D1 just turned 25. She is still on my employer-provided health insurance. However, that insurance pays only for coverage at certain providers in my state, and D1 lives 1,000 miles away. I’m wondering whether it makes financial sense for her to buy insurance that will cover more things in the state where she resides. The cheapest ACA plan seems to be approximately $325 per month, with a $6,000 deductible. D1 is healthy and I think it might make more sense to pay for health care on an as-needed basis. Any thoughts? Thank you.
What is the plan if her appendix comes out or if she is in a car wreck as far as the inevitable $10K bill from the hospital? If she has that laying around then awesome. I can’t tell you how many young adults I’ve seen who dropped coverage and then have an emergency come up that literally wipes them out financially.
Edited to add: I hope my response is ok…it looked like you were considering advising her to drop coverage entirely?
I do see lots of people purchase high deductible plans and then just elect to pay for any routine care (cough, flu, etc.) out of pocket. Most offices have a reasonable cash pay rate.
Does your plan cover emergencies that occur in another state? Probably it does. I doubt that your insurer would be able to get away with saying, Whoops, you should have planned to have your car crash at home, not when you were on vacation. We’d don’t cover emergencies that happen out of our area.
So assuming that it covers emergencies, she’d probably be better off paying out of pocket for urgent care if she needed it. She’d have to move back to your state if she developed some condition that needed continuing care, though.
It’s only for a year. Next year she turns 26 and has to buy her own insurance.
I’m definitely not planning to drop her from my insurance, @carachel2. The question is whether she should have two plans. My plan covers her for emergency room visits to out of network providers but not for hospital care. So I guess the issue for me is whether to pay an additional $300-plus per month for the peace of mind that I won’t be wiped out financially if she has a bad accident and then must be admitted to a hospital in her current state of residence.
I assume you looked at ACA plans in the state she lives in now? We are able to insure my 21 year old college student for about $200/month with a much lower deductible, and have done so in 2 different states for about the same cost (I moved last year, hence purchasing in 2 states over the past couple of years). But I know some states are higher, and maybe your D’s slightly higher age makes a difference. In any case, it has worked well for us to have an ACA plan for her.
In our state, a Kaiser plan under ACA for someone that age costs around $200/mo for basic coverage - so a bit like intparent’s.
A little-known provision of ACA is that individuals under age 30 can buy catastrophic-only insurance. This means that she pays out of pocket for office visits and routine tests, but is covered in the case of unthinkable, “catastrophic” health events like cancer, extended hospitalization, paralysis, etc. Catastrophic-only health insurance is inexpensive.
I wish I could buy it. I’d rather pay out of pocket for routines visits, have a lower premium, and just be covered for potentially bankrupting events.
I’ll have to ask her more about her expected income for the year (to see what the subsidy would be). In California, she was paying in the high 200s for a plan; the least expensive one where she is on the east coast seems to be at least $300.
Does her employer offer a plan? If so, she is not eligible for subsidies.
I don’t see that a catastrophic plan, as a second plan, would make sense for carachel’s daughter. She already is covered by carachel’s plans for catastrophes.
I just looked at the website again, and there are catastrophic plans available. Thanks, everyone, for leading my brain in this direction! I’ll suggest that she get such a plan.
I meant as her only plan. It would likely be the most cost effective option.
By the way, for anyone interested . . . catastrophic-only plans are also available to individuals (and individuals with families) over age 30 for whom the cheapest available regular plan would amount to more than 8% of their income (MAGI – modified adjusted gross). Actually, it might be 8 and some fraction, but I can’t remember what it is.
Yeah, as a sole plan catastrophic could make sense. Catastrophic plans are little different than the Bronze, though, which means they often have premiums not much lower than Bronze premiums.
Pay on an as needed basis? Really?? My very healthy 26 year old had an injury last year that cost more than $100,000 in medical costs. Her $5500 deductible was a bargain…and so was her $275 monthly premium.
When she moved to another state, she got another plan in that state. Her plan here covered emergency room anywhere…but not any care beyond that. Make sure you read her current plan carefully if you keep it.
My kid does not qualify for a subsidy.
I don’t think i can drop her from my current plan now in any case. So I’ve recommended to her that she buy an ACA plan.
I have a friend who had a HMO that covered his kids when they were in college. Two of his three kids ended up needing emergency medical treatment. The HMO refused to pay, since the kids were rushed to the nearest ER instead of the participating/preferred HMO facility. The resulting medical bill was higher than tuition & he had to work with the providers to try get a payment plan and any reductions he could get! After that, he bought the medical plans for each college for each of his kids, so the emergency medical treatments after that were all covered by the university insurance plans.
If she has moved to another state, that is a qualifying event.,she can buy health insurance in that state.
When she does so, you WOULD discontinue her on your plan.
By the way, I hope I don’t seem like I don’t want my children to be taken care of. It’s just that money is tight now. I pay all the household expenses and would like to be able to continue to help my children with things like health care costs, because they live in an expensive city. My soon-to-be ex-spouse is not likely to chip in for anything for anyone other than himself.
If she is eligible for subsidies, a Bronze plan, or even a Silver plan might end up cheaper than catastrophic. If she’s buying an ACA plan with subsidies, she should look hard at Silver. It turns out that for people with income less than 250% of poverty (about $30K/year for a single person), Silver plans have secret lower deductibles and lower copays. (Not really secret, I mean, but it’s not widely advertised.)
We kept S on our health plan until he aged out at age 26. We kept D on our health plan until she aged out at 26 as well. I see no down side to allowing them to stay on our insurance plan, as it has excellent coverage and doesn’t affect the premiums we pay much whether they are on or off our plan.