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Health-insurance dilemma

Published: Tuesday, Nov. 19, 2013 5:30 a.m. CDT

To the Editor:

Mr. President and members of Congress, I have a question I need help with.

My wife and I, early 60s and in good health, have been informed that our insurance policy is sub-par and will need to be replaced. We like it, but we can’t keep it.

We have a policy with a $5,000 deductible and 50/50 co-insurance for the next $10,000 for a max out of pocket of $10,000. The premium is $4,351.56 a year, and our average out-of-pocket expense runs about $3,500 per year for the past three years.

Our new policy has a $6,350 deductible and then covers at 100 percent. It also covers mental health issues and maternity benefits, which I assume increased the premium. Doctor visits and medicine also will come out of the deductible first. The new premium is $1,321.58 per month – or $15,858.96 per year, an increase of $11,507.40 per year.

I checked on subsidies and discovered that if we earn $62,000 a year, we qualify for a subsidy of $1030.83 per month, which brings the yearly premium to $3,489. However, if we earn $65,000 a year, there is no subsidy.

Surely you understand our dilemma. Would you recommend we earn less and save the $12,369 in premiums, or try to earn more and pay the full bill? I’m sure we aren’t the only ones with this question.

As a final thought, please remember if we need to pay the additional premium we can’t print the money, and it’s likely to come out of other purchases.

Jim Cosgrove


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