Health insurance for my under 65 wife

[MJ]

I apologize for this being very long. I am retired and on Medicare. My wife is below 65 and a homemaker (ie: unemployed). This inquiry is primarily for anyone under 65, either self employed or retired and knows or has found a way get good POS or PPO group health insurance. I also have recently learned about Christian health sharing organizations such as Altrua and Medishare but don't know much about them.
Just a little history. When we moved to Georgia in 2015, I was able to get my wife a pricey but great Humana platinum POS health insurance on ACA. In 2016, Humana only offered gold POS insurance which I got for her. In 2017, Humana dropped out of Georgia leaving only BCBS offering a still pricey "silver" POS insurance. Now, BCBS has also dropped out and all that left is Ambetter which only offers nearly as pricey limited HMO. It appears to have a very bad reputation in paying their providers so many doctors don't accept them. The 2 doctors my wife uses don't accept it nor does one of the 2 major hospitals in our city. Any suggestions will be appreciated.

 

[LakeRat1]

Insurance has gone up so much the past few years, that we 55 and 63 decided to join Christian Healthcare Ministries.... AKA ...CHM..... We are self-pay, no penalty, and have been getting our providers to give us a discount from 40% to 50% discounts for routine visits to the Dr...... We are saving $1150 Per month

 

[zinger1457]

Not sure about Georgia but here in AZ it's pretty much ACA or bust for those not on some type of employer plan. I only have one carrier (BCBS) to choose from in ACA, so far the plan meets my needs. How is your wife's health, any preexisting conditions? If there are that could be an issue with the ministry option. Some here have gone back to work just for the health insurance so that may be an option.

 

[davebarnes]

For us (well, for the trophy wife), Kaiser.
Cheapest plan will be $730/mo in 2018.

 

[Katsmeow]

I am under 65 (DH is on Medicare) and I get insurance through his retiree insurance. So, I don't face the exact situation. When I semi-retired with DH (still do a little part-time work but not enough to qualify for insurance) I did think about what I would do if Megacorp dropped the retiree insurance which they could do (we pay a good part of the cost of it, but it is subsidized and is really great coverage). I especially worried if the ACA options weren't acceptable (in my area they are not great, but are acceptable at this point if it came to it - but Ambetter is one of the options and doesn't have a great reputation so I understand your concern).

There were basically two options I would consider:

1. Get a job that would come with health insurance. That is something I maybe could do. But, if your wife hasn't worked in many years (or never) that might not be an option.

2. Move. That might mean moving to a different area in the same state with better health insurance options or move to a state with better options. That may seem radical but I would do that before considering going without real health insurance (and, no I don't think the Christian sharing organizations would be adequate for serious very costly conditions).

If the only insurance I could get in an area was Ambetter and I couldn't employer based insurance then I would probably move.

 

[mnopqr]

Enroll in a class at a community college and sign up for the student insurance policy

 

[HGTVfan]

I apologize for this being very long. I am retired and on Medicare. My wife is below 65 and a homemaker (ie: unemployed). This inquiry is primarily for anyone under 65, either self employed or retired and knows or has found a way get good POS or PPO group health insurance. I also have recently learned about Christian health sharing organizations such as Altrua and Medishare but don't know much about them.
Just a little history. When we moved to Georgia in 2015, I was able to get my wife a pricey but great Humana platinum POS health insurance on ACA. In 2016, Humana only offered gold POS insurance which I got for her. In 2017, Humana dropped out of Georgia leaving only BCBS offering a still pricey "silver" POS insurance. Now, BCBS has also dropped out and all that left is Ambetter which only offers nearly as pricey limited HMO. It appears to have a very bad reputation in paying their providers so many doctors don't accept them. The 2 doctors my wife uses don't accept it nor does one of the 2 major hospitals in our city. Any suggestions will be appreciated.

I just looked up BCBS in Georgia and it looks like there are plans offered in many counties. It looks like mostly or maybe only HMO plans but hopefully your wife's doctors are included. Maybe these plans are only offered off the Marketplace and that is why you didn't come across them or maybe you are not in one of the counties listed. Here is the link I found.

https://www.bcbsga.com/individual-and-family/georgia-health-insurance/

How old is your wife? Does she have any serious medical conditions? If she only has a year or two until Medicare I think I would go with Ambetter if you can't get BCBS and just negotiate with her doctors who don't take their plan.

Good luck

 

[MJ]

Yes, BCBS will be offering insurance in GA but not in my county. My wife currently has their ACA compliant POS insurance for 2017 which BTW was not even listed on the ACA marketplace last year. I found it off market on google. Only their equally expensive HMO that did not include any of my wife's doctors was available through the marketplace. I suspect that is what they will be offering in the other GA counties in 2018.

Their well nourished CEO put out a "SAD" apologitic letter about their decision.

https://www.bcbsga.com/blog/member-...-georgia-individual-aca-health-plans-in-2018/

 

[HGTVfan]

Yes, BCBS will be offering insurance in GA but not in my county. My wife currently has their ACA compliant POS insurance for 2017 which BTW was not even listed on the ACA marketplace last year. I found it off market on google. Only their equally expensive HMO that did not include any of my wife's doctors was available through the marketplace. I suspect that is what they will be offering in the other GA counties in 2018.

Their well nourished CEO put out a "SAD" apologitic letter about their decision.

https://www.bcbsga.com/blog/member-...-georgia-individual-aca-health-plans-in-2018/

HaHa, well nourished indeed. Probably would be denied coverage because of obesity before ACA.

So BCBS is not offering plans in your county even off market I guess. Maybe call a broker and see what he/she says. You did not say your wife’s age. I still think I would choose Ambetter if it is only for a year or two.

Some friends here in Florida have been priced out of the market and will try one of the Christian ministries (not sure which one) but they are a bit nervous if the $$ would be there for a serious illness. They have two years until Medicare.

Another option is a short-term plan which now you can get for a year. But I believe pre-existing conditions are not covered.

Good luck.

 

[poorcarver]

In addition to cost, there is the question of network. My wife who is under 65 is in a jam. There is no company offering a network to private purchase either via ACA or any other option that includes any academic medicine, U of C, Northwestern, Loyola, etc. So I invented a small business with no income or expense that employs her. Magically BCBSIL offers plans, at less than we were paying, that include academic medicine, for partnerships or corporations with minimum of two employees but only one has to take the insurance. Really? No offerings for individuals, but you got this scam going. So we have formal partnership agreement, EIN, and all the rest, just to buy insurance. And you wonder why people hate insurance companies.

 

[MJ]

poorcarver, I looked into the small business option but I thought to qualify you need at least 2 employees, of which one cannot not be your spouse.
Perhaps I missed a loophole. Would you mind clarifying?
You can either reply here or send me a private message.
Thanks