I don’t know any couples that carry their own insurance. The cheaper or better (depending on your priority) insurance is chosen to cover both/family.
Dh worked for a Fortune 200 company and we had high deductible plan. I think $7500pp. Retired at 59 and currently have Cobra at $2400/mo. Need to go on the exchange next year and anticipating that cost goes up. We need to go back to paying drs directly for service and make catastrophic insurance available again.
ouch - $30K a year. That’s scary.
Wouldn’t $7,500 deductible be similar in concept to catastrophic insurance?
That’s what most plans are today - and what qualifies for an HSA (to which some companies put money in - mine gives me $1K).
If the employers cover the employee at no additional cost, but have significant upcharges to add a spouse and little or no rebate for waiving coverage, it may be least expensive for both spouses each to take their own employer’s coverage.
Exactly. My son’s company essentially provides employee-only at little cost (0 cost for low income employees and $100/mo. for upper income folk). It’s a HD plan, $5k if I recall. But since it’s essentially “free” it’s a reasonable deal for employee-only. However, adding dependents comes with a large increase in monthly costs.
His wife, OTOH, is in a family-friendly company which covers child dependents with a small monthly increase. (Adding spouse costs much more than adding children.). So they split the insurance: son gets his thru his employer as ee-only, and his wife covers herself and the kids.
The net is less costly than choosing one employer or the other.
I don’t doubt what you’re saying. I just don’t know anyone personally (well my friends, who I’ve had these conversations with) who have separate plans.
I don’t think so. It wasn’t like we chose that plan; that’s what the company offered. To me catastrophic would cover serious accidents or expensive diseases such as cancer, true catastrophes that could wipe a family out. So a much higher deductible and much lower premium. Our $2400 for a $7500 deductible (ironically dh was employed by an insurance company) is a joke. Even pre-Cobra he was paying around $600/mo for the same deductible. We would’ve been so much better off not being insured and banking the $600 a month. We never got remotely close to that deductible. But the fear of an accident or diagnosis of an expensive illness kept us paying. We haven’t taken that option off the table in the future - know some couples that are rolling the dice. Thankfully we are healthy and aren’t on any meds. Just have to hope and pray we stay that way a few more years!
Yes, my husband’s company was the same. We added the max allowed for the last few years, but once you’re retired you can’t do that anymore.
We paid/I pay now as H is on Medicare similar to what you pay on COBRA. Mine is half of what you pay and together last year it was what you pay as a couple. In case I wasn’t clear.
The difference is the deductible. Instead of a family deductible it was individual. $10,000 per person.
I would argue this is the catastrophic plan.
Next year I go on Medicare April 1 
The problem is that you don’t know when you will have that catastrophic event.
It’s not something you can plan on
My D didn’t plan on cancer at 32. My husband didn’t plan on an autoimmune disease in his late 30’s. A heart attack before he was 50. Ruptured discs that same decade. Being the carrier of my D’s cause of cancer and having to get preventative care.
I’ve been lucky but that could change today or tomorrow. Or when I’m 90
H and I had had separate plans for a few years. His insurance would allow him to have the kids on it but since I COULD get health insurance through my employer they would not accept me on his plan. Initially they did - I had to submit a letter from my employer saying I was part time and insurance was not covered or was only at a high fee - and his org let me stay on his with the letter. But then I became full time and while I still had to pay a monthly portion they no longer would let me be on his plan.
H and I had separate plans until I had our second child. It was cheaper to have 3 deductibles than pay for family. After our second, there wasn’t an option for single plus kids, so that’s what we did. This was 25 years ago, but my employer still doesn’t care if the spouse can be insured elsewhere. Adding the spouse is where the premium jacks up. Kid isn’t that bad. Even now that it’s just me and H, it’s not much cheaper than the family rate
I also hadn’t heard of the baby rule. We informed my employer that the baby would be covered and then they were added within a certain number of days. This was 25 years ago.
Insurance companies have made a killing off of my family. There have only been 1-2 years where what they had to pay to cover surgeries and wellness care excess the premiums paid by me and my employer. Usually we overpay by $20K or so. And those couple of years the difference was <$10K
Medicare for me on July 1. Time is dragging…
It was a story on the news of how they had a baby who ended up in the NICU ($$$) and they submitted to mother’s insurance and it was paid, but then they were told it had to go thru the father’s so it was backed off the mother’s and the father’s was disputing or hung up or something, so the family was getting late notices and everything wouldn’t be paid.
It seems wrong they couldn’t pick which plan they wanted to add the child to.
Disagree. That is the whole point of the birthday rule, to eliminate people choosing, particularly employers’ plans. Otherwise, every time a newborn has a medical issue requiring a longer stay, both insurers/employers would point the finger at each other.
But why shouldn’t the family get to pick which plan they want, maybe what covers more or costs less? The family should be able to pick which plan they want to add the child to, and pay for that plan.
Why should that mother be penalized if her plan is better and costs less, just because her birthday is later in the year? And what if the father refuses to pay the cost? I spent 90 days in the NICU and saw all kinds of family situations. My sister was not married to the father of her children and her insurance was much better than his, but his name was on the birth certificate. I think my sister’s didn’t cost anything or much to add the children as she was on a union policy and his was a small employer’s (not so good).
Common sense, making sense and laws don’t always go hand in hand together
Doesn’t the “birthday rule” only apply when the child is covered under both parents’ insurance plans?
So if parent A has self + kids insurance, and parent B has self only, then wouldn’t parent A’s insurance cover any kids (including a newborn), regardless of the parents’ birthdays?
That would make sense—we never had to sort the issue out. Both my insurer and H’s insurer were the same and had great benefits—his from fed govt and me from state. We had dual coverage, as we both had family plans for nominal cost and then I left workforce for several years until the kids were doing well in grade school.