<prompt> Human: A kind person suggested that I post this on rpersonalfinance to get more eyes on it, and hopefully to find something that I havent looked at, or if there is something else that can be done. I really really appreciate any help here. I am really depressed about the situation.Text:So, I have a chance at a promotion coming up. I will know by Friday, at the latest. I was really excited for the opportunity, nailed the interview, and left with high hopes. Later last night, I crunched the numbers, and found out something absolutely ridiculous. I cant afford to take this promotion.I make a little over 15hour right now. My Wife is a SAHM to our two daughters. One is six, and is in first grade. Our youngest is 2, and will start kindergarten in a little over two years. Once she is in school, my Wife will have time to find a job or start her photography business back up.Since I am the only income, and at 15.23hour, we are on our countystate run insurance through New York. Child Health PlusMedicaid. Now that it has been reworked a bit, they go by gross income now. The cutoff for the children is a monthly income of 2,961. The cutoff for my Wife and I is a monthly income of 2,643.The new jobs salary is a bit over 38,000. So the knocks us all off. Now, we would have to pay a ridiculous premium for a family plan, along with an even more ridiculous deductible. So the insurance is basically useless except for catastrophic. We will need separate dental insurance. We will need separate vision insurance.Sure, I would make more money. But now all of that extra money, or more, is now allotted for insurance premiums and deductibles. I wouldnt be able to pay for as many bills as I could before. Now, we may have to choose between electric for a month or food for our kids. We would most certainly cancel NetflixHulu we dont pay for cable, we cut that out years ago. I would stop paying my cell phone bill and sell my phone, we would just use hers we go through pageplus, so its 30-40 a month. We only have one vehicle we are still making payments on. I very much want this job. Way more responsibility, would look great on a resume. Vacationpaid sick time. Wife and I talked for hours last night about all of this. We were both crushed to find out all of this financial information about insurance and everything else. It is completely overwhelming. A promotion should be a GOOD THING! But its not! Its causing us SO much stress, over a PROMOTION. What the hell?What the hell do I do? I literally cant afford to take this promotion.Assistant: So, lets dig into this:Now, we would have to pay a ridiculous premium for a family plan, along with an even more ridiculous deductible. So the insurance is basically useless except for catastrophic. We will need separate dental insurance. We will need separate vision insurance.First off, vision insurance is mostly useless and rarely saves money. Pay cash and go to CostcoWarby Parker.Dental insurance also doesnt provide a ton of coverage. Do you have major dental problems? If its just cleanings youre fine paying out of pocket, andor go to a dental school.So health insurance is the big thing. Is this an Obamacare plan youre describing? How much is it costingwhats the coverage? 38k is little enough for a family of 4 that Id still expect decent subsidies.Human: First off, vision insurance is mostly useless and rarely saves money. Pay cash and go to CostcoWarby Parker.This is a good idea. I dont know why I didnt think of this, considering its what I do myself. Get the eye exam, and order glassescontacts online for really cheap. 75 exam per year, not bad at all. Dental insurance also doesnt provide a ton of coverage. Do you have major dental problems? If its just cleanings youre fine paying out of pocket, andor go to a dental school.I need a root canal on a molar, along with a cap. Thats 2k right there. My Wife, not so much. And the kids have regular visits for checkups and cleanings, as my oldest daughters adult teeth are coming in. So Im not sure if I should not have dental. So health insurance is the big thing. Is this an Obamacare plan youre describing? How much is it costingwhats the coverage? 38k is little enough for a family of 4 that Id still expect decent subsidies.I was looking at New Yorks marketplace. Cheapest I could find, which is catastrophic, 466.60 per month. However, I just looked there again, and I dont know how I missed the Estimate financial help button. I input out information, hit search, and this comes up: Based on your yearly household income, you andor your children may qualify for low-to-no cost insurance. Contact Customer Service at 855-355-5777 to learn more.So Ill have to give that number a call today after work.  <response>: Based on your yearly household income, you andor your children may qualify for low-to-no cost insurance. Contact Customer Service at 855-355-5777 to learn more.I would suggest you contact your Medicaid case worker and work with that person in running your promotional income scenario to see what impact it may have. Its likely you and your spouse may no longer qualify but I would guess that your children could stay on some form of medicaid CHIP or something similar in your state based on a gross income of 38,000 for a family of 4 in NY state. The medicaid program in my state has many nuances with respect to eligibility and what determines whether you qualify. For example, even if you are above the income limits per the Fed poverty limits you may still qualify for coverage using what is called a draw down whereby once your out of pocket medical expenses reach a certain threshold you become eligible again. These are state specific though so see if you can find NYs medicaid manual online and look for these provisional conditions usually under the income chapter or speak to your case worker. 