Health Insurance Options

[weymiller]

I am trying to determine my options for health insurance this fall.  I am 26, so I cannot be covered by my parents while in graduate school.  The school offers plans, but it is almost 900 per semester. For the fall semester, this would be about 200 a month.  Spring semester includes the summer, so it is not as bad but still unaffordable for me.  I am not sure if I can get on the exchange because the school offers insurance.  I have to have some insurance because the school requires it.  Any suggestions on what you have done?

[TakeruK]

I know I am not eligible for the exchange (in California) because my school offers a health insurance plan that is about the same level or cheaper than the exchange plan. When my wife applied, she had to provide info about me too and while she qualified, the website gave this reason for me not qualifying (I wasn't even applying but they automatically check everyone's eligibility apparently).

 

But, I don't know what the actual cutoff is and I suspect it might really vary by state and plan too. 

 

It sounds like you are saying your health plan costs $900 per semester, and 3 semesters per year so $2700/year, right? This is $225 per month, which is about the same level as the "Silver" PPO plans on the California Exchange. In honesty, I think this is a decent deal because we were paying $7000+ per year until the Exchange opened (pre-existing conditions suck).

 

On the California exchange, I remember seeing Bronze plans at $100-something per month and Catastrophic insurance-only plans at around $100 per month. Perhaps you might still be eligible for these Exchange plans if your school's option is $225/month? Might be worth a check in November.

 

Another alternative is to shop for private health insurance outside of the Exchange. We did this too to compare. We found some pretty competitively priced plans outside of the Exchange as well. So, if you don't qualify for the cheaper Exchange plan, you could work with an insurance broker to set up your own plan that covers the things you need at a more affordable price? If you do this, you should be able to waive your school's plan and save some money. This might go without saying, but obviously you should be careful to make sure your new plan covers enough so that premiums + out of pocket expenses is still cheaper this way!

 

Finally, one option is to see if your school lets you opt out of a plan in the middle of the year. Sometimes you can choose to renew your school's plan by term, so you might enroll in the plan for the first semester/term and then when the exchange opens up this fall, you can compare options. However, really make sure you can opt out mid-year because not all schools/plans allow this!