Health insurance options for unemployed in NYS
September 18, 2013 11:16 AM   Subscribe

I'm temporarily unemployed in NYS. My wife's a grad student, and her college provides health insurance for the two of us for about $7500 for the year, paid up front by the end of September. That's $2500 for her, and $5000 for me. We can afford it, but it seems very steep. Can the hive mind suggest any alternatives? Amazingly, this seems like the best deal I can find.

We're promised a pro-rated reimbursement if we find an alternative before the year's out. I'll have a job before then, so at least there's that.

There seem to be cheaper plans for self-employed people, but I think I'm not eligible, being simply unemployed at the moment. The freelancer's union says that you need to have earned $10,000 from freelance work in the last six months to eligible, and NYS has similar requirements for its self-employed health insurance program.

It's confusing that the NYS health exchange opens October 1, the day after the deadline for buying insurance through the university, but I doubt the options on there will look any better.
posted by Estragon to Health & Fitness (14 answers total) 2 users marked this as a favorite
When I got laid off, I did a program called Healthy NY. You get subsidized health care, but you do need to pay a monthly premium. When I did it, it was about $300 per month, but I have a pre-existing condition that requires medication every month, and I'm always scared something will happen to me, so it was worth it. Beside, that was like one week of my unemployment benefits, so I could afford it. See if you're eligible: For what it's worth, I thought my Healthy NY coverage was good and co-pays were reasonable. You can choose which insurer you go through. I did Independent Health because at the time it was the cheapest.
posted by AppleTurnover at 11:21 AM on September 18, 2013 [2 favorites]

$7500 for a year's worth of insurance for two people is actually a pretty good deal; you're probably not going to find a better price for better coverage (or worse coverage, even).
posted by ThePinkSuperhero at 11:23 AM on September 18, 2013 [2 favorites]

$625 a month for two people isn't that bad (I pay $300 just for myself,) but you may want to see if you might be able to qualify for Medicaid-managed care. I have no idea how it would work in a married couple where one person is unemployed and the other is a student, but it may turn out favorably.
posted by griphus at 11:36 AM on September 18, 2013

(I qualified for it when I was working part-time and in school part-time.)
posted by griphus at 11:37 AM on September 18, 2013

You can actually look at NYS marketplace estimates now. I can't remember how I got to it but I found an official excel file where you could punch in your info, find out how much of a subsidy you could get and look at costs of different policies. It was really helpful. I'm on my phone now but will link it if I can find it.

Also Healthy NY coverage ceases Jan 1 because of the all the new ACA/marketplace stuff.
posted by greta simone at 11:47 AM on September 18, 2013 [1 favorite]

What's the maximum out of pocket? What's the deductible, co-pay? What's the coverage? If it's pretty broad coverage with a deductible of say, 500, and a maximum out of pocket under about 2500 each, that's not bad. I picked these numbers out of the air, but I'm paying 500/ month for a 250 deductible, copay of 10 in-network, 20 out-of-network, max out of pocket is @ 5000, I think. It covers prescriptions and my therapist, so I'm staying with it for now.
posted by theora55 at 12:02 PM on September 18, 2013

I would call the college and explain the situation, particularly if you know exactly when you'll be employed next. You may be able to use the college's plan only for the few months you'll be unemployed, and only pay those months. Explain that $7,500 is a lot to come up with in 11 days. Maybe you can work out a payment plan if they won't budge on that (to be paid off with your pro-rated refund later).
posted by tckma at 12:02 PM on September 18, 2013

You can actually look at NYS marketplace estimates now. I can't remember how I got to it but I found an official excel file where you could punch in your info, find out how much of a subsidy you could get and look at costs of different policies. It was really helpful. I'm on my phone now but will link it if I can find it.

Yeah, this. We pay about the same as you guys as a fairly low-income couple for insurance through Healthy NY. I did the same excel spreadsheet mentioned by greta simone and our premiums are going to go down to anywhere between nothing and two hundred dollars a month thanks to subsidies. Go socialism!
posted by PhoBWanKenobi at 12:12 PM on September 18, 2013 [2 favorites]

Here's the spreadsheet.
posted by PhoBWanKenobi at 12:19 PM on September 18, 2013 [2 favorites]

Another factor: to my understanding, while the state health insurance exchanges open for enrollment on October 1st, they will be enrolling people for plans that start on January 1st, not plans that start immediately. I would suggest you double check to make sure that's valid for NY, though.
posted by needs more cowbell at 12:47 PM on September 18, 2013

What level of coverage do you expect to need? Do you have any chronic conditions? What were your healthcare costs last year?

If you are both young (under 30) and healthy, the "catastrophic" tier of plans is very likely going to be cheaper than what your wife's college is offering. However, it doesn't cover anything except total disasters, so make sure you're comfortable with that level of risk.
posted by tinymegalo at 1:28 PM on September 18, 2013

Response by poster: Thanks for the suggestions, everyone.
posted by Estragon at 11:29 AM on September 19, 2013

I'm with tinymegalo. While between jobs at the moment, I have some high deductible insurance ($5k, I think), basically to cover me if some drastic injury occurs. This time, I got it through my alumni association. Once before, I went directly with BCBS. Plans around $60-80/month. Essentially, I end up paying directly for any basic care, since my deductible is so high, but it works for now.
posted by ktkt at 9:20 PM on September 19, 2013

There will be more good options soon, but in the mean time I think your only chance at doing better than what the university is offering is one of these options:

1. HealthyNY (current cheapest premiums are around $350 and that doesn't include prescription drug insurance or mental health)

2. BCBS has a hospital-based Tradition Plus plan that they say starts at $165 per month. That is probably the closest thing to what ktkt described, which doesn't really exist in NYS.

If money is very tight, I'd be tempted to go with the BCBC plan and hope nothing happens until the Obamacare plans kick in in January.
posted by Salamandrous at 9:27 AM on September 20, 2013

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