HELP! So confused navigating insurance changes due to pregnancy in Oregon
Thank you in advance to any and all willing to help me navigate this.
Current situation:
Me 30 y/o, pregnant 97405 :
– Employed as a W-2 employee at a private therapy practice that offers sponsored medical and dental on the condition I work 21 billable hours/week- Insurance plan year ends May 2023- Average 64k (can be lower as clients cancel)- Currently pregnant, due to deliver early 2023
Change: January 2023-April 2023: Will take unpaid leave: this will mean I do not qualify for paid insurance, but I can choose to pay for the insurance for me, my child, and my husband through employer.
Husband 42 y/o 97405
:- Employed as a W-2 employee at a private business who offers no health insurance option via employer, thus I pay for his through my employer. My employer covers nothing for anyone but me.- Average 32k (can be lower as work load fluctuates)
So, currently our joint income is 97k for this year. Next year, we will live off of my husband’s 32k annual income for at least three months, and if we continue to pay for the insurance my employer offers, we would be paying:
$403.33×2 for medical for spouse and I$46.50×2 for dental for spouse and I
and then when baby arrives,$1149.50 for medical for spouse, myself, and child$160.05 for dental for spouse, myself, and childSo a total of $1309.55/month for family insurance through my employer> This would be paid for out of a 32k salary, and then reduce in price by $404.33 and $44.71 for my portion when I return to work and be paid by a 97k salary.
This is for the PacificSource Navigator Silver plan with a single deductible of 5.5k, a family deductible of 11k, a single out of pocket max of 8k, and a family out of pocket max of 16k. The same plan with nearly identical coverages but lower deductibles (2500, 1000) is offered as well. Nearly nothing is covered, or with a 30% coinsurance, until deductible is met.
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Here is my question: would we qualify for a tax credit with marketplace insurance if my employer does offer this plan, but does not offer to pay? We will be living on about 2500/mo for three months until I resume my work, which according to the calculation tools online makes us eligible for substantial tax credits and even OHP for at least baby. But from what I have been reading, it seems if there is “affordable” employer based insurance, we wouldn’t qualify for credits. I get the sense that we would be better off getting OHP while we can, then switching to marketplace insurance with a tax credit.
In short: Is there a way for us to qualify for credits or are we stuck paying $1309.55 (1/2 my husband’s income, and nearly a 1/4 of my income, and around 16% of our shared gross monthly income) a month for insurance, JUST because my employer offers it?
Could someone help me clarify if this is possible? I am so confused!