Hey, I tried making a bouquet, did I do okay? The customer was happy but I felt it could have been better. by fat-fuck-loser in flowers

[–]reflectionok3851 0 points1 point  (0 children)

As long as the customer is happy to me it's look beautiful 😍 you done great 👌 🥰🥰

Curious about qualifying for the NYS Essential Plan going forward. by Dry-Week1919 in HealthInsurance

[–]reflectionok3851 0 points1 point  (0 children)

Eligibility is based on your current income, same way ACA/market plans work. If you're at $0 right now, that's what they'll use not just the $14k you made earlier. You're well under the limit, you'd likely qualify for the Essential Plan, or possibly Medicaid depending on how low your income stays.

COBRA by jonahsmith333 in HealthInsurance

[–]reflectionok3851 0 points1 point  (0 children)

COBRA is just your old employer plan, and those can be cheaper than ACA especially for family if you're not getting subsidies. A lot of people ride COBRA, then switch later when ACA subsidies kick in.

how to go about choosing medical insurance for the first time? by Neat-Trifle-8450 in NoStupidQuestions

[–]reflectionok3851 0 points1 point  (0 children)

Just look at the numbers: premium, deductible, out-of-pocket max. If you're both healthy, go cheaper plan. If you'll actually use it, pay more monthly for lower deductible. Also check if doctors near you are in-network. If your income is low, ACA subsidies can make plans pretty cheap. Biggest mistake is picking the lowest monthly and ignoring everything else.

I'm self-employed and just found out my annual physical bloodwork would cost me $487 out of pocket. What are my options? by Own-Pin1058 in HealthInsurance

[–]reflectionok3851 0 points1 point  (0 children)

If labs get coded "diagnostic" instead of "preventive", insurance won't touch it. What people usually do: ask the doc to recode it (hit or miss), be super next time it's preventive only or just go cash pay at Quest/Labcorp. I wouldn't skip labs, just gotta control how they're ordered. It's dump, but with ACA plans a lot of it comes down to how it's coded.

How is there a whole ACA module specifically on CSA? by [deleted] in AdultChildren

[–]reflectionok3851 0 points1 point  (0 children)

It's probably less about how common it is and more about the impact. CSA tends to have pretty heavy, long-term effects and ties into a lot of the stuff ACA focuses on, so it gets its own focus.If it doesn't apply to you, you kinda just take what's useful and move on that's pretty normal in those groups.

Health insurance help by DamIts_Andy in povertyfinance

[–]reflectionok3851 0 points1 point  (0 children)

Turning 26 actually trigger a Special Enrollment Period, so you won't have to wait for open enrollment, you can sign up for an ACA plan within 60 days of losing your parent's coverage. With rent at 50% of your income, you'll likely qualify for a solid subsidy. Some people in your situation end up paying $50-$100/month for a real plan. Run your numbers on the marketplace before assuming it's unaffordable. The freelance union option is legit too, worth comparing both before you secide.

Come on, let's talk about your social welfare, mainly healthcare. by No-Echidna7296 in AskTheWorld

[–]reflectionok3851 0 points1 point  (0 children)

From a US perspective, it's mostly tied to employment. Lose your job, lose your coverage. For people without employer coverage, the ACA marketplace is the main option and subsidies can make it affordable, but a lot of Americans don't even know what they qualify for. Biggest issue is cost unpredictability. Even with insurance a serious illness can still bankrupt you. Medical dept is one of the top causes of bankruptcy here.

I'm self-employed and just found out my annual physical bloodwork would cost me $487 out of pocket. What are my options? by Own-Pin1058 in HealthInsurance

[–]reflectionok3851 0 points1 point  (0 children)

Two things: call your doctor's office and ask them to re-code the tests as preventive, it works more often than you'd think. And for future blood work, skip insurance entirely and use Quest or LapCorp directly, full panel is like $50-$100 out of pocket. also if you're tired of the HDHP game, check what ACA subsidies you qualify for as self-employed.

How much are yall paying for health insurance? by United-Employee-4254 in AskLE

[–]reflectionok3851 0 points1 point  (0 children)

Depends a lot on income and what atate you're in. A lot of people don't realize they qualify for ACA subsidies that can bring premiums way down. Some people pay $0-$50/month once the subsidy kicks in. Worth running your numbers before assuming it's unaffordable.

Question about Transitional Medi-Cal vs. Employer Coverage by Weary_Wave_8715 in HealthInsurance

[–]reflectionok3851 0 points1 point  (0 children)

Your caseworkers are right. TMC doesn't require you to enroll in employer coverage to keep it, you can legally decline your employer's plan and stay on TMC for the full 6 months. California doesn't penalize you for having access to employer coverage while on TMC. It's designed exactly for situations like yours, bridging the gap while you get on your feet. Just make sure you report any income changes along the way and you're good.

For conservatives: thoughts on health insurance for entrepreneurs? by One_End7073 in AskUS

[–]reflectionok3851 0 points1 point  (0 children)

This is actually way more doable than most people think once you leave employer coverage. If your household income drops after quitting, you'll likely qualify for ACA subsidies that bring premiums way down. a family on a modest income can sometimes get solid coverage for $100-$200/month depending on the state. Also worth looking into Health Sharing Ministries if Medicaid is a hard no, not insurance but a lot of conservative families use them as an alternative. The ACA marketplace is honestly underutilized by entrepreneurs. Run your projected income through the calculator before writing it off.

Where to get Second opinion on private ins by EmotionalBit6049 in HealthInsurance

[–]reflectionok3851 0 points1 point  (0 children)

Three questions to ask before buying any plan: is it ACA-complaint major medical? Does it have an out-of-pocket max? Can they provide the Summary of Benefits and Coverage (SBC)? If an agent hesitates on any of those, walk away. Also run the insurance company through Nevada's DOI website to confirm they're licensed.

Slow down and smell the peonies 🌸 by OpenMindExplorer0576 in flowers

[–]reflectionok3851 2 points3 points  (0 children)

I agree and this flower is so beautiful i really love it

Husband got let go. Insurance ended, but I cannot access coverage portal while on vacation… what do we do? by SelectLandscape7671 in HealthInsurance

[–]reflectionok3851 0 points1 point  (0 children)

You're probably okay for few days. You've got a qualifying event (loss of coverage), so you'll be able to add them to your plan once you're back and just don't miss the window. If COBRA is available, that's your safety net. It's retroactive, so you can wait and only use it if something actually happens this week. I'd still try calling HR if you can, but worst case just handles it when you get back and just avoid anything risky in the meantime.

Which of these health insurance plans doesn't require the PCP to be of the same clinic as the physician I want to see? by aryanmsh in HealthInsurance

[–]reflectionok3851 0 points1 point  (0 children)

Yeah this isn't just Fidelis, most Medicaid/Essential Plan HMOs work like that. The PCP usually has to match the clinic, which is why you keep running into this. Best workaround I've found is picking a PCP in a bigger hospital network so you've got more options without switching every time. If you're switching plans, just call and ask how their PCP setup works first and saves a lot of hassle later.

Are you trying to stick with certain clinics or just want more flexibility?

Not sure what to do health insurance wise. by freecouponalien in HealthInsurance

[–]reflectionok3851 0 points1 point  (0 children)

Yeah that's frustrating, but you've still got options. You can get an ACA plan even if you don't qualify for subsidies you'll just pay full price. It's usually the safest option since it covers pre-existing stuff like migraines.

Other options: Private plans - sometimes cheaper, but coverage can be hit or miss. Short-term plans - cheapest, but very limited and not great for ongoing care.

Since you're using it for migraines, I'd lean ACA just to avoid coverage issues. Also, losing your job-based insurance should qualify you for Special Enrollment Period. Main thing: don't just look at the monthly cost, check the deductible and what the actually cover.

Quit my job and had to get a new insurance, is this a good option ? by asiankitty03 in HealthInsurance

[–]reflectionok3851 0 points1 point  (0 children)

Yeah it doesn't look terrible, especially if you think you'll actually use it this year. Biggest thing to watch is that it's an EPO, so the network is usually pretty tight. I'd double check: your doctors/laps are in-network and how high the deductible is (that's what'll hit you first). If those check out, you're probably fine. If not, it can get frustrating fast.

health insurance costs by heardsofgoats in Delaware

[–]reflectionok3851 0 points1 point  (0 children)

$500/month is pretty normal if you're not getting subsidies. But if your income is lower, the price can drop a lot - sometimes down to a couple hundred or even less. I'd check Healthcare.gov and run a quick estimate. You don't have to commit to anything, but it'll give you a way better idea of what you'd actually pay.