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Message
Any way to switch insurances mid-year and carry deductible over?
Posted on 6/28/24 at 10:01 am
Posted on 6/28/24 at 10:01 am
My wife is ~6 months pregnant and I just hit her deductible for the year. Of course, I've decided to take a new role at a new company where I'll start from scratch on the year. Any chance I can carry her deductible over?
The good news is both plans are with Cigna.
The good news is both plans are with Cigna.
2
Posted on 6/28/24 at 10:04 am to thegreatboudini
Can you pick up COBRA to cover her through the next 3 months? Probably a lot cheaper than a reset deductible.
Posted on 6/28/24 at 12:23 pm to Bestbank Tiger
quote:
Can you pick up COBRA to cover her through the next 3 months? Probably a lot cheaper than a reset deductible.
This is what we did last year with my wife. Carried over her previous plan paying cobra because her deductible was $250 and met it (with low OOP max). The new plans at her new work had much much higher deductible/out of pocket maxes or were very expensive for her for the low deductible (like $525/mo). When ran out the numbers it made more sense to pay cobra for a while than move to a new plan with the baby on the way. Not to mention the trouble of going through making sure all the doctors/hospital and stuff were all also covered under the new plan with the baby on the way.
We moved her to her new insurance Jan 1 this year, put the baby on her cobra plan since she needed surgery too towards end of last year with the low deductible again. When we stopped paying cobra after December last year it was a "change event" where she could still go on her new plan Jan 1 of this year even though she was at this new job for a while last year. I was on a high deductible plan with HSA where I just reimbursed all the baby expenses basically since we're married.
This post was edited on 6/28/24 at 12:27 pm
Posted on 6/28/24 at 3:41 pm to thunderbird1100
quote:
We moved her to her new insurance Jan 1 this year
OP would need to determine when his insurance is able to be renewed also as if its through the employer he may only be able to do it during open enrollment. Now with a baby, you can likely do something at that point also.
I don't think I'd do Cobra for a pregnancy, if there is something like a complication that requires an extended hospital stay for mom I wouldn't want to be paying Cobra and not regular insurance, personally.
But a lot of that depends on what plans and what not OP has available.
Posted on 6/28/24 at 3:56 pm to thegreatboudini
What's the new deductible and how much would you pay if you went the Cobra route?
Posted on 6/28/24 at 5:42 pm to La Place Mike
Cobra sounds like an interesting route that could save me some money.
The plan I'm on right now is an HDHP with a 3.5k deductible. This is what I have already met.
New plan is a PPO, with still a high deductible at 2k.
I don't have all the cobra details, but I believe it's between 400 & 500/m.
Due date is late October, so I would be paying cobra for at least 3 months.
Ideally I could contact Cigna and have them say my deductible is already met for the year to save me that 2k.
The plan I'm on right now is an HDHP with a 3.5k deductible. This is what I have already met.
New plan is a PPO, with still a high deductible at 2k.
I don't have all the cobra details, but I believe it's between 400 & 500/m.
Due date is late October, so I would be paying cobra for at least 3 months.
Ideally I could contact Cigna and have them say my deductible is already met for the year to save me that 2k.
Posted on 6/28/24 at 5:48 pm to thegreatboudini
quote:
400 & 500/m.
For and individual or a family? Even for an individual that sounds low.
Posted on 6/28/24 at 6:04 pm to baldona
quote:
don't think I'd do Cobra for a pregnancy, if there is something like a complication that requires an extended hospital stay for mom I wouldn't want to be paying Cobra and not regular insurance, personally.
COBRA is regular insurance.
The 1996 Combined OmniBus Reconciliation Act allowed people to keep the insurance from a previous job for up to 18 months. Benefits are the same. Difference is on the premium side. You pay the full amount instead of the employer subsidizing a portion.
Even with complications it might still be better to go COBRA. For example, if the premium is $500/mo and you pay it for 4 months that's only $2000. Whereas resetting the deductible might mean $5000 out of pocket before the insurance starts paying and another $5000 to reach stop loss. If there are complications you want to have the insurance where you already maxed out your OOP.
Posted on 6/28/24 at 6:24 pm to La Place Mike
Individual.
Posted on 6/28/24 at 6:27 pm to thegreatboudini
How long before she can enroll in the new plan?
Posted on 6/28/24 at 6:36 pm to La Place Mike
July 8th is start date, so we would have both new and old plan coverage for the month of July starting on the 8th, cobra for the old plan would kick on in August if we went that route.
This post was edited on 6/28/24 at 6:37 pm
Posted on 6/29/24 at 9:13 am to baldona
quote:
I don't think I'd do Cobra for a pregnancy, if there is something like a complication that requires an extended hospital stay for mom I wouldn't want to be paying Cobra and not regular insurance, personally.
I’m pretty sure the benefits afforded under cobra are exact same as what you had through work, with the difference being the cobra premium is essentially full price as you lose the employer subsidized rate.
Posted on 6/29/24 at 10:07 am to thegreatboudini
quote:
Cobra sounds like an interesting route that could save me some money.
The plan I'm on right now is an HDHP with a 3.5k deductible. This is what I have already met.
New plan is a PPO, with still a high deductible at 2k.
I don't have all the cobra details, but I believe it's between 400 & 500/m.
Just because you met your deductible doesn't mean you hit your Max Out OF Pocket, in fact you likely have not. Sometimes those are the same, but rarely. For a HDHP your Max out of pocket could be $25,000 or even $50,000.
It could be $5,000 it could be $2500, but usually HDHP have high deductibles and high Max out of pocket.
How much is your wife paying now? monthly? Again, you have to figure out when you can add her to her new insurance. You maybe paying Cobra until the 2025 open enrollment which could be November.
Posted on 6/29/24 at 10:10 am to 632627
quote:
I’m pretty sure the benefits afforded under cobra are exact same as what you had through work, with the difference being the cobra premium is essentially full price as you lose the employer subsidized rate.
You are correct, the healthcare benefits are the same. But what I'm implying and don't know, but this is an insurance company. If her renewal comes up Jan 1 and she just had a baby, its very possible they don't renew her. Then OP is going to have to find a new insurance company with post partum wife.
Posted on 6/30/24 at 9:23 am to baldona
quote:
You are correct, the healthcare benefits are the same. But what I'm implying and don't know, but this is an insurance company. If her renewal comes up Jan 1 and she just had a baby, its very possible they don't renew her. Then OP is going to have to find a new insurance company with post partum wife.
I believe they’re legally obligated to offer cobra for a minimum amount of time… 18 months IIRC
Posted on 6/30/24 at 5:06 pm to baldona
quote:
For a HDHP your Max out of pocket could be $25,000 or even $50,000.
No, the max out of pocket could not be $25,000 or $50,000 for an HDHP! Let’s try to do a little basic research before winging it, OK? No need to scare this guy with false information.
IRS Announces 2024 HSA and EBHRA Contribution Limits, HDHP Minimum Deductibles, and HDHP Out-of-Pocket Maximums
quote:
For 2024, the minimum deductible on an HDHP is $1,600 for an individual and $3,200 for a family. The maximum out-of-pocket expenses allowed are $8,050 for an individual and $16,100 for a family.
Posted on 7/1/24 at 8:47 am to thegreatboudini
quote:
Individual
How can it be an individual plan if your wife is covered as well? That doesn't make sense to me
I also agree that the $500 seems extremely low. How much are you paying per month in premiums?
Posted on 7/1/24 at 1:34 pm to Jag_Warrior
quote:
No, the max out of pocket could not be $25,000 or $50,000 for an HDHP! Let’s try to do a little basic research before winging it, OK? No need to scare this guy with false information.
Ha my bad I honestly am shocked a HDHP is that low. That’s frankly ridiculous imo and one of the cost issues with insurance. There should be HDHP for young people with MOP of more than that as catastrophic coverage. It’s not that hard for someone under 30 to pay off a $30,000 bill if they want to take the risk on a smaller premium.
Given all that, touché on the proper information but I’m not sure $16,000 is really much different than $25,000.
He still needs to consider that his $2,500 deductible is not the most important number here.
If he adds a baby with the HDHP plan that cost is going to be very high the first year also.
Posted on 7/2/24 at 9:10 am to baldona
quote:
Given all that, touché on the proper information but I’m not sure $16,000 is really much different than $25,000.
I’m really not trying to give you a hard time, but in my world (index options business), a delta of 56% is a very significant difference.
quote:
It’s not that hard for someone under 30 to pay off a $30,000 bill if they want to take the risk on a smaller premium.
Sorry, but I cannot agree with that opinion. I don’t see it being “not that hard” for a young family to be able to pay off a $30,000 bill, medical or otherwise, without it putting a strain on their budget.
Posted on 7/2/24 at 10:51 am to baldona
quote:
It’s not that hard for someone under 30 to pay off a $30,000 bill if they want to take the risk on a smaller premium.
Have to agree with the guy above here, you're telling me the age group with student loans, probably a car payment and are likely not close to maximizing their income still in early career stage can "easily" pay off a $30k medical bill? No way in hell for most people. That would be a gigantic strain for just about any mid-late 20 something.
quote:
Given all that, touché on the proper information but I’m not sure $16,000 is really much different than $25,000.
$9,000 is a huge difference for probably 4 out of every 5 people.
This post was edited on 7/2/24 at 10:51 am
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