because it would keep birth costs low even though it would be more expensive monthly, that the low cost of the birth would make up for the higher monthly payments. Which, I think it did, we only ended up paying like $400 for the birth. The problem is that the family HMO plan (Florida BlueCare 60) is costing us $1,336 dollars per month. That's the same as my mortgage.

Summary of Benefits and Coverage

The kicker is that I have an 8-year-old with severe special needs and while he's been relatively healthy for the past 3 or so years, there's always that chance of an ER visit or hospitalization.

What drove me to come to you guys is that last week, we had a trifecta of misfortune. We're trying to get my son with special needs on growth hormone for cognitive benefits so he had to have some labs drawn and an Xray of his hand ($275 cost to us), my oldest got diagnosed with a heart murmur (thankfully it came back as an 'innocent' heart murmur which fixes itself so nothing to worry about) but he had to have an echo done ($275 cost to us), and my wife broke her pinky toe which meant having to get a walking boot and imaging done (so far $550 cost to us, with another $626 bill pending with insurance waiting to see how much we're going to need pay for that one).

See also  Went to a hospital in network owe hundreds more ! Any advice to get the bill down ?

Can someone help me make sense of this? I know next to nothing about health insurance, but I just don't understand how I can be paying $1,336 a month for health insurance with the salary that my wife and I are making, while still having to pay what's probably going to end up being $1,350+ for these appointments last week.

Any information or guidance would really, really, REALLY be appreciated. Especially if we should be looking elsewhere for insurance. Thanks.

submitted by /u/Fastball48
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