Dear Penny: Can I switch plans if health insurance eats up half my paycheck? (2024)

Dear Penny,

I got downsized a year ago and accepted a job in a different field than I was in. Though I’m making a bit more than I was in my previous job, health insurance takes up half of each paycheck (for me, my 19-year-old son and my husband).

It would have been OK if my husband could have gotten his own insurance through his work, but his was even more than ours put together. I’m having to use savings to make things work. Should I look into the Health Insurance Marketplace, find a new job or suck it up and stay here?

-C.

Dear Penny: Can I switch plans if health insurance eats up half my paycheck? (1)

Dear C.,

When you have to dip into savings for basic expenses like healthcare, your situation is unsustainable. So yes, shop for a different job and a different health plan.

Unfortunately, you can only do the latter during open enrollment unless you experience what’s called a qualifying life event, like you lose your job-based coverage or get married or divorced. Open enrollment is usually a period of several weeks in the fall at most companies. But you can start comparing your options on the Health Insurance Marketplace using healthcare.gov so that you know whether you want to decline your employer’s coverage. If you opt for a Health Insurance Marketplace plan, you’ll have to enroll between Nov. 1 and Jan. 15 in most states.

I don’t know if a Marketplace plan would actually save you money. Employers generally pay at least part of your health premiums, and you’d be shouldering all of these costs on your own. But if your employer’s plan doesn’t meet the minimum affordability standards set by the federal government, it’s possible that you’d qualify for Marketplace subsidies.

One thing I’d suggest doing is comparing costs if you and your family don’t stay on the same plan. Most companies cover a significantly higher share of premiums for the employee than they do for family members, so it doesn’t always make sense to keep the entire family on a job-based plan.

If you and your husband have different medical needs, it may make sense not to stay on the same plan. For instance, when one spouse is relatively healthy and the other has a chronic medical issue, sometimes it makes sense to go with different plans so the healthier spouse can choose a plan with higher deductibles and lower premiums.

Though the Affordable Care Act allows people under age 26 to stay on their parents’ health plans, that isn’t always the best option. If your son is a college student, you could look into whether he could enroll in a campus health plan. He may also be able to get a cheaper plan on his own through the Marketplace.

The flip side, though, is that many plans charge a flat fee for family coverage instead of basing it on the number of people covered. If that’s the case, you wouldn’t save money by removing your son from the plan.

You may be able to find more affordable insurance through your employer when open enrollment comes around. If you have a traditional health plan, you could look into whether a high-deductible health plan with a health savings account is an option. As the name implies, you pay high deductibles (in 2024, that will be a minimum of $1,600 for individuals and $3,200 for families). Those high deductibles lower your premiums substantially, but your out-of-pocket costs are a lot higher.

The advantage is that you can save pre-tax money in your HSA and use that for out-of-pocket costs. Many employers will also contribute on your behalf.

It’s essential to consider your family’s health history before making this switch, though. A high-deductible plan with an HSA is often best for people who are relatively healthy who don’t require frequent specialist visits or take pricy medications.

In the meantime, you should definitely look for a different job with better health insurance. You might want to consider opportunities at larger companies, which can often negotiate more generous health plans for employees. Research benefits on sites like Glassdoor and Comparably to get a sense of how satisfied employees are with their coverage.

Even if you’d have to take a significant pay cut, you could come out ahead if you’re able to get a job with cheaper health insurance. So make health benefits just as high of a priority as salary during your job hunt.

• • •

Robin Hartill is a certified financial planner and a senior writer at The Penny Hoarder. Send your tricky money questions to [email protected].

Dear Penny: Can I switch plans if health insurance eats up half my paycheck? (2024)

FAQs

Can you decline health insurance for a higher salary? ›

You can and should ask for it. I think the best way to go about it is to be direct. There's no reason why you cannot just point out that you've saved the company thousands of dollars and would like to have a raise.

Can I pay out-of-pocket instead of using insurance? ›

You may choose not to use insurance if the service you need isn't covered, or it's less expensive if you pay out of pocket. In most cases, providers and facilities must give you an estimate when you schedule care at least 3 business days in advance, or if you ask for one.

Should all employees pay the same amount for health insurance? ›

Are employers allowed to offer different benefits to different employees and to charge more for the same benefit, or is this a discriminatory practice? There are no federal laws requiring plans to provide the same benefit coverage to all employees.

When to deduct health insurance premiums from paycheck? ›

Typically, you want to start taking deductions during the first coverage month. So if your coverage begins on May 1, you would want to start taking deductions out of the May paychecks.

Can you ask for money instead of health insurance? ›

It is legal to offer employees cash in lieu of health plan benefits, but it has to be done appropriately through a cafeteria plan that includes a “cash-in-lieu” agreement. If they opt out for cash in the agreement, they will be taxed on those funds as if they were wages.

What percentage of salary should go to health insurance? ›

No one eligible for our coverage will have to pay more than 8.5 percent of their overall household income for health insurance (unless you choose to sign up for a plan with richer benefits, like a Gold or Platinum plan).

Is it better to self pay or have health insurance? ›

Sometimes, paying cash is less expensive than processing the claim through the insurance provider. However, keep in mind that the money you spend out of pocket won't count toward your deductible when you don't use your health insurance to pay for medical care.

Is it cheaper to pay out-of-pocket for health care? ›

We discovered some health care providers' cash or self-pay discounts are cheaper than what you'd pay using your insurance. People with high deductibles are finding it's better to pay their bills with cash or card than let billing departments send it to their insurance.

Can I pay cash even if I have health insurance? ›

Paying Cash vs.

The California Department of Managed Health Care tells us: yes, you can. Lisa Berry Blackstock, a private patient advocate, says many of her clients have saved hundreds or even thousands of dollars by paying cash, even when they have insurance.

What is the most expensive health insurance? ›

Platinum health insurance is the most expensive type of health care coverage you can purchase. You pay low out-of-pocket expenses for appointments and services, but high monthly premiums. Plans typically feature a small deductible or no deductible and cheap copays or coinsurance.

What is the 60 day loophole for COBRA? ›

Once your employment ends, you have 60 days to elect COBRA coverage with your former employer. Some people all this the “60 day loophole for COBRA.” COBRA is retroactive, which means that it begins the day after your employer coverage ends.

How much does the average American pay for health insurance? ›

Average annual health insurance premiums in 2023 are $8,435 for single coverage and $23,968 for family coverage. These average premiums each increased 7% in 2023. The average family premium has increased 22% since 2018 and 47% since 2013.

Does paying health insurance affect your tax return? ›

Whether you get financial help or not, health coverage is part of filing your taxes. Unless you report that you had health coverage, you may have to pay a state tax penalty. If you received federal or state financial help, you'll report that as well.

Can I deduct health insurance premiums paid out-of-pocket? ›

If you paid the premiums for a policy you obtained yourself, your health insurance premium is deductible when they are out-of-pocket costs. If your insurance is through your employer, you can only deduct these: Amounts you paid with after-tax funds.

Can a W-2 employee deduct health insurance premiums? ›

by TurboTax• Updated 7 months ago

Most premiums are paid with pre-tax dollars, which means they are deducted from your wages before taxes are applied. Deducting them again as a medical expense would be "double-dipping." You can only deduct the premiums if your employer included them in box 1 (Gross Wages) of your W-2.

Can you ask for a higher salary instead of benefits? ›

If the benefits and pay do not align with your skills, qualifications, career level or education, you can negotiate for more money or better benefits. It is also acceptable to suggest other forms of compensation, such as stock options or extra vacation days.

Can you negotiate salary without health insurance? ›

After receiving an offer, don't be afraid to negotiate a higher starting salary in light of the lack of benefits, Patrick says. “It doesn't hurt to ask, and the worst they can do is tell you no,” she says. This can be key as you contemplate: Should I take a job with no benefits?

Does salary affect health insurance? ›

For instance, an employee earning less than $25,000 a year may pay $631 a year for individual coverage while an employee making $150,000 or more may pay $2,151. At most companies, insurance premiums vary only by the type of plan selected and family size.

Can I ask for more money if I don't take health insurance? ›

Some organizations may offer a cash-in-lieu of health insurance option, but if they do not you may be able to negotiate more salary because you won't be taking the insurance.

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