If her income for 2015 was below $11,000 then, if anything, she would have been eligible for a larger credit (or Medicaid). She won’t be penalized because she would have also qualified for a hardship exemption in most states. The Kaiser foundation has a good set of Q&As for these scenarios: http://kff.org/health-reform…

If you’re fairly certain that your wife will need pre-natal and maternity care in 2016, I’d recommend she be on a plan that has: 1) the OB/GYN that she’d like for her care and 2) the lower deductible since you’ll know you’ll be incurring health care expenses. The PPO probably has a broader network than her current…

That shouldn’t be the case. There is a special rule to protect people in her circumstances. If the Marketplace found she was eligible for premium tax credits at the time she enrolled (because her best estimate at that time was that her annual income would be between 100% and 400% of the federal poverty level, which is…

If you’re not eligible for premium tax credits or the cost-savings programs, then you don’t have to shop on the federal or state marketplace. However, I’d encourage you to look there first to see what your options are. But you’re certainly free to shop plans that are “off-exchange.” Off exchange, you’ll probably find…

Hi UrbanEconomist - if you’re happy with the HMO plan (and it includes any doctors your family wants to see), then I wouldn’t worry about the negative reactions. At a given coverage level, an HMO plan tends to be cheaper than a PPO for a couple reasons: 1) you have to stick to the plan’s network...there’s no coverage…

It sounds like, in addition to whatever rate increases the insurance company has imposed, your employer might also be increasing the share of employee contribution to the cost.

Hi James - unfortunately you can’t opt out of maternity coverage...it’s one of the essential benefits required in health insurance. However, if you’re a low maintenance health consumer (which it sounds like you are), you can look into high deductible plans (i.e., bronze level plans) that carry lower monthly premiums.…

Hi Steven - because you and your wife have recurring medical expenses for visits, medications and devices, I would encourage you to sign up for either a flexible spending account (FSA) or a health savings account (HSA). These accounts allow you to contribute pretax dollars to an account that you can use for qualified…

It’s certainly not easy, RTS1005. There are a few sites where you can pull and compare plan data, and check for inclusion of your families’ doctors (keeping in mind that ultimately you will enroll in your state’s marketplace to make sure you qualify for any cost savings for which you might be eligible). I like…

Hi Ender2003 - that sounds pretty high, if we’re just talking about premium increases...although insurance companies in some states have requested rate increases upwards of 50% in some states. Does that increase also maybe include an increase in employee contributions that your employer requires? In any case,…

Great question, Stavros. It depends on how frequently you think you’ll use your health insurance. If, for example, you have regular doctors visits or chronic conditions you manage, you may want to opt for a lower-deductible plan. Also, take a look at the networks of the plans offered. If you have doctors you really…

It’s not an easy decision, and it depends on what you’re trying to optimize for. If choice of providers is important for you (i.e., you want the ability to go out-of-network), then you’re probably best sticking with a PPO. If you want to save on monthly premiums, then a high deductible plan (HDHP) with an HSA would be…

Great question, Rekabor. If you have a sense of what your income will be in your new business, you can go to the marketplace for your state and see what the costs would be and whether you’d qualify for the premium tax credit and out-of-pocket savings programs. When you enroll, they don’t use your former salary;…