Any Health Insurance Experts?? Going back to work, but DH's plan is much better

[Theta]

I have accepted a teaching job in NC. I am covered under DH's plan for the past 10 years and it is MUCH better than the teacher's health insurance plan. The health benefits coordinator told me I could decline the teachers plan. Is it silly to decline this? What things should I take into account if I decline my insurance? What are the benefits to have my primary and his at secondary?

 

[golfgal]

If his plan is better then decline your school plan. Unless your portion of the school health plan is given to you at no cost, there really isn't any advantage to having it as a second plan-unless there is some coverage in that plan you need that your DH's plan does not offer. If the school pays 100% of the employee portion, take the plan because it doesn't cost you anything, otherwise any payout in that plan is going to be much less then what you would put into it. They will have a form for you to fill out to decline the plan. DO sign up for any and all disability coverage they offer though.

 

[Theta]

Yes, my employer pays 100% of my plan. My copays would be $25 primary/$60 specialist where I pay only $15/$25 copays for his.

So you are saying to keep my insurance plan if I am not paying for it? Should DH keep me on his so I have a secondary plan?

Please tell me more about accepting the disability coverage. What sort of things will this cover.

Sorry for all the questions, I am new to the US medical system.

 

[prncess674]

Yes, my employer pays 100% of my plan. My copays would be $25 primary/$60 specialist where I pay only $15/$25 copays for his.

So you are saying to keep my insurance plan if I am not paying for it? Should DH keep me on his so I have a secondary plan?

Please tell me more about accepting the disability coverage. What sort of things will this cover.

Sorry for all the questions, I am new to the US medical system.

You copays don't sound terrible. Most plans do not cover the cost associated with a spouse. You may want to see how much he is paying for you to be on his plan. It could easily be $100 a month. Consider saving that money in a separate account to cover the additional copay if you happen to need a doctor visit. Are you a sickly person with chronic health problems that would need ongoing and costly care, which in turn may be beneficial to have duplicative insurance.

 

[ameraumi]

I *HIGHLY* recommend you accept the disability insurance! That will be your life saver if you become very ill (or hurt) and cannot work. It will pay a portion of your normal salary until you can return to work.

An example: my late-DH was diagnosed with cancer 3 yrs ago. From the date of diagnosis he was wisked to another hospital to undergo surgery and start treatment. Because we had the disability insurance, he received his normal paychecks uninterrupted. The first 6 months was covered under Short Term Disability, then it went to Long Term Disability with a lower rate of pay. But it was worth it and saved us.

 

[golfgal]

Yes, my employer pays 100% of my plan. My copays would be $25 primary/$60 specialist where I pay only $15/$25 copays for his.

So you are saying to keep my insurance plan if I am not paying for it? Should DH keep me on his so I have a secondary plan?

Please tell me more about accepting the disability coverage. What sort of things will this cover.

Sorry for all the questions, I am new to the US medical system.

Accept your plan since you don't have to pay for it and stay on his. Without knowing the actual plan there is probably a good chance that somewhere in there you will have some kind of deductible or your medical network may cover something his does not. Depending on the laws in your state, you could possibly use his plan as your primary plan and your plan as your secondary. Ask the HR person at work for sure.

Disability coverage covers you for extended absences from work for things like maternity leave or a prolonged illness or injury. Often school districts do NOT have short term disability and if you need maternity leave you have to use vacation/sick time for that. If that is something that may be an issue, ask about that. Long term disability usually covers you after short term runs out. Short term, in general, runs from a couple weeks to a month or so, then long term kicks in for however long. Say you have cancer and need to be in the hospital for 6 months, this is what would pay a portion of your salary while you are sick.

 

[candy0730]

Something else to consider.....will your husbands plan allow you to be covered only under him if you decline health insurance offered to you through your employer? More and more companies will not cover the spouse if they are offered health insurance through their employer and decline it but will allow the spouse to be covered secondary. I found this out the hard way years ago........

 

[Lisa loves Pooh]

I *HIGHLY* recommend you accept the disability insurance! That will be your life saver if you become very ill (or hurt) and cannot work. It will pay a portion of your normal salary until you can return to work.

An example: my late-DH was diagnosed with cancer 3 yrs ago. From the date of diagnosis he was wisked to another hospital to undergo surgery and start treatment. Because we had the disability insurance, he received his normal paychecks uninterrupted. The first 6 months was covered under Short Term Disability, then it went to Long Term Disability with a lower rate of pay. But it was worth it and saved us.

Disability is not a shared (as far as I know) family benefit, so definitely get your own.

When hubby and I worked, we had kept our insurance separate b/c there was a cost savings to do that. When we had a child, I went on his. Then I ended up leaving work anyway--but that is another story. We had worked for the exact same company.

My sister works for the city in Kansas City, but she is on her husband's healthcare plan and he works for Delta.

YMMV--based on the nitty gritty. I.e., if they pay for your insurance--but then you have higher co-pays or different deductibles, or different pre-approval procedures, it may end up being a worse deal.

 

[tar heel]

Please pay attention to what Candy said. At my DH's company, a spouse who is eligible for insurance at his/her company cannot be on DH's company's plan. They do audits periodically and anyone found to be doing this is terminated. I think I could use his plan as secondary coverage, but we save over $100 a month by him covering parent/children and not covering me.

 

[golfgal]

Please pay attention to what Candy said. At my DH's company, a spouse who is eligible for insurance at his/her company cannot be on DH's company's plan. They do audits periodically and anyone found to be doing this is terminated. I think I could use his plan as secondary coverage, but we save over $100 a month by him covering parent/children and not covering me.

This is something to consider. It is very common in government positions (state/federal, etc.). I know one plan for a group of employees in MN doesn't allow ANYONE (including the employee) to be on the state plan if their spouse has access to family coverage at work. It is a cost saving measure for the state.


Also, there is more to any health plan then the deductibles. Look at all the coverages and take last year's medical bills and put those "into" this plan and see what works out financially. Yes, your deductibles may be higher but your plan may cover $100 of the costs after that vs 80% on your DH's plan, for example.

 

[Theta]

Thanks for your help.

I will find out the rules of DH's plan before I decline my plan. DH's plan is FAR superior in every way to my plan. Next step to find out what he pays to insure me and go from there.

Friends are telling me to accept my plan and keep his as a secondary plan. Still not sure...

 

[kaytieeldr]

One major consideration is, whether you accept or decline your insurance coverage, your husband won't be able to change his own level of coverage except during his employer's open enrollment period - unless there is a major change in his situation such as a marriage (obviously not ), child born or adopted, etc. You simply accepting a job that provides/offers health insurance is generally not considered a major change.

 

[AndyLL]

Something else to consider.....will your husbands plan allow you to be covered only under him if you decline health insurance offered to you through your employer? More and more companies will not cover the spouse if they are offered health insurance through their employer and decline it but will allow the spouse to be covered secondary. I found this out the hard way years ago........

Yes... our company implimented this policy this year... there is a surchange.

 

[HM]

I am on the NC state health plan by myself. My husband's has been better for years. I am on his policy as Family along with him and our two kids, so they are my secondary coverage. Most of my bills are covered by the two insurances.

 

[Kathi OD]

Something else to consider.....will your husbands plan allow you to be covered only under him if you decline health insurance offered to you through your employer? More and more companies will not cover the spouse if they are offered health insurance through their employer and decline it but will allow the spouse to be covered secondary. I found this out the hard way years ago........

DH's company just instituted this policy. It wasn't a problem for us, as I have a much better plan that is fully paid by my employer.

Another thing to think about...where I work, I can cover DH even if he has insurance through his employer. He would pay the co-pays as required by his plan, but can then submit them to my insurance and get his co-pays reimbursed. This was explained to us at a big insurance meeting my employer held this past spring. I think they called it coordination of benefits. It's something I would consider only if we both had our insurance paid for by our employers.

 

[golfgal]

One major consideration is, whether you accept or decline your insurance coverage, your husband won't be able to change his own level of coverage except during his employer's open enrollment period - unless there is a major change in his situation such as a marriage (obviously not ), child born or adopted, etc. You simply accepting a job that provides/offers health insurance is generally not considered a major change.

Usually a change in a spouses ability to get health insurance is considered an ok reason to change a plan outside of open enrollment.

 

[pilesoflaundry]

Something to consider about your's is if you work for the state for so many years do you get it keep it as a retired adult? If so, it may be worth taking now so you have coverage for ever (if you work enough years I mean) vs. more than likely not getting to keep your dh's coverage when he retires.

 

[emma'smom]

You should also check to see if your school system will pay you NOT to take the insurance. When I worked for the NYC Schools, they gave us a small check for not taking TRS insurance (and I just was covered by my DH's insurance).