NYS health insurance marketplace these days?

October 8, 2022 1:51 AM

Desperately want to quit my job for burnout recovery, but I'm my household's source of employer-sponsored health insurance. Is the NYS health insurance marketplace reasonably affordable and good?

I'm a mid-30s professional in New York State, DINK but I'm the spouse who has the option for employer-sponsored health insurance. I'm desperately burned out and depressed (depression/overachieving standards my whole life), and really want to just quit my job and take a good long rest for a while. I feel a ton of pressure and resentment that I'm our household's point of access to subsidized employer health insurance. That will not change -- spouse does not have traditional career. One of the only barriers to my quitting/taking several months of unemployed time off is health insurance. I have savings. Does the NYS healthcare exchange have coverage options that aren't eye-poppingly expensive for 2-person households while also not being totally terrible in terms of covered providers and services? I'm so envious of other nations where this is not a huge ball and chain for employees! I do know that this is a very privileged position I'm in. I'm just really close to a mental health crisis from this burnout.

posted by anonymous to Work & Money (7 answers total)

As an alternative plan, you might be able to take leave through FMLA and/or elect COBRA coverage.

I don't have NY state specific experience with the healthcare exchange marketplace. But I do have some more general info that may be helpful. What is somewhat tricky about the marketplace is that the amount of subsidy is determined by one's (predicted) yearly income. Moreover, if your household monthly or yearly income is reported on the application to be below a certain threshold, your application will be flagged for possible Medicaid eligibility... a process that in my experience (not NYS) takes some time and happens outside the healthcare exchange marketplace. So when you have a moment (okay a few hours)... create an account and poke around. The process wasn't fun, but wasn't as bad as I was expecting.
posted by oceano at 2:57 AM on October 8, 2022

I'm pretty sure you can go on the N.Y. State of Health Marketplace website and find out what premiums you would pay for coverage for various plans and insurers. I've been on the exchange since it started (self-employed) and I think quality of care depends on which insurance company you use. I'm an otherwise healthy woman in my fifties with one preexisting condition, and I subscribe to plans with low deductibles (usually gold level, but sometimes silver level makes more sense) and my premiums run between $750 and $875 a month, depending on the year/what insurer I use (I don't qualify for any subsidies).
posted by newpotato at 3:00 AM on October 8, 2022 [1 favorite]

In addition to the exchange, New York has its own “mini-COBRA” that gives every former employee the right to buy coverage for three years from their former employer.

Employee plus spouse can be very expensive though - easily over $1,000 per month, and quite possibly closer to $2,000 if there’s a good network and low deductibles / co-insurance.
posted by MattD at 6:04 AM on October 8, 2022 [2 favorites]

Fourthing that going online and entering your info is the way to go. But as a guideline, in my friends' experience, if they're pretty low income they can get it very cheaply or free. At higher incomes it was around 10% of their income.

Good luck to you and I hope you are able to make this work for you.
posted by metasarah at 7:26 AM on October 8, 2022

I was on Obamacare in NYS for 5 years. I got fantastic coverage and when I was low income (but not low enough for Medicare) I got a significant discount. I went with Fidelis.

Honestly, best insurance I ever had. Far better than any employer provided insurance including the insurance my job provides me now.
posted by nayantara at 7:49 AM on October 8, 2022

(A friend was also able to to use short term disability to deal with burn out recovery so I would see if this is possible with your insurance/ work with clinicians in order to get the necessary paperwork in order)
posted by raccoon409 at 7:49 AM on October 8, 2022

i had a doctor write me a script for 2 weeks of mental health leave earlier this year-- i didn't tell my work it was burnout related, but it was definitely burnout related. she offered to give me longer, it was not a big deal at all. i really encourage you to take 4-12 weeks off to think about next steps before committing to leaving your job completely. it's a long time-- 12 weeks gets you through the rest of the year. it might be enough and if it's not you can still quit afterwards.
posted by katieanne at 2:28 PM on October 9, 2022