I, f24 and my partner, m25 are in need of health insurance. (and possibly dental/vision) I have a massive amount of gynecology problems and we don’t have insurance. Nor do we qualify for gov programs. The only one I do qualify for (women’s health), I have been told by numerous Dr’s offices that they don’t accept it. And also, my partner doesn’t qualify for that one. We do live in TX and I looked into blue cross blue shield but I can’t really tell if it’s the right one. We don’t have primary doctors either so figuring out the “network” thing has been weird. Niether of our parents or family members know much about insurance so hopefully we can get some help here.
Edit to add I am F24, my partner is M25, I am unable to work due to my gynecology problems. My partner makes abt 20-25k a year and we live in the DFW area of TX.
Unfortunately, Texas hasn’t expanded Medicaid to include coverage for those who are low/no income. With that being said, unless you have a qualifying life event in the last 60 days, you’re not going to be able to enroll in a healthcare.gov plan until November 1 for a plan that is effective 1/1/2024.
Because you have pre-existing conditions, you will need a plan that is ACA compliant (won’t deny pre-existing conditions, free preventive care, etc.). Most people get those through work insurance or healthcare.gov going anywhere else to get this care will almost guarantee the plan is not ACA compliant and then they won’t cover your pre-existing conditions.
Head on over to this website, it’s a subsidy calculator and can help you view plans you’ll be able to sign up for starting in November. I put in the info you shared and it’s kicking back a $700 subsidy— which makes some of the plans ZERO cost to you. I recommend taking a look— and while these are 2024 plans that may change slightly in 2025, it will give you a good idea of what is available.
Silver plans are a great choice for you at this income level because they maximize the benefits of Cost Sharing Reductions (CSRs). These CSRs can significantly lower your out-of-pocket healthcare costs.
Just to clarify Lizzie’s point: If you buy a plan on Healthcare.gov during the Open Enrollment period happening between 2024 and 2025, your coverage will actually start on January 1st, 2025
We do live in TX and I looked into blue cross blue shield but I can’t really tell if it’s the right one. We don’t have primary doctors either so figuring out the “network” thing has been weird. Niether of our parents or family members know much about insurance so hopefully we can get some help here.