WWYD? Re: Health insurance options.

[x__amour]

If you never go to the doctor, would you opt for a cheaper plan with co-pays and a higher deductible or a more expensive plan with co-pays and no deductible? DH never, ever goes to the doctor. The only doctor he needs to see is a psychologist (specialist) once in a while for his bipolar disorder or if the off chance he got really sick and needed a general practitioner.

He has a new job and for a bare minimum, high deductible health insurance plan through his job it's $600 per month for just him, it's insane. We qualify for the government subsidy if we get our own private insurance but I don't know what plan to get.

I'm trying to decide between these 4 plans. The prices are per month.

https://i57.tinypic.com/ehxljt.jpg

I hate insurance, it's so confusing. What would you do?

 

[RaspberryK]

The cheapest one on the left, the savings per month would outweigh anything you have to pay on the occasion he sees the specialist.
I'm not 100% sure how the deductible stuff works in us insurance.
Xx

 

[RaspberryK]

Hmm on second thoughts if he ever did need treatment that's a lot to pay out...
You have to pay the amount first before the insurance pay anything and then you still have to pay a percentage?
That's crazy.
We have medical insurance on top of nhs, anything that we want doing that is within our policy and don't want on the nhs due to waiting times or something we just need a gp referral and pay £100 excess per year. There are yearly limits on treatment but that's a huge amount.
Our policy is £ 100 per month for the 3 of us.
Xx

 

[Bittersweet]

Not sure as we get it free here but wow sounds complicated!

 

[Jes.shortcake]

I would go for the last. That's not too bad a price for no deductible. My LO's individual plan is $134 a month! And I think it's $1000 deductible. We didn't qualify for any government help.

Health care cost in the US is ridiculous!!

 

[wishuwerehere]

I wouldn't go for a cheaper plan on the premise that you "never go to the doctor" because you just don't know what's going to happen in the future.

 

[x__amour]

I'm not 100% sure how the deductible stuff works in us insurance.

Unless you have co-pays, you have to pay the full deductible every year before insurance pays for anything. It's frustrating.

 

[pb921124]

Hi Amour,

Based on the details that you described, it might be best to go with the second to lowest cost plan. It appears that this plan provides you with only a flat co-pay for visits 1-2 for office visits, which may be ideal if you only see the doctor once in a year and it has a lower deductible that the cheapest plan. However, its hard to say without taking into consideration the rest of the plan coverage details.

You should definitely keep in mind two things:

1. it appears that you are looking a plan comparison which has WAY less details (I also don't see family annual deductibles listed) than each individual plan summary which includes items like exceptions and limits that you may need to take into consideration when TTC. For example, prenatal costs and hospital stays may be covered up to a certain amount of visit at a flat copay dollar amount or you may have to pay a percentage of bill after your deductible is met.

2. the individual annual deductible should be take into consideration as this is how much you will need to pay out of pocket before your plan will cover the listed % amount unless a flat dollar copay amount is given.

It can all be very confusing and there are so many caveats, you may want to tell your husband to speak with HR to figure out how to interpret the plan summaries to understand what is best for your family.

Hope I did more help than harm in trying to explain

 

[x__amour]

wishuwerehere, that's what the logical side of me says. Last year we had a high deductible plan and I got my ass kicked when I got pneumonia. Still paying off the thousands of dollars in bills. That's where the other "oh crap, we need all the extra dollars we can get" side is coming in. But I know I should probably listen to the logical side in case DH does get very sick like I did or has an accident or something.

pb921124, thank you very much! I forgot to mention this is only for DH. I have health insurance through my father. DH is the only one who needs a new plan right now. There was also all the information on the website, I just shortened it on here.

 

[Natsku]

I think the no deductible one is the wisest option as you never know when you might get ill or have an accident but if you really want to go for a cheaper one with a deductible then the second one sounds best.

 

[smileyfaces]

Wow so confusing, thank god for the NHS!

 

[x__amour]

Wow so confusing, thank god for the NHS!

It is insane. And the whole healthcare reform, even more confusing. So tempted to move to the UK sometimes. Or at least Canada.

 

[smileyfaces]

Yes come to the UK, everything is free here lol!!

But seriously, I dont know how we would cope with medical expenses, our costs are covered by taxes. Cant believe you have to pay so much

 

[pb921124]

Do you know if your husband has the option of a flexible spending account (fsa) through his job or Health savings account (hsa)? If this is offered to him, this might be something for him to take into consideration before making a plan choice, as these accounts can be used to cover medical expenses. These accounts can be beneficial as a set amount of money can be assigned to them pre-tax and sometime employers provide a match. HSA are tied to plans and deductibles have to be met before the HSA account funds can be used, but the money can roll over from year to year. FSA are not tied to medical plans and can be used for any qualifying purchases or charges, including everyday items like band-aids and contact solution. However, most FSA plans don't allow funds to roll over each year and are use it or lose it. These accounts also cover other items like dental and vision costs.

Not to make it more confusing for you but I know most employees under utilize these options when they are offered by their employer because they don't understand how they work or may not even know to ask if they are available.

 

[pb921124]

Wow so confusing, thank god for the NHS!

It is insane. And the whole healthcare reform, even more confusing. So tempted to move to the UK sometimes. Or at least Canada.

Completely agree!!! It's enough to drive you crazy!!!

 

[Jes.shortcake]

Unfortunately health seems to be a money making business here. It's sad. The government doesn't really over see it or set prices (besides Medicare and Medicaid) so it seems like fair game as far as costs.

 

[morri]

Come to germany, all the health insurances cost the same just have different focus