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Anyone else stressing out about how they are going to afford health insurance?

post #1 of 57
Thread Starter 

I need to learn more about our particular situation, how much we are really going to pay, and by when and what the penalties will be, but the whole thing is stressing me out.   We lost our subsidized insurance because of an inheritance, and have to wait 3-5 years to have a place again (little more than a year left to reach the 3year mark.)  


Both dh and I are self-employed, homeschooling parents and I don't know how we are going to afford this when the time comes.  What a shit time to implement a plan that I am otherwise on board with.


I am thankful that the girls still have their medical insurance through DSHS, which, in WA only counts actual income to determine eligibility.  I was literally in tears when DSHS told me that the girls would keep their insurance, and again this year when I resubmitted eligibility forms.  I can't believe how much this is stressing me.  I'm 43, dh is 50 in October, and insurance is not cheap for our ages.


Sigh... I guess this is just a rant.  I really need to get in gear and find out exactly what our situation will be...


Am I the only one flipping out?

post #2 of 57
Thread Starter 

Maybe I am the only one..... shrug.gif

post #3 of 57

How much do you actually know about the requirements of the plan, your state's availability of insurance, and the tax credit for the insurance, and the opt outs for financial hardship? 

post #4 of 57
Thread Starter 

I'm not finding specific information, just some "might", and "some key pieces taking effect".  I am encouraged that Medicaid will be expanded, and our kids are covered now, but I still don't know if this will affect us personally.  I did shop for insurance after dh and I lost it 2 years ago, with the help of an insurance broker and some of my own research, and I could not find an affordable health plan.  Some decent options--like $350 per month for a covers-nothing Health Care Saving plan, but nothing we could pay out for--the cheapest decent plan was $440 per month.  We had been paying $130-$170 per month for good, subsidized insurance.


I'd like to think that we could get a good allowance for income (if they take 2013 taxes, the first without an estate payout), but we've so often been just above the cutoff.  That's why this is stressing me out--I just don't know the specifics for our family,  It could be great, it could be no big deal and a great help--I have not enjoyed being without insurance for 2 years.  We are lucky to have not needed it.  


We are at a place where things are getting really tricky--dh and I have not raised our rates in 10 years, we must maintain 2 vehicles because dh is a professional gardener, gas prices have doubled in that time, food prices have gone up, taxes have gone up, everything is getting more expensive and the people we rely on for work are struggling as well.  The only things that have saved us are our refinance (we have excellent credit despite our income) and savings.  We just blew a chunk (pun intended) paying for a new engine for dh's work truck.  I hate to think about needing a "new" car (not imminent, but you never know).


Al I know is that things are going to get mighty tight around here, and money stresses me to no end.  Hopefully the news is good news.

post #5 of 57

You are definitely not the only one!! We're in a similar situation-- both DH and I are self-employed, and our income was low enough to qualify us for Medicaid until about 2 months ago. Now we're on our own-- and I'm feeling totally panicked and lost. Our business is doing well enough to disqualify us for Medicaid but not well enough that we're rolling in $$. Basically, we're right on the edge, and I can't fathom paying hundreds of dollars a month for health insurance that we'd only use in an emergency. And I can't find any specifics on when the new health care law will take effect and what it will actually mean for us.....


The whole thing makes me feel so anxious. I've even considered extreme solutions like moving out of the country (DH is from another country, so it's not that crazy....) and cutting our business down so that we're back under the poverty line. 


How do other self- employed families do it!?

post #6 of 57

Here is a website w/ info and a calculator (it may or may not be outdated)



(I have read a lot of information on this (early retirement) board lined below... you may find some other articles or information here)



Personally, I am waiting as I have found very little (none) information that pertains to my situation or information that makes a difference. (i.e middle class, high rates). (Other then in 2014 , when one will be charged a penalty  (at tax time) if you do not carry health insurance. I also have the option of moving back to Canada (my home country), so I dont fret too much about long term ... although I hope that obamacare works out well.


I have heard that insurance prices may cost more in most states, but not where I am from because the prices are already ridiculous (self-employed, 1300 / mth premium - two years ago, with a track record of increasing 200/mth). I dropped it a few years ago, so I am not stressed right now :), and I don't see a change coming.  Note: In NY its a one cost program / everyone can get coverage @ the same cost (if you can afford it); also, in NY all children can get coverage, $ determined on a sliding scale. (So my kids are covered)



Yes, there is a tax credit, but it sounds to me that you have to pay out first (big bucks) before getting the money back at tax time - that doesn't help most people or at least, you spend the first year paying out, the 2nd year you have the tax credit money to put towards next years premiums. (When I was paying for health insurance as a self-employed person, this credit was significant).

post #7 of 57
Thread Starter 

I'm not aware of any tax credit when I file taxes--only write-offs for the business.  Perhaps that will change?  


gitanamama, yes, being self-employed is not always easy!  Small business assistance usually is aimed at those with employees.   


I'll check out the links, just to see.

post #8 of 57

Following... we are currently on medicaid, but if either of our business take off we will be making too much. 


The current quote I am getting from Humana One is $850 a month, not including dental. Plus co-pays, 30% not covered, and a $7500 deductible. 

post #9 of 57
Thread Starter 

The Kaiser Foundation calculator says we would qualify for Medicaid, but I'm not sure if they mean taxable income?  If they mean before write-offs, I'm not sure.  Plus, it wobbles several thousand every year.  I'm not done stressing yet!  I do hope they expand Medicaid, because we couldn't even pull off the $350 insurance with no benefits (except for one insurance company allows you to pay the contracted rate for services instead of the full cost, but still no covered services except the required 4-6 office visits).  


It doesn't help that both dh and I lost one client who provided us with about 1/3 of our income.  Ouch.  We are scraping by because we have renters in our town house we couldn't sell when we moved to our property.  Still, if we don't qualify for Medicaid, we are staring down extreme cuts everywhere and it will be painful and we still might not pull it off.


Just when I think I'm in the clear, something happens to screw things up.  I thought last year I was finally going to afford private health insurance, then I lost that $600 per month income.  We keep scraping by, but it's getting harder and harder...

post #10 of 57
Originally Posted by SweetSilver View Post

I'm not aware of any tax credit when I file taxes--only write-offs for the business.  Perhaps that will change?  


gitanamama, yes, being self-employed is not always easy!  Small business assistance usually is aimed at those with employees.   


I'll check out the links, just to see.


I suppose I meant write offs, one can claim premiums and all other medical costs (dental payments, gas to and from, etc) and lower your taxes owed or get a refund.

post #11 of 57

One of my many concerns is how the subsidies affect how much I will be paying monthly once this goes into effect. For instance, based on our rough estimate income for 2014, our premiums would be between 11K-12K (I'm assuming this is for the year). With the tax credit subsidy, we'd only have to pay just under 3K so it would be roughly 220/month. However, are we just going to pay that 215/month, OR do we pay the 1K monthly until tax time THEN get the 9K tax credit? I don't get it. Another thing that sucks is, in October, you have to estimate what you make for 2014. If you overestimate, you overpay. If you under estimate and underpay, you get penalized for that. Which is worse. I don't like this AT ALL.

post #12 of 57

What substidies are we speaking about? The only thing I've seen is on the irs website and only covers people under certain retirement plans which I think are for teachers?

post #13 of 57
Thread Starter 

Ones that will be in place in 2014 for lower incomes to "afford" the insurance they are required to buy.  I've heard different versions of what will happen.   I need to do some more looking.  

post #14 of 57

The subsidies are available for people/families whose income falls between 100% to 400% of the federal poverty levels, which means you pay premiums anywhere between 2.0% and 9.5% of whatever level of coverage you choose... gold, silver or bronze. Gold is you pay more for more comprehensive coverage. Silver is the middle ground. Bronze is the cheapest and lowest level of coverage. The bronze level is the least amount you are required to have by law.


I wonder if the premiums we have to pay will be considered a tax-deductible, out-of-pocket medical expense. Since you are getting a tax credit, will those subsidized monthly premiums be allowed to be written off at tax time? I am not finding an answer to this question. I know co-pays, deductibles, prescriptions, etc are tax deductible. If it was private insurance, then yes, for sure the monthly premiums can be written off. But, what about the subsidized premiums? Anyone know?

post #15 of 57

Do you have a link to more info? Thanks.

post #16 of 57

I got the general info from my last two posts from one of the links given in post #6 of this thread. It was this one... http://kff.org/interactive/subsidy-calculator/. I read through the frequently asked questions area also. I am going to try to find answers to my specific questions and if I find it, I'll post a link for that.

post #17 of 57
post #18 of 57

OK. Yes, the subsidy will apply to monthly premiums. Phew. This is a better estimator... http://laborcenter.berkeley.edu/healthpolicy/calculator/

post #19 of 57

The tax credits can also be applied directly to the insurance premium.  According to the govt website, the tax credit will go directly to the insurance company to cover the premiums: http://www.healthcare.gov/marketplace/costs/tax-credits/index.html

post #20 of 57



Bumping this thread! Our current employer-sponsored insurance premium is going up A LOT in the fall. At that point we would be paying 20% of our net monthly income for the premiums. I am having a lot of trouble comparing options - does anyone have any tips?


This is what I have come up with so far:


Option 1 - Suck it up and pay 20% of our net to health insurance. I am concerned about the opportunity cost of that, as well as the chance that choosing something different might end up costing us the same anyway due to higher deductibles, etc. DH is leaning toward this. He is concerned that changing insurance would be a downgrade (it would be).


Option 2 - Bump me off of our insurance, but keep kids and DH on. This lowers the premium for them to <10% of our net monthly income plus whatever mine costs. The quotes I am seeing for insurance for myself would put us back at what we are paying now, which would be OK, but I am having trouble figuring out how this would play out with deductibles, losing prescription coverage, higher co-pays, 80/20 coverage after deductible, etc. I don't want to end up paying more than Option 1. Bonus would be that I could get a tax credit (deduction?) for the premiums, because I work for my own S-corp and would be paying through the company.


Option 3 - When I plug our figures into the calculators above, it looks like making 300% of poverty level + paying 20% (counting net - is that right?) toward premiums would allow us to get subsidized. This would drop our premiums back to what we are paying now. Our state will have an exchange. But does that mean completely dropping the employer plan and changing insurance? 


Are there consultants for this??? I feel like I need one!! dizzy.gif

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