A lot is based on age, but it’s also based on other things. Tobacco use drives the price up exponentially. There’s a list (~10) of preexisting conditions that drive premiums and deductibles up too. Then you factor is average prices of medical care per state/county, which is why some can be significantly higher or lower, just due to a state or county line.

I’m early 30s, so is my sister. I plugged in my information, and I have a plan selected for just under $400/month, $20 copay, dental/vision, no deductible. The lowest my sister could get (if she didn’t have coverage through the VA, and if we lived in the same place) would be at least double per month, with $50+ copays, no dental or vision, and $8000+ deductible. Both of those are for individual plans; obviously family plans are more, with it averaging out to less per person.

Anonymous wrote:You can also use the Health Reimbursement Arrangement for "medical expenses" that are not premiums. So, she could buy catastrophic coverage, and then you could reimburse her for all OOP expenses up to the limit for the year.

I’ll look into this. Thanks.

You can also use the Health Reimbursement Arrangement for "medical expenses" that are not premiums. So, she could buy catastrophic coverage, and then you could reimburse her for all OOP expenses up to the limit for the year.

Anonymous wrote:It also depends on where you live, and can change county by county. Some people are just really unlucky and there are very few options, and all expensive.

The reason only a portion is untaxed is because it's a loophole for small employers. They really want employers off the individual exchange to reduce subsidy and tax fraud (employers paying for it, but employees still claiming they are eligible for subsidies and simultaneously not counting the insurance stipend as income) and into employer programs, but most won't take you if you have fewer than 2 employees.

Group insurance typically offers better benefits than individual insurance, too, for the same premium, but, again, not offered when you have 1 employee. For awhile, I was able to do the small business version of the exchange in my area (SHOP), but this past year no insurers offered plans, so we had to do the individual exchange, too. Luckily, we had some decent plans to choose from at reasonable prices.

OP, you are not required to provide FREE health care for your nanny, though that is something we'd all like to have. It's ok if it costs her $25-$30 to go to the doctor. Maybe you can buy the catastrophic plan, and pay a proportion of her OOP costs. Of course, if she does have an expensive, but not catastrophic health need, you'll have to budget for that.

Plans with a $25/30 co-pay were $1200-1400/month. The $900-1000 plans all have giant deductibles before you move over to copay. For our nanny, who never gets sick and thus would not likely exhaust the deductible unless something crazy happened, that would mean that she got basically no practical benefit out of the plan, besides the peace of mind of knowing it was there in case of a disaster.

Anonymous wrote:If she is not sick, she can get quite cheap care at Cardozo in DC. Not sure how much you pay her and whether she is married and dependents, she could apply for medicaid in DC.
This healthcare crap is a scam and nobody should have to pay the prices they have to pay.

All of us live in Virginia, and I would assume that if we pay her too much for her qualify for subsidies, as noted in my original post, then her income is also too high for Medicaid. (~$60K/year, before any "extra" OT, of which there is some occasionally)

If she is not sick, she can get quite cheap care at Cardozo in DC. Not sure how much you pay her and whether she is married and dependents, she could apply for medicaid in DC.
This healthcare crap is a scam and nobody should have to pay the prices they have to pay.

It also depends on where you live, and can change county by county. Some people are just really unlucky and there are very few options, and all expensive.

The reason only a portion is untaxed is because it's a loophole for small employers. They really want employers off the individual exchange to reduce subsidy and tax fraud (employers paying for it, but employees still claiming they are eligible for subsidies and simultaneously not counting the insurance stipend as income) and into employer programs, but most won't take you if you have fewer than 2 employees.

Group insurance typically offers better benefits than individual insurance, too, for the same premium, but, again, not offered when you have 1 employee. For awhile, I was able to do the small business version of the exchange in my area (SHOP), but this past year no insurers offered plans, so we had to do the individual exchange, too. Luckily, we had some decent plans to choose from at reasonable prices.

OP, you are not required to provide FREE health care for your nanny, though that is something we'd all like to have. It's ok if it costs her $25-$30 to go to the doctor. Maybe you can buy the catastrophic plan, and pay a proportion of her OOP costs. Of course, if she does have an expensive, but not catastrophic health need, you'll have to budget for that.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Our nanny is older—early 60s—and the marketplace plans are all $1000 or more per month! And we pay her too much for her to be eligible for subsidies. Anyone else in this situation? We’d been planning to help out $500/month but that still would be super expensive for her.

And let me guess -- a $6000 deductible on top of that. Depending on where you live, this can happen. I don't know what the answer is; weren't there some non-compliant plans people were allowed to buy?

And, truthfully, she's in the same bind as a lot of folks -- it's expensive, but it's necessary. She's only going to have to pay for it for a few years, then she'll be eligible for Medicare.

Yes, $6000-ish deductibles before the plans pay anything. It's ridiculous. She's never sick, in great health--but if she is sick I want her to be able to go to the doctor without paying out of pocket and God forbid she was really sick I'd want her to have actual coverage. Looks like the options are to pay for a non-compliant plan that offers catastrophe coverage (seeing as it is unlikely she'd hit the deductible basically ever, the high-deductible plans are effectively catastrophe coverage that is just priced 3X as high), or maybe we'll just sacrifice and pay a giant chunk of it for two years until she is eligible for Medicare. What's an even bigger burn is I think only the first $450 or so a month is untaxed--seems like bad public policy. Just discourages employers further from paying for insurance for their employees, especially as in our case an older employee! UGHHH.

Is it because she's old? My family can get a plan for $400 per month with a $7000 deductible. We do not qualify for a subsidy. HHI 90k

Assume so. A few years back when I was between school and my next job I was able to get coverage for $300 a month. Late 20s at the time.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Our nanny is older—early 60s—and the marketplace plans are all $1000 or more per month! And we pay her too much for her to be eligible for subsidies. Anyone else in this situation? We’d been planning to help out $500/month but that still would be super expensive for her.

And let me guess -- a $6000 deductible on top of that. Depending on where you live, this can happen. I don't know what the answer is; weren't there some non-compliant plans people were allowed to buy?

And, truthfully, she's in the same bind as a lot of folks -- it's expensive, but it's necessary. She's only going to have to pay for it for a few years, then she'll be eligible for Medicare.

Yes, $6000-ish deductibles before the plans pay anything. It's ridiculous. She's never sick, in great health--but if she is sick I want her to be able to go to the doctor without paying out of pocket and God forbid she was really sick I'd want her to have actual coverage. Looks like the options are to pay for a non-compliant plan that offers catastrophe coverage (seeing as it is unlikely she'd hit the deductible basically ever, the high-deductible plans are effectively catastrophe coverage that is just priced 3X as high), or maybe we'll just sacrifice and pay a giant chunk of it for two years until she is eligible for Medicare. What's an even bigger burn is I think only the first $450 or so a month is untaxed--seems like bad public policy. Just discourages employers further from paying for insurance for their employees, especially as in our case an older employee! UGHHH.

Is it because she's old? My family can get a plan for $400 per month with a $7000 deductible. We do not qualify for a subsidy. HHI 90k

Anonymous wrote:

Anonymous wrote:Our nanny is older—early 60s—and the marketplace plans are all $1000 or more per month! And we pay her too much for her to be eligible for subsidies. Anyone else in this situation? We’d been planning to help out $500/month but that still would be super expensive for her.

And let me guess -- a $6000 deductible on top of that. Depending on where you live, this can happen. I don't know what the answer is; weren't there some non-compliant plans people were allowed to buy?

And, truthfully, she's in the same bind as a lot of folks -- it's expensive, but it's necessary. She's only going to have to pay for it for a few years, then she'll be eligible for Medicare.

Yes, $6000-ish deductibles before the plans pay anything. It's ridiculous. She's never sick, in great health--but if she is sick I want her to be able to go to the doctor without paying out of pocket and God forbid she was really sick I'd want her to have actual coverage. Looks like the options are to pay for a non-compliant plan that offers catastrophe coverage (seeing as it is unlikely she'd hit the deductible basically ever, the high-deductible plans are effectively catastrophe coverage that is just priced 3X as high), or maybe we'll just sacrifice and pay a giant chunk of it for two years until she is eligible for Medicare. What's an even bigger burn is I think only the first $450 or so a month is untaxed--seems like bad public policy. Just discourages employers further from paying for insurance for their employees, especially as in our case an older employee! UGHHH.

Anonymous wrote:Our nanny is older—early 60s—and the marketplace plans are all $1000 or more per month! And we pay her too much for her to be eligible for subsidies. Anyone else in this situation? We’d been planning to help out $500/month but that still would be super expensive for her.

And let me guess -- a $6000 deductible on top of that. Depending on where you live, this can happen. I don't know what the answer is; weren't there some non-compliant plans people were allowed to buy?

And, truthfully, she's in the same bind as a lot of folks -- it's expensive, but it's necessary. She's only going to have to pay for it for a few years, then she'll be eligible for Medicare.

Our nanny is older—early 60s—and the marketplace plans are all $1000 or more per month! And we pay her too much for her to be eligible for subsidies. Anyone else in this situation? We’d been planning to help out $500/month but that still would be super expensive for her.

Anonymous wrote:Hi all, our nanny is a long time green card holder. We are trying to assist with researching and purchasing insurance now during open enrollment. Does anyone know if green card holders have the same marketplace options as citizens, or if there is a good primer in this somewhere? TIA!

She's a legal resident subject to taxes, etc., so, yes, should be the same.

Hi all, our nanny is a long time green card holder. We are trying to assist with researching and purchasing insurance now during open enrollment. Does anyone know if green card holders have the same marketplace options as citizens, or if there is a good primer in this somewhere? TIA!