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If you're a productive person in the United States, you already know that our health insurance market is a giant suck-fest where productive people are financially bled to pay for the health care of everyone else. To avoid devolving into a political rant, I'll cut to the chase.
I very recently learned that our family qualifies for a subsidy even if our annual income is $250,000/year. The sad thing is, this information is incredibly hard to find. Nearly everywhere you look, including the Blue-Cross-Blue Shield Web site, sources say you don't qualify for a subsidy unless you are low-income. This is not true. (Not now, anyway.)
Background – AKA How I Learned This the Hard Way
About ten years ago, our Blue Cross-Blue Shield insurance was around $800/month for a family of three. We had decent coverage with reasonable deductibles. But today, thanks to laws designed to "expand coverage" and "reduce cost," (LOL, except it's not funny) we are now paying over $2,400 a month for lackluster coverage. One recent year, we paid in additional $16,000 out of pocket for medical expenses on top of what we paid for our pricy Blue-Cross/Blue-Shield policy. (And no, we didn't qualify for lube on this giant a$$-reaming, not even at tax time.)
On a similar note, we previously had Medishare (not insurance, but rather a health-cost sharing system) for several years, but this proved to be a disaster when my son needed minor surgery. Medishare refused to pay for a single cent of his surgery costs. This would have been bad enough, except it took me probably fifty hours of time to discover this unhappy fact. Plus, because we weren't covered by "regular insurance", the health care providers charged us the absolute highest price for his surgery-related expenses until I called each one individually and haggled them down. It was a huge sink of time and money.
This is when I decided I needed regular insurance in spite of its high cost. And, because we're not low-income, the policy prices were outrageous. They're still outrageous, but…
A few months ago, while researching some other tax issues, I learned that we DO currently qualify for a health insurance subsidy due to a temporary act of congress. This particular subsidy is set to end in 2025, so this might be our last year to qualify – unless it's extended of course.
What's the Catch? (And there are many.)
You MUST purchase your health insurance from the government Web site, healthcare.gov. If you purchase it directly from Blue-Cross/Blue-Shield, for example, you will NOT get the subsidy no matter what you spend.
Plans on the Government Web Site Are More Expensive. In my own case, the plans available from the government Web site cost about $500 more a month compared to similar plans purchased directly from Blue Cross-Blue Shield. They make it difficult to compare plans by not offering the exact-same plans in both places. No doubt, this is on purpose, so people don't realize they're getting reamed in yet another way. However, let's say you quality for a monthly government subsidy of $1,200. Even if your healthcare.gov plan costs $500 more a month compared to the price from BCBS, you're still saving $700 a month.
Time Is Limited: You must purchase your policy during open enrollment, which is ending soon. Dates may vary by state. In my state, I need to purchase my insurance by December. 15 to begin coverage on January 1. On a similar note, open enrollment ends on January 15, which means that on January 16, it's too late to get coverage at all. (Some exceptions might apply, but I'm no expert.)
How to Discover if You Qualify: Go to Healthcare.gov, and begin keying in your information. Make sure to reply to the questions about your household income. When you're done, it will tell you how much of a subsidy you qualify for, and it will list the plans, along with their cost to you.
Of course, if you have a great financial year, and your income exceeds your estimates, you will owe the government more money at tax time. On a similar note, if your income is less than your estimate, you will receive money at tax time.
GIANT DISCLAIMER: I am no health insurance or tax expert, so research this on your own. This isn't medical or tax advice. I just wanted to share my own personal experience to help other self-employed people who are paying far too much for health insurance.
Oddly enough, there is a shocking lack of information on this. I only learned this by accident. This discovery led me to the following article, which in turn led me to conduct some deeper research on my own.
Obamacare’s ‘subsidy cliff’ eliminated through 2025
SUMMARY: You may be able to get more affordable insurance, even if the relief lasts only one year. If you've been putting off pricy medical procedures, such as a knee replacement, etc., this might be your chance to get great coverage, get that surgery, and actually receive some benefits from our craptastic government for a change. Heaven knows you've probably earned them.
I very recently learned that our family qualifies for a subsidy even if our annual income is $250,000/year. The sad thing is, this information is incredibly hard to find. Nearly everywhere you look, including the Blue-Cross-Blue Shield Web site, sources say you don't qualify for a subsidy unless you are low-income. This is not true. (Not now, anyway.)
Background – AKA How I Learned This the Hard Way
About ten years ago, our Blue Cross-Blue Shield insurance was around $800/month for a family of three. We had decent coverage with reasonable deductibles. But today, thanks to laws designed to "expand coverage" and "reduce cost," (LOL, except it's not funny) we are now paying over $2,400 a month for lackluster coverage. One recent year, we paid in additional $16,000 out of pocket for medical expenses on top of what we paid for our pricy Blue-Cross/Blue-Shield policy. (And no, we didn't qualify for lube on this giant a$$-reaming, not even at tax time.)
On a similar note, we previously had Medishare (not insurance, but rather a health-cost sharing system) for several years, but this proved to be a disaster when my son needed minor surgery. Medishare refused to pay for a single cent of his surgery costs. This would have been bad enough, except it took me probably fifty hours of time to discover this unhappy fact. Plus, because we weren't covered by "regular insurance", the health care providers charged us the absolute highest price for his surgery-related expenses until I called each one individually and haggled them down. It was a huge sink of time and money.
This is when I decided I needed regular insurance in spite of its high cost. And, because we're not low-income, the policy prices were outrageous. They're still outrageous, but…
A few months ago, while researching some other tax issues, I learned that we DO currently qualify for a health insurance subsidy due to a temporary act of congress. This particular subsidy is set to end in 2025, so this might be our last year to qualify – unless it's extended of course.
What's the Catch? (And there are many.)
You MUST purchase your health insurance from the government Web site, healthcare.gov. If you purchase it directly from Blue-Cross/Blue-Shield, for example, you will NOT get the subsidy no matter what you spend.
Plans on the Government Web Site Are More Expensive. In my own case, the plans available from the government Web site cost about $500 more a month compared to similar plans purchased directly from Blue Cross-Blue Shield. They make it difficult to compare plans by not offering the exact-same plans in both places. No doubt, this is on purpose, so people don't realize they're getting reamed in yet another way. However, let's say you quality for a monthly government subsidy of $1,200. Even if your healthcare.gov plan costs $500 more a month compared to the price from BCBS, you're still saving $700 a month.
Time Is Limited: You must purchase your policy during open enrollment, which is ending soon. Dates may vary by state. In my state, I need to purchase my insurance by December. 15 to begin coverage on January 1. On a similar note, open enrollment ends on January 15, which means that on January 16, it's too late to get coverage at all. (Some exceptions might apply, but I'm no expert.)
How to Discover if You Qualify: Go to Healthcare.gov, and begin keying in your information. Make sure to reply to the questions about your household income. When you're done, it will tell you how much of a subsidy you qualify for, and it will list the plans, along with their cost to you.
Of course, if you have a great financial year, and your income exceeds your estimates, you will owe the government more money at tax time. On a similar note, if your income is less than your estimate, you will receive money at tax time.
GIANT DISCLAIMER: I am no health insurance or tax expert, so research this on your own. This isn't medical or tax advice. I just wanted to share my own personal experience to help other self-employed people who are paying far too much for health insurance.
Oddly enough, there is a shocking lack of information on this. I only learned this by accident. This discovery led me to the following article, which in turn led me to conduct some deeper research on my own.
Obamacare’s ‘subsidy cliff’ eliminated through 2025
SUMMARY: You may be able to get more affordable insurance, even if the relief lasts only one year. If you've been putting off pricy medical procedures, such as a knee replacement, etc., this might be your chance to get great coverage, get that surgery, and actually receive some benefits from our craptastic government for a change. Heaven knows you've probably earned them.
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