Should I go full time to get insurance through my workplace, or take private health insurance with "tax credits" and "Lower out-of-pocket costs"?
In a previous post I got lots of advice. https://www.reddit.com/r/HealthInsurance/comments/16fthyp/about_to_lose_minnesotacare_due_to_my_income/
I’m posting again because I have the opportunity to go full time at work and receive their fulltime insurance.
Ideally, I don’t want to go full time at work. I work part time because my wife is disabled and it gives me more time to take care of her needs. Going full time will allow me to bring in more money, however it will have the impact of me not being around as much. She’ll still be safe and have her needs taken care of, but her wants may have to take a hit.
She receives SSdI and has her own insurance through the state, so she will not be on any of these options I chose.
My other option is to stay part time and take private health insurance through MNsure. I’m eligible for:
An advanced premium tax credit amount of $227 /month.
Cost-sharing reductions, which lowers the amount you pay for out-of-pocket costs like co-insurance, co-pay and deductibles.
Focusing only on the silver plans: I’m looking at plan in the range of $140-$248 a month. These plans are from Medica, Ucare, Blue Cross Blue Shield and HealthPartners.
Their yearly deductibles range from $1750 to $3400. Their Out of pocket max range from $6200 to $7250.
Plan Types are PPO, EPO and HMO.
If anyone needs more information to help me make a decision, I can post more details or screenshots of the plans.
The full time plans at work are:
High Deductible Health Plan with Health Saving Account (HSA)
Low Deductible Plan (no HSA)
The high deductible plan offers a $2.5k in network deductible ($5k out of network). No copays (must reach deductible). My employments center for heath visits – Free preventative care, labs, and wellness coaching. $20 sick, physical therapy and behavioral health visits. $5k out of pocket max in network (8k out of network). Preventative care meds are 100% covered, the rest must reach deductible. It has a HSA.
This will cost me $60 per paycheck every 2 weeks. However they have a program that if I do certain things regarding my health, I can get that down to as little as $30.
The low deductible plan offers $1k in network deductible ($4k out of network). Copays: $75 primary care, $150 specialty care, $75 urgent care + 20% coinsurance, $300 emergency room visit + 20% co insurance. All visits and labs at my employers health center are completely free. Out of pocket max is $3k in network ($8k out of network). Pharmacy’s copays: Generic $10, Preferred brand $35, non-preferred $60, specialty 20% (up to $200). No HSA allowed per IRS rules.
This will cost me $100 per paycheck, but could go down to $66 next year if I compete all the health tasks.
There’s a lot of language in here that I’m unfamiliar with. I kind of get the idea of a HSA, but don’t understand it fully. I don’t know what coinsurance is and have been pronouncing it coin-insurance. I’m still learning, but currently don’t know enough to decide which direction to go. I feel that my work plans offer the best value given their deductibles are lower, however there’s lots of variables I don’t understand.
Personally I’m fairly healthy, no conditions. I currently take zero medications and visit the doctor when I need to for temporary things that come up.
The main decision I need to make asap is if I should take my employers insurance (if so which one) or take a private plan with discounts through MNsure. If it’s deemed better to take the MNsure plans, then I’ll call MNsure and have them help me decide which.
Thank you so much for taking the time to read.
