So, I'm not trying to be a baby with this whole thing, trying to get someone to hold my hand and help me make a decision, but I do feel like the purpose of me blogging is to get some advice and input from people who have more experience than me and can give some insight to my decisions. (Man, what a run-on sentence!) It's been a long time since we've had to do the whole health insurance thing and I'm just having a hard time wrapping my head around each plan and the benefits and drawbacks of both. I appreciate the comments everyone has left, and I was wondering if I could get more input if I put some of the specific numbers. (You know that commercial where the girl talks to everyone she comes across about her car insurance? Sorry, I'm going to be like that for a bit here)
Medical Rates
Plan A
Plan B
A few things to keep in mind. Besides well-child visits, so far Rae and Blaise have been to the doctor maybe 10 times. They've only ever had 3 prescriptions and no hospital stays. Rae went to the emergency room once, but not for a true emergency. All of this could change in the next year, so I don't want to have my hopes up.
As for me, I plan to be pregnant while on this insurance. Both plans have the same maternity coverage. I'm leaning towards Plan A, since they have the "co-pay" type plan. (except not for maternity if I'm reading it correctly) Roy would like to be able to go to the doctor a few times for checkups, since he hasn't been to one in like 5 years. Anyway, any input is helpful. Thanks.
3 comments:
The only differences between the plans besides the deductibles and the out of pocket maximums is the ER section. Plan A covers 100% after the first $100, while Plan B does 80% after you pay the deductible. So now we go to the break even point on your deductibles. The difference in monthly payments between Plan A and B is $184.07. The difference in the deductibles is $1000. If you go with Plan B, every 5.5ish months, you'll save enough money to pay the difference on the deductibles. Call it every 6 months to be safe. Unless you expect to have more than 2 medical incidents costing more than $1500 per year, you'll come out ahead with the higher deductible. Unless something is really weird about Missouri doctors, most of your medical visits won't be over $500 anyway. I'd suggest putting the difference between your monthly payments into a savings account for your emergency fund, and you'll be good to go. In the event that your health situation changes, you can always change your plan at the annual enrollment.
I started looking at these plans without looking at the comments, fully expecting to say Plan A. I like good insurance. But I think Plan B is reasonably good. The thing is, like James said, you need to be willing/disciplined to set aside some money to pay for medical expenses. And I'm looking at these plans through the eyes of someone who has had a baby that racked up a quarter of a million dollars in bills the first 2 months of life. Even in such an event you have a 4,000/year out of pocket maximum as long as your hospital and everything is in network. Look at that worst case scenario and weigh the possibility of hitting the yearly max against the amount you would save in premiums.
Of course part of it (for women, especially) is a security question.
Well, I just had a sister in the branch come over to do family history, so I'll have to finish up my thoughts later.
Have you looked into a completely different insurance for you and the kids? You're paying $400+ a month on plan A for this plan. You may be able to pay 400+ a month for really great insurance from someone like bluecross or whatever. As far as plan B, if you're anything like my brother, he's always in the emergency room. You have to have the funds to pay that giant deductible otherwise you're in trouble. Just some thoughts. I would look into other insurance. You could put Roy on the school's plan and find something else for you guys. I know that's just more work and may not even compare, but it's worth looking into it.
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