Insurance is INSANE: Advice Needed
Thanks in advance for reading, really need some advice ASAP.
TL;DR: How can I get adequate insurance for cheap? Losing my insurance next month and need it for necessary medication.
I am a type one insulin dependent diabetic with epilepsy. If I do not have access to my meds I'll simply die. I have a full time job, married to my wife who also has a full time job. I'm 25 turning 26 late next month. I've been on Medicaid for a few years, including a year when I was making considerably more than I am making now. A few months ago we were trying to get my wife insurance through her job, which was denied because she was 'eligible for state insurance' and there is no 'life event' to enter outside the enrollment window. We went to the local DHHR office and asked if there would be any effect on MY insurance if we applied for her to be insured. We were told that there would be no effect, just an approval or denial letter. About a month later we received letters stating that we were BOTH denied coverage, this was about a week ago. She has not had coverage for about a year and mine is ending on the first of next month. We were both denied for the same reason: 'your income is above the income limit for this type of assistance.'
My minimum expected income by the end of the year: $19,548
Wife's minimum expected income by the end of the year: $26,400
There is clearly some margin for error, so I'm assuming we fit into the 200% or 250% of the FPL. Calculated using this website.
DHHR said that there is basically nothing they can do for us. We do not qualify for any assistance. They recommended the meta website for health insurance coverage, Healthcare.gov, but after going through the application process, it shows the most outrageous plans. I'm going to break it down a bit as it seems there are a couple ways to go about it. We can get covered jointly or we can get covered individually. Also a third option, going for long term coverage for me, short term coverage for her through another website/company, but I read that it's expensive to do so. We do however qualify for a tax credit of $525 if we file our 2024 taxes jointly.
Joint Coverage: The least expensive plan for us is $506.61/mo with a $17,800 deductible.
My Individual Coverage: The least expensive plan is $256.31/mo with an $8,900 deductible.
Wife's Individual Coverage: The least expensive plan is $250.30/mo with an $8,900 deductible.
We live below our means and are just making it out of living paycheck to paycheck. We don't vacation, we don't call off, we're never late to work. So, I really need some fucking help here, if anyone can offer any advice on navigating this mess.
How can I get a higher tax credit? Seems worthless to lie about my income, as I'll have to pay it back at the end of the year.
How is it possible that the cheapest coverage costs so much? Don't we all pay into it from our 9-5's?
Why do people call any of this good? My coverage wouldn't even start until August 1st.
What changed from last year or the year before that would have effected my coverage? I've had Medicaid for at least five years. The DHHR told me that the limits for income change frequently, but it doesn't seem logical that I would make more money and pay less, really pay nothing, for my coverage. Now that I make less, I'm supposed to pay more? The cheapest plan for just myself is 250% more than what I've had previously.
What countries could we avoid these issues by emigrating to?
There is absolutely some subtext about being grateful to even be offered aid. With all the atrocities and problems plaguing other parts of the world, other parts of the country, it really seems trivial to think I've been paying nothing but what's taken out of my taxes for coverage. I appreciate the fact that we have systems in place to afford people like me appropriate healthcare — I'm just pissed that the system frankly sucks for air. I will not be able to pay the out of pocket costs for my medication while paying other bills. We are both on the path to switch careers which should solve some of our financial problems.
My plan going forward is to call the healthcare people, Blue Cross Blue Shield, whoever, and see what they can do. I'll ask them these same questions and see where it gets me. There must be a solution beyond limiting all factors of our privileged existence. Then, I'm going to reach out to her job and tell them she has been denied coverage, hopefully there is a plan for us with them now that we fit back into their requirements, or you know, their reason for denial being null. $506 for a married couple's insurance is insane but I'm sure we'll dig it out of our couch cushions. IF this is really the best deal then so be it, but I'm going to need a senator or some big wig to mail a few letters to regarding all this. I appreciate you for reading, even if you don't have any advice. I hope your journey through our health insurance system is less complicated and more forgiving.
submitted by /u/ZenNihilistAye
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