I was recently laid-off and needed to shop for health insurance for my family.
This was complicated by the fact that my wife has an autoimmune disorder and needs access to certain medications, specialists, and labs.
Nonetheless, I was able to find the best healthcare option for my family, so, today, I’m sharing how you can effectively shop for health insurance if you’ve been laid off.
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Michael Lacy 0:00
If ever there was a time where you needed to make sure that you have health insurance, it's during the global pandemic. And sadly, over 44 million Americans have found themselves unemployed over the last 12 weeks. And seeing is how most of us get our health insurance from work. This means that a lot of folks are stuck trying to figure out where to find the best health insurance for their family. So, you may be asking, what are your options? Well, let's talk about it.
Michael Lacy 0:46
Now, the first thing you need to know is that a job loss is considered a qualifying life event. What this means is you have plenty of options right now. But the thing is, you don't want to procrastinate. You probably only have 60 days from your last date of coverage with your previous insurer to get enrolled in a new plan, otherwise, you're going to have to wait for a another qualifying life event such as getting married or divorced having a baby or something similar to be eligible for a special enrollment period. Also, in just in doing this, one of the things that I learned is that a lot of the plans are going to start your coverage on the first day of the following month. So if you register for coverage on June 1, your coverage still starts on July 1 in most instances, and again, that could just be a really bad thing during the global pandemic. So when it came time to really start researching and digging around and finding health insurance for me and my family, the first thing I did was check the cost of my wife's insurance plan. Now, layoffs are considered qualifying life events. So if you're married, you're now eligible to hop on a spouse's plan even better They're not in an open enrollment period. But this isn't always the best option. And it definitely was not the best option in our case. For starters, the cost of a family plan for a teacher in Texas is astronomical, but I'm not going to get on my soapbox and go into how much of a shame that is. Outside of the cost. We were very quickly reminded why I've always just paid the surcharge to have my wife on my plan when I was working. So because my wife has lupus, she has regular specialist appointments. She has lab visits, and she has like a pretty expensive medications that she has to take like on a daily basis. As a matter of fact, in the 45 days prior to my layoff, the cost of everything she needed in 45 days was almost $4,000 before insurance. So making sure everything that she needs is covered is super important to us and it's something that you need to consider As you research your plans as well. So sadly, the plan that the state of Texas provides for teachers didn't cover a lot of her needs. So we were out on this one, like certain medications they wouldn't cover. Her doctor wasn't really a part of the plan, just all this janky stuff, but your situation may be different. So it's always worth it to just check out the details of a spouse's plan, really, before you do anything else. Like that's a great place to start. And in a lot of cases, it'll probably be your best bet, but your research shouldn't stop there. The next thing I did once I realized that that was going to be out. I looked at the Cobra coverage. Now there are some positives and some negatives to Cobra. Like on the bright side, you get to keep your exact same coverage, which means you get to keep your exact same doctors, dentists, everything. And you can also elect to only keep a portion of your benefit elections which that was something that I didn't really know until this time. around. So for example, we decided against keeping the healthcare from our last employer because it was just too like ridiculously expensive. However, we did choose to keep the dental plan as it was really just as affordable if not more affordable than other plans that we found that allowed us to keep our same dentist and all that other stuff. But as I mentioned, the cost can be like way higher with Cobra. And for us personally, the health portion of our insurance plan was like 80% higher than the plan that we ultimately chose. And this is because you know, when you go on Cobra, you're responsible for the entire cost of the insurance premium, like when you're working, your employer covers a portion of it, but when you're no longer working for them, they stopped covering that portion so you're responsible for that entire premium. And Another drawback to Cobra is that you're really only able to have it for so long before you have to enroll in a different plan. And so usually this is like 18 to Or 36 months, something like that. And at that point when it's cut off time, you've got to find a new plan to enroll in. So it's really only a temporary fix. And that was another reason why it just didn't work for us. So yes, it is great to be able to keep the same coverage and get the assurance that you'll have like the same doctors and all that kind of stuff. But Cobra definitely comes with a cost and it's not a permanent solution when it comes to health insurance. If you've lost all of your household income or a significant portion of it, you actually might be eligible to replace your health insurance with Medicaid. And so Medicaid is the low cost National Health Insurance Program for low and no income earners. And eligibility is based on what your projected monthly income so you're going to have to submit what you project your monthly income to be. And so with my wife still earning her salary, we actually weren't eligible for Medicaid. So To be honest, I really can't go into much detail about like, what the signup process is like and everything like that, because we weren't eligible. But if you've lost your job, you should definitely check your eligibility for Medicaid. And you can do [email protected] And there's like a search bar there. And you can just type in Medicaid because there's like a really long URL if he's like trying to put it all in. So you go to benefits.gov. And then you can search for Medicaid, and you can check your eligibility right there. So once we realized that we weren't going to be eligible for Medicaid, we took a look at some of those health share ministries that are really the kind of becoming popular, but the thing was, Taylor has an autoimmune disease, so she wasn't eligible and so that was very quickly out for us. Also, it's important to know that this is called health sharing and although it can keep the surcharges from not having any insurance off your back and you could pay less out of pocket for care and All those things, it's technically not health insurance. But if you're generally healthy, this could potentially be a great option for you. And so what I'll do is I'll be sure to link to a few sites that I really think do a good job based on some feedback that I've gotten from other people. And I'm going to put that in the show notes, which you can find the link for in the episode description down below. Now, my final recommendation is to check on the exchange that's been set up under the Affordable Care Act or Obamacare, as most people know it. And so this is actually where we found the health insurance part of our plan. And I'll be honest, this process wasn't as bad or as expensive as a lot of people say it is like, when we got to this point, I was thinking, Oh, man, this is gonna be a nightmare. Just based on the horror stories you hear from other people and I'm like shoot, we got the specialist in certain labs, and certain Your medications, and it's just going to take forever, but it really wasn't that bad. So what I'm going to do is I'm going to kind of walk you through what our process was for this whole thing. And then I'm going to end it with why we chose to buy the plan that we chose from the exchange. So as I mentioned, Taylor has a lot of very expensive specialist appointments, lab visits, medications, just all kinds of stuff. And so what we did was we laid everything out that we knew that she was going to need from now until the end of the year. Now, you may be wondering why we only laid out what we expected until the end of the year. Well, that's because for our state open enrollment happens in November in December, with a new plan starting January 1. So it made sense for us to project costs from June through December because no matter what we're going to be on a completely different plan by January 1 of next year. So the first thing I did was I pulled out the eo B's from our previous insurance. And then I listed and categorized everything that Taylor has had to get done or do for the last year. And then I created like a calendar so that I could get a good idea of just how often she would need to get, you know, lab visits, how often she'd went to the doctor how often certain prescriptions got refilled. And it really kind of gave me a sense of like, Okay, this is what I can expect to spend, like at a minimum for the rest of the year. And the cool thing about the exchange was I could input every single medication that she takes, I can input the doctor that she visits and I could input the lab that he referred her to, and I could find plans that listed all of those things collectively in network and I think we came up with like six or seven plans that we were eligible for that met all those requirements. And so once I had the plans that covered everything that we needed, all listed out, I laid out the cost of everything that I've just mentioned, like the lab visits to specialists, the prescriptions, all that before insurance. And I got that from my EOB. And the reason I did this was because some plans were paying a percentage after we hit a deductible. And then some were paying just a flat copay for each visit for each prescription, and all those. And so what I wanted to do was look at the total cost, and then go through and based on what I knew we needed to do figure out a total cost that we would have to spend for the rest of the year. And so from there, I went item by item calculating and listing the cost of each item for every plan that met I need, and I'll be honest, there's probably a better way to do this. But because I was laid off mid month, I really only had like two weeks to figure it out in order to have us insured by June 1. So I didn't want to spend time trying to like look for a tool and wasting time and potentially not finding something. And so I just decided to do everything myself. I mean it It's not like I had to work or anything like that. And so here's what it looked like, let's say a specialist visit under a certain plan cost $90. And I know that Taylor has two scheduled visits left for this year. So my minimum cost will be 180 for the specialist visit under that particular plan. And so I did that math for specialists labs and the prescriptions for the six different plans for the remaining six months of the year. And what this did was allow me to get a true baseline for what I could reasonably expect to spend this year under every single plan that was a viable option. And thank goodness, there was only six and not like 30 of them.
Michael Lacy 11:41
And I'll be honest, I was really surprised to see that it was the third most expensive plan in terms of premium out of the six plans that were listed, that actually had the lowest expected cost for us once I had laid everything out. And so having this ability to just check everything we needed and really get into kind Take my time over those two weeks to really make sure that the numbers are right. It's going to end up saving us like a ridiculous amount of money over these last few months of 2020. Which is great because I ain't got a job man. So like, so we're now insured with this company called Oscar and we're on a great plan and allows my wife to keep everything to the same. One of the cool things that I really liked about Oscar too, they have this like, they give you like a daily step goal and you sync it with, you know, your step, tracker or calendar or whatever. And every day that you hit the step goal, they give you $1 so that's kind of cool a way to knock off some of the cost of the premium. I thought that was like a nice added little benefit. They also give you stuff like the peloton membership for like 90 days for free, and just all these little perks that they try to do to get you to live active and healthy lifestyle which was very encouraging and not something that we saw or got from some of the other plans that were out there. There. Now, as I mentioned, we did keep the demo portion from my Cobra plan. And, truthfully speaking, I couldn't be happier with the choices that we made. But here's what I want to say what's best for me and my family may not be what's best for you. So like, you know, we kept the dental Cobra and found healthcare on the exchange, but yours may be a Christian health care ministry and you go find a separate dental plan somewhere else like, I don't know. But that's why I didn't want to just share like what we did. But I also wanted to give you some things that could help you or that could point you in the right direction so that you can do research for your family, if you find yourself laid off and are, you know, in need of health insurance and all those things. And so to recap, if you've been laid off and you're in need of health insurance, you do have a few options. First, you can switch to your spouse's plan. You can sign up for Cobra coverage, you can apply for Medicaid, you can check with It's one of those health sharing companies, or you can hit the exchange and sign up for Obamacare. And honestly, my recommendation is that you really do research and kind of take a look at all of them, because based on others experience, I never would have guessed it like the third most expensive plan on the Obamacare exchange was the best plan for our family. But I'm glad I did that level of research. And then I got it right for us. And so I'm sure that there are other options out there that I may not be aware of. And if you know of some Feel free to hop in my private Facebook community and share I'd love to learn more about this and learn what other people have done during this time. And but you can find the group over at winning to wealth comm slash teammates, that is winning to wealth, comm slash teammates, and again, I would just love to learn more and we've talked about this in the group. Other people are worried that if they get laid off, like what are they going to do so if you have some other recommendations, feel free to swing by the community. Let us know what You've found or what you've been able to do. Also, if you found this info to be helpful, please do hit solid and consider leaving a five star review on Apple podcasts. It's going to help the show grow and helps people see that hey, you know what we do put out good, valuable content and this is something worth listening to. But hey, that's all the time I have this week. So until we talk again, keep racking up those wins one at a time. Take care
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