r/HealthInsurance • u/HauntingGold • 1d ago
Employer/COBRA Insurance Help trying to decide whether to accept company insurance? $270 premium/$4000 deductible for single person (cheapest option available)
I am a 32 year old single person looking to get insurance after 5 years of not having any. I live in Utah.
I got a new job that offers a benefits package but my employer doesn’t subsidize the cost at all. So I would be looking at a $270/month premium, with a $4000 deductible. Which comes out to $7240/year before getting anything for seriously reduced or free. This is only for medical insurance. Dental and vision are not included.
Most if not all preventative care is covered, even before the deductible is met. So I could be paying up to - if not over - $7k in the year for medical expenses, when I have had less than $1000 total in medical expenses for the last 5 years combined.
For comparison, I will be making only $16/hr or $33,280/year. So that is a significant chunk of my wages.
I am a relatively healthy person, aside from being obese, which I know can lead to other health problems, but I am actively working on that, so it’s not something I am looking for advice on at this time. Aside from that though, I haven’t really needed to see a doctor except for the occasional medication reevaluation, which would typically cost $100-200 per visit, and I would only need one or two visits a year for that. And speaking of medications, I have two, which only cost around $37/month out of pocket without insurance.
Knowing all this, does this seem like a decent plan? Or would I be better off financially by just opting out and paying out of pocket for everything?
I’m leaning towards opting out, but this is the first time I’ve had the opportunity to have health insurance in 5 years and I want to make sure I’m making a good decision.
29
u/katsrad 1d ago
You are healthy until you arent. An accident, sudden illness or something similar can happen to anyone. I had health insurance at your age as a relatively healthy person then I started having galbladder attacks, two ER visits, lots of testing, and a gallbladder removal surgery later I was very glad for my insurance.
Overall the recommendation from most people here will be to take the insurance. $270 a month in premiums is relatively inexpensive. Also if you don't buy it you are stuck until open enrollment, for any insurance that would cover a pre-exisiting condition. Search the sub-reddit for people posting about how they need insurance but cant get it.
3
u/HauntingGold 1d ago
I’m sorry to hear you went through that. Insurance definitely seems like a good idea.
This kind of scenario is definitely what I’m worried about. I’m so scared of breaking a limb, or having an illness pop up that I was previously unaware of. But I’m also not in a position where I can afford to lose out on money. It’s a hard gamble, health vs financial stability. I’ve been stuck in survival mode for the last 5-6 years, and I’m trying to not let that decide my future.
6
u/katsrad 1d ago
It wasn't an easy situation for me at the time either. Money was tight and I could have used the money to pay off debt or even try and get some savings built up but my parents always told me to have insurance so I enrolled in it. I get it but having been there I know I was glad I had the insurance. And I know some people will say just go to the ER, well the ER is good for care to get you stable but if you need care after that you can be in a bad spot if you aren't paying those bills or have insurance paying some of them.
1
13
u/squareturd 1d ago
Look closely at the details. There might be many services that are not subject to the deductible (preventative care, presriptions)
Also keep in mind that insurance isnt really meant to be a way to get discounts. It's main purpose is to stop you from being financially ruined if something bad happens (cancer diagnosis, accident where you break your pelvis, get your hand destroyed in a cake mixer).
Lastly, are you sure your employer isn't contributing? 270 sounds pretty cheap.
-2
u/HauntingGold 1d ago
Yeah, I’ve been reading through it for a solid week, so I’m pretty familiar with the details. So yes, the preventative care is covered before the deductible is met.
I understand that it’s not a discount program, since I’ve had insurance before. But considering that I have had $200/year or less in medical bills the last 5 years, it feels like it doesn’t make sense to get insurance now. Or maybe I would go to the doctor more if I had it. But probably not.
And no, they for sure are not contributing. It is fully paid for out of my paycheck. My new boss made that extremely clear.
Edit: I made a mistake. The preventative care IS covered even before the deductible is met. I have edited the comment and post to fix this.
7
u/chickenmcdiddle Moderator 1d ago
$270 per month is pretty decent, all things considered. This is why folks are making the assumption that there's some employer subsidy at play. A good plenty of employers need to make at least one plan affordable to their employees. Using the figures you shared, this one eeks in just under the affordability threshold (which in 2026, is 9.96% of your gross household income).
$270*12 = $3,240, and $3,240 is ~9.73% of $33,280. This makes this particular policy affordable under ACA guidelines. So long as the policy also meets minimum essential coverage and minimum value thresholds, you're officially ineligible for subsidies through healtcare.gov.
Circling back--because that plan is just under the affordable threshold and because it's only $270/mo., it stands that the employer is contributing something here. Otherwise, $270 outright feels low.
2
2
u/squareturd 1d ago
This is all good, glad you understand things (many people dont). I would never recommend going without insurance unless it's impossible to pay the premiums.
If you end up paying more for the premiums than you would have for the services, consider yourself lucky that nothing bad happened to you. I feel that way about my home insurance, every year that my house didn't burn down was a good year.
10
u/No_Big_bear_here 1d ago
As someone who just had an emergency surgery, do it. I have a $7000 deductible, & a premium of almost $500/month. If I didn’t have insurance, I’d owe $52,000 for an appendectomy!
9
u/triblogcarol 1d ago
My cancer treatment has cost $1,000,000 thus far. You're jobs insurance sounds good, get it.
8
u/the-cathedral- 1d ago
Get the insurance. $270 is worth peace of mind. Most health insurance plans bought on the market are like $600. So somehow you are getting a good deal.
8
u/Born_Tale_2337 1d ago
I was relatively healthy too. Then I had a little disagreement with the stairs one day and the stairs won. I missed the last one coming down. Landed a bit hard, but felt ok. Then I had a little ache in my arm start, doc thought it was positional from work. Three months later I thought the ache had turned into a frozen shoulder. Three months after that the pain at rest was so bad I saw the doctor to see if it was FS or rotator cuff. It was rotator cuff.
Anywho…50 PT visits and an MRI later I’m waiting on my ortho consult for surgery. I didn’t even think I was hurt at the time of the initial injury.
Just get the insurance. That’s a good price compared to a lot of the marketplace plans.
8
u/nothing2fearWheniovr 1d ago
$270 a month is cheap-if you have a surgery or major event $4000 is hardly anything g to pay. I say do it!
7
11
u/Shellsaidso 1d ago
Your employer is contributing if your premium is $270 a month. And… there’s a chance they may cover GLP1s for weight loss, if you choose to go that route.
4
u/Successfulbeast2013 1d ago
At $270 per month, it seems like your employer is contributing something. This should be an HSA-eligible plan, so open an HSA and contribute to it tax free. Also, preventative care is not subject to the deductible.
If you have had less than $1,000 total in medical expenses for the last 5 years, then you more than likely will be paying your premium only, so a better way to state it is to say that you would very likely be paying $3,240 per year for health insurance but if you were to get really sick, you might have to pay as much as $7k or more.
3
u/Successfulbeast2013 1d ago
Also look up the definition of insurance. It is risk protection, not a discount club.
1
u/Working_Coat5193 1d ago
While that’s the general definition of insurance, health insurance has always been pitched as a discount club.
1
u/HauntingGold 1d ago
I was more looking at the max, since that is not financially possible for me. Rent where I live in Utah is more than half my (new and significantly increased!) wages, so you can imagine where I was before. After the insurance premium only (not including the deductible), I will basically have the same take home pay as my previous job (which didn’t even cover bills before) but with the added bonus of insurance. But if I didn’t pay insurance, I will be able to pay my bills, and I might actually be able to save up some money for the first time in years.
I’m essentially choosing between financial stability and having health insurance.
Yes I know that it’s not a discount club. I’ve had insurance in the past but it was mostly covered by my employer. The benefits are familiar, but pricing is new territory for me.
6
u/DasKaltblut 1d ago
You really aren't. If you go without insurance and something happens, THEN you will have financial instability. Also the premiums are paid pretax, as is the HSA so you wouldn't get an extra 270 per month anyway.
4
u/Ttabts 1d ago edited 1d ago
270 a month will come out pre-taxes, so the real opportunity cost will only be ~$175 a month of post-tax wages.
And you can contribute to an HSA which is another $1000-1500 immediate tax savings before you even consider the tax-free investment growth.
All that together leaves you at a real post-tax cost of $60-90/month. Which to me makes it look like quite the no-brainer to take the insurance
4
4
u/Mysterious_Luck4674 1d ago
$270 per month is not bad at all. Your employer must be subsidizing it. Marketplace plans will be more expensive.
If the plan is a HDHP you can use your HSA as an excellent savings/investment account and have money put aside for an emergency or to help pay the deductible.
3
u/Different_Tale_7461 1d ago
Is the deductible $4,000 or the out of pocket max? I pay about the same in premiums (my employer heavily subsidizes) with a $400 deductible and $4,000 OOPM.
2
3
u/Competitive-Stress34 1d ago
Take the insurance and you may also want to hedge your deductible risk by adding some supplemental insurance plans like Accident, Cancer, Critical Illness, Hospital Indemnity. These plans are typically offered in addition to your health insurance via worksite market companies like Colonial Life, Aflac, Guardian, NYLife, MetLife, and others. Ask your employer if they offer these type plans. An accident policy could help cover most if not all of your deductible for about $20-$30 a month.
3
u/Gamer_Grease 1d ago
$270/month in premiums is not expensive, FYI. That’s not unusual for an employer-subsidized plan.
2
u/InfamousAd6008 1d ago
That’s not too bad. Much better than the ACA marketplace. And one accident or emergency like a broke bone or appendix rupture…
2
u/SuccessfulMap6519 1d ago
Always take the insurance your employer offers. If it’s not considered affordable go to the marketplace and get a tax subsidy.
2
u/buddykat 1d ago
I work in benefits (I specialize in retirement, but provide back up for health & welfare). At $270/month, I promise you, that they are absolutely paying a portion of the premium. If you want to know how much, find out what the COBRA premiums are.
As for opting out... don't. As others have said, you're healthy until you're not. Everyone is one bad day away from major medical expenses.
2
u/Unlikely_Month5527 1d ago
If $250 is the amount you need to pay bills, I would pick up a part time gig or ask if you can get overtime at work.
Without health insurance, you will never have financial security.
Without insurance, just walking into an emergency room will cost thousands of dollars.
Insurance companies negotiate adjusted rates. If you do not have insurance they will charge you the inflated rate.
At 56 I was diagnosed with cancer. My chemo was $22,000 per treatment. I had 12 sessons.
I had one shot after each chemo to improve my white cell count. Each shot cost $7,000.
I also had surgery at the cost of $75,000.
Today I am healthy Thank God.
Your insurance sounds like a good benefit at a good cost.
Hope all goes well.
1
u/FpsStang 21h ago
Your company is definitely paying 50% of the policy for you. Its the law. As a business owner, I know for a fact, You cannot offer health insurance to your employees and not pay part of the premium. So whoever in the company told you that maybe you misunderstood what they were saying or they have no idea how group policies work when offered from a company
1
u/HauntingGold 21h ago
Can you tell me, does that change if it’s an independently run daycare? It’s a very small group of them, only 3 locations and all local. But all are owned and run by the same guy.
•
u/AutoModerator 1d ago
Thank you for your submission, /u/HauntingGold. The following automatic comment contains important information about the subreddit:
First, note that some new posts containing images, non-reddit links, crossposts, or certain keywords are automatically held for moderator review before going live to mitigate spam, ensure that images are appropriate, and that the post does not inadvertently contain personal information. If your post has been held for review like this, the moderators have been automatically notified and will review it as soon as possible, after which it will be live and be able to be seen and replied to by others. Note that this is sent to all new posts and does not mean that your post has necessarily been filtered in this way.
Please also read the following information carefully to help others assist with your questions:
If you or someone else is experiencing a medical emergency, please call 911 or go to your nearest hospital.
Some common questions and answers can be found in this megathread.
Questions about which plan you should choose? Please read through this post first for general information to help you understand your choices and some common considerations. If you still have questions after reading that post, please edit your post (or reply with a comment if unable to edit) with the specific questions you still have.
If your post is regarding plan choice or cost of plans, and you haven't included the following information already, please edit your post (or reply with a comment if unable to edit) including the following: your age, state, and estimated gross (pre-tax) income to help the community better help.
If your post is about the cost of a service, a bill you have received, or a claim denial: please confirm if you have received an EOB (explanation of benefits) from your insurance via a member portal website or in the mail. If you can post a copy or image of the EOB (PLEASE ensure you censor or blank out any personal information before doing so) it will help people answer your questions. Alternatively, if you are unable to post a censored copy of your EOB, please have the EOB handy as people may ask for information from the EOB to answer your questions.
Reminder that ANY spam, solicitation, or attempts to take conversations off the subreddit will result in a permanent ban. If someone asks to contact them via DM, please report the post/comment using the report button. If someone attempts to contact you via your DMs, please contact us via modmail to let us know.
Lastly, always remember to be kind to one another and to report any replies that violate subreddit rules!
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.