Insurance costs have been a huge financial burden for us because my husband’s employer doesn’t pay for family member premiums. When we registered with the New York State ACA marketplace, we were thrilled to find out that our son, who suffers from hydrocephalus, qualified for Child Health Plus. It costs only $60 a month, requires no co-pays and covers all of his medical needs. More importantly, his pediatrician and neurosurgeon accept this plan, and we do not have to change his doctors. We welcome being able to provide our son with the comprehensive coverage that he needs. We have more peace of mind than we have felt in a very long time, and that is priceless.
estimate my costs
Estimate My Costs
What you pay out of your own pocket for health care can add up, and the marketplace plan you choose will affect how much you may have to spend over the year. Estimate My Costs will help you learn about the different types of marketplace plans in your state and how to pick one that meets your needs. After you fill in the information below, you will see a report with a How-To Guide explaining the results in both English and Spanish. Después de llenar la información abajo, verá un informe con una guía de cómo explicar los resultados en inglés y español.
Before picking a family health insurance plan, you need to estimate all of your family’s health care expenses.
First, think about the ages and health needs of everyone in your household. Use Estimate My Costs for each family member to understand what type of plan would be best for him or her. A good way to estimate the premium for family plans is to add together the premiums that you pick from Estimate My Costs for each family member. Keep in mind that this total may be a little bit high. Some health plans may have discounts on family plan premiums. It also may be less expensive for someone with higher health costs to have his or her own health plan, instead of being on the same plan with the other family members.
Next, it is important to understand the different health plans offered in your state, their monthly premiums, and how much you might have to spend out-of-pocket for other costs, such as deductibles, copays, and coinsurance. Most family health insurance plans have both individual and family deductibles. Family deductibles are usually twice as high as the deductible for each individual in the same family plan. The out-of-pocket costs for any family member covered by the plan are applied to the family’s total deductible.
Finally, each year the federal government sets the maximum out-of-pocket limits for individuals and families. The maximum out-of-pocket limit for family plans in 2015 must not be more than $13,200. After a family reaches the maximum out-of-pocket limit, their health plan will cover the full cost of covered services for all members of the family. Each individual member of a family plan cannot spend more than $6,600 in out-of-pocket costs in a year.