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Recently married, trying to figure out health insurance
Old 10-24-2015, 07:38 AM   #1
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Recently married, trying to figure out health insurance

I just recently got married in September, and now my wife and I are trying to figure out how to handle our health insurance. This is one area that I know very little about. I can put together a passively managed index portfolio, pay down debt and get the savings rate up. But I don't know how to decide who's health insurance to use.

A little about what I do know: My plan with my employer is a high deductible plan that costs $38.50 per paycheck. Currently my deductible is $2000 for an individual, and $4000 for employee/spouse/family. I have an HSA with the plan that I max out. Coinsurance is 30%. Preventive care is covered 100%. It would appear that other coverage kicks in after the deductible is met. I personally don't get sick a ton or have many health issues so I have been using this as an opportunity to max the HSA, really to serve more as a "rainy day fund" for health issues that come up as I get older (I am 33 now). Healthcare expenses I do have, I pay out of pocket, but they have been very minimal.

My wife is a bit of a different story. Her plan is a higher premium out of each each check (not sure the amount), but I suspect better coverage. Her company has her in what they call a Health Reimbursement Account. I have no idea what that is and only recently discovered she was in it. She suffers from bad migraines and takes two medications for those migraines that are covered 100% by her insurance. She is generally healthy other than her migraines.

If she did not have these medications I would probably just have her come onto my plan as otherwise were are health overall. But her medications, and the fact that they are covered by her insurance, have caused me to really reassess how we should go about approaching health insurance. Knowing that we are both generally healthy people, aside from the migraines, what should we be looking for when deciding which health insurance to use? I genuinely feel lost when it comes to figuring this out and am not even really sure what things to look at in making an assessment for the two of us. I know this isn't a ton of information to work off of, but even just knowing what to look at and assess would be incredibly helpful. I appreciate any insight anyone has.
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Old 10-24-2015, 08:34 AM   #2
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It is generally better to each have your own plan. Employers typically subsidize the employee portion more than the dependent portion of the premium.

A Health Reimbursement Account is a use it of lose it proposition. Never put more in it than you can use.

Keep the HSA for retirement. Find out how to invest in S&P funds with it.
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Old 10-24-2015, 09:27 AM   #3
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Originally Posted by Senator View Post
A Health Reimbursement Account is a use it of lose it proposition. Never put more in it than you can use.
I believe you may be thinking of a Flexible Spending Account (FSA). The employee does not contribute funds to an HRA.

Quote:
Health Reimbursement Accounts are funded solely by the employer, and cannot be funded through employee salary deductions..... Through health reimbursement arrangements, employers reimburse employees directly only after the employees incur approved medical expenses....There is no minimum or maximum contribution limit on the employer's contributions to an HRA.

Advantages of HRAs for employees include:
Unused funds in the HRA can be rolled into future years for reimbursement.
Source: https://en.wikipedia.org/wiki/Health...sement_Account
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Old 10-24-2015, 09:35 AM   #4
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Many employers will no longer cover the spouse if they have their own health insurance through work, so the issue may be resolved for you. Check with you benefits department.

I know nothing about Health Reimbursement Accounts, but the link that was posted seems to indicate that it is required by the ACA to be attached to a qualified group health insurance plan.


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Old 10-24-2015, 02:49 PM   #5
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Many employers will no longer cover the spouse if they have their own health insurance through work, so the issue may be resolved for you. Check with you benefits department.

I know nothing about Health Reimbursement Accounts, but the link that was posted seems to indicate that it is required by the ACA to be attached to a qualified group health insurance plan.


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+1. You may have no choice. One of you may not be able to opt out, or you may not be able to get spousal coverage if they have insurance "available" through their employer.

If you do have a choice, figure out how much the migraine meds cost within each plan. For each plan you will have the premium cost, the likely cost if your usage continues as in the past (premiums plus meds plus any normal usage), and the maximum cost (premiums plus deductibles plus co-pays up to the out of pocket maximum).

There may be a clear winner that is lower cost for all three cases, or maybe one that is a winner for your most likely case and only slightly more expensive for the less likely cases.
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Old 10-27-2015, 06:55 PM   #6
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Thanks everyone for the feedback. Turns out my employer will cover DW, but at a surcharge. That would take my premium per paycheck from $38.50 per pay to either $151 or $191 per pay (depending on the deductible level we would choose).

She is going to check on premiums if I go onto her insurance but she knows that her employer also has a surcharge, so I don't expect it would make much sense for us to be on the same plan.
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Old 10-27-2015, 10:50 PM   #7
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I had a Retirement Health Savings Account that worked just like a 50% matching 401K. The funds were conservatively invested for a number of years.

When I retired, the RHSA account paid my share of the $420 monthly cost of health insurance for almost 6 years. I had to pay it all part of the last year before going on Medicare. Turning 65 was like getting a $350+ per month pay increase.
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