Health Insurance question - Wife got a new job halfway through the year

My wife is going full time starting in August. She, and our daughter, have been on my insurance all year. 

We're trying to evaluate if we should put my wife, and possibly my daughter, on the new insurance option. But what happens to our out of pocket and deductible? We've already met the deductible; and are about halfway to the out of pocket. Does that spend follow to the new insurance? Would mine just be maxed out? 95% of our medical expenditures are from my wife and daughter. 

FWIW, currently the deductible is $3,200, but if it was just me it would be $1,600. My wife's deductible on the new insurance would be $2,600 for her and my daughter, or $1,300 for just my wife. Current out of pocket is $7,700 and new one would be either $8,000 or $16,000 for a family, halved for just my wife - the two numbers depending on in network/out of network; some of my wife's doctors are out of network annoyingly. 

Does this question even make any sense? 

I don't think the deductible/out of pocket follows your wife to a different insurance if she changes carriers during the year.

The other question I think you may need to look into is if your insurance imposes a requirement that your wife would have to take her new job's insurance and can't stay on yours if her job offers insurance. Apparently that's a thing now...

In reply to BoxheadTim :

That's been a thing for at least 20 years. Typically there is a clause saying "unless spouse's employer insurance premium is more than "$XXX per month."  That often makes it possible to keep the spouse on original insurance.

Duke said:

In reply to BoxheadTim :

That's been a thing for at least 20 years. Typically there is a clause saying "unless spouse's employer insurance premium is more than "$XXX per month."  That often makes it possible to keep the spouse on original insurance.

 

We'd pay a penalty for it. $50 a month or something like that. 

Looks like kiddo is staying on mine, at a minimum.

Also, the insurance companies sometimes specify which spouse's insurance covers the children. It's based on the birthdates of the parents on my insurance. Earliest birthday gets the kids. Be sure to ask about that.

In reply to mtn :

DW has always been in the large corporate world so we have always been on her health insurance.  My previous employer offered health insurance (current one does not).  I was required to go on mine as primary because my company's insurance premium was under whatever DW's employer's threshold was per month.  The kids stayed on hers, and I came back on when I changed jobs.

Your deductible and OOP max are going to reset when switching plans. Based on what you've laid out I'd wait until next open enrollment, and potentially not move them at all depending on the premium difference. Any penalty from not moving the family to your wife's insurance is going to be far outweighed by the deductible/OOP max resetting to zero.

szeis4cookie (Forum Supporter) said:

Your deductible and OOP max are going to reset when switching plans. Based on what you've laid out I'd wait until next open enrollment, and potentially not move them at all depending on the premium difference. Any penalty from not moving the family to your wife's insurance is going to be far outweighed by the deductible/OOP max resetting to zero.

Yeah, I think I'm going to go ahead and play dumb on this one and not do anything. We'll make the switch at open enrollment. 

And for anyone who says I might be cheating the system, I don't care. The system cheated me out of $3,000 in 2018 because the neonatoligist we saw when we first transferred hospitals wasn't in network - but you don't really get to pick the intensiveists when you make a hospital transfer at 2AM.