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Who here knows the health insurance game?

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Have to make a decision for the coming year's health insurance for our July 1 renewal.  Below are the two options I am considering.  (There are two other plans available but they are out of the question due to even higher costs)   I am currently on the right hand column.  If I stay with what I currently have my monthly premium goes up $378 per month before taxes.  If I take the option in the left hand column my premium still goes up but only by $152 per month before taxes.

 

Looking at the coverages below what plan would you choose?  Everyone in household is healthy and we rarely go to the doctor.  (knock on wood)  All of us in the household are active so there is always the risk that someone ends up in the ER or urgent care.  Nobody takes medications.

 

How much bigger out of pocket risk is the left plan compared to the right?   Is the option on the right enough better to be worth an additional $2,700 a year?

 

Our benefits rep wasn't much help narrowing down what the best plan for me is.  Thoughts?

 

 

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Is the network good?  As long as you stay in network your deductible is $2k.  Out of network you need a second mortgage.

 

The coinsurance will also expose you to higher costs. Is your HSA pretty well funded already to take care of any unexpected expenses this year?

 

$2700 is enough to make the question relevant. I usually opt for the security of known expenses, but at north of a cnote a paycheck (bimonthly pay) its worth a deeper look.

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3 mins ago, Tom T said:

Is the network good?  As long as you stay in network your deductible is $2k.  Out of network you need a second mortgage.

 

The coinsurance will also expose you to higher costs. Is your HSA pretty well funded already to take care of any unexpected expenses this year?

 

$2700 is enough to make the question relevant. I usually opt for the security of known expenses, but at north of a cnote a paycheck (bimonthly pay) its worth a deeper look.

My current plan is not an HSA so basically that would be starting from $0.

 

I honestly have no understanding of what the $40 Coinsurance after Deductible means in terms of real dollars if we had to deal with illnesses.

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2 mins ago, mako capt said:

My current plan is not an HSA so basically that would be starting from $0.

 

I honestly have no understanding of what the $40 Coinsurance after Deductible means in terms of real dollars if we had to deal with illnesses.

Not $40.  40%.  Your worst case scenario is the OOP... out of pocket limit.  You don't pay a co-pay after you hit the OOP.

 

Check that with your benefits rep.  I'm just a dude on a fishing board.

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8 mins ago, Kings over Queens said:

If im you i pick the left hand hsa option.

 

Does your company match on hsa contributions?  If not, and this is your first hsa, you can make a 1 time transfer from an IRA to fund it.

 

No match on HSA.  I have no IRA......only a 401K.   I had an HSA Account years ago but closed it out when our insurance changed and our bank stopped offering HSA accounts.     My current bank does not offer HSA accounts.

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11 mins ago, Kings over Queens said:

Just checked the math.  HSA option without blinking.

 

Saves premium dollars, lower deductibles and total out of pocket exposure AND you can fund an HSA for future tax FREE distributions for qualified medical expenses.

 

 

Yeah. Me too.  That assumes that you expect a low frequency of medical service use.

 

The plan on the right is for someone that has (or expects) a high frequency of medical service use.  Pretty much every service imaginable is covered by a co-pay (rather than you paying full freight until you hit deductible).  That's why it costs more even though it has higher ded/OOP.

 

Nice thing about the HSA is that you can apply that money to dental.  

Edited by Slacker
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3 mins ago, mako capt said:

 

No match on HSA.  I have no IRA......only a 401K.   I had an HSA Account years ago but closed it out when our insurance changed and our bank stopped offering HSA accounts.     My current bank does not offer HSA accounts.

You can fund the HSA with tax free deferrals.  The company may have a preferred bank, othwrwise fidelity has options.

#otterlivesmatter

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Those charts appear to only address "in network" costs/coverage.  Ask your benefits provider what the coverage is for "out of network" for both plans.  Also check to see if there is a difference in who/where is considered to be "in network" for both plans. 

 

"In network" may or may not be a big deal for doctor selection but can be a huge deal for facility selection...

 

"I want to go to Memorial Sloane Kettering for cancer treatment".

"Memorial Sloane is not in-network for your plan."

 

Unfortunately, you really only find out the extent of your coverage when you try to use it.  I wanted to get a diagnostic test at a local surgery center.  The center was "in-network".

 

I go there, have a consult, get to the scheduling desk and they say, "You can't have it done here.  You have to go to the hospital.  This facility is in-network for your plan but is not in-network for that procedure on your plan.  The hospital is in-network for both your plan and that procedure." :squid:

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Try being self employed and paying the whole fecking thing !  $ 1,740 per month plus a 6 K deductible EACH for my bride and myself. Obamacare fecked us up. 

IN FAVOR OF COMMERCIAL FISHING AND SURFING THE NORTH SIDE

MAY THE RICH GET RICHER!!

FISH ARE FOOD!!

UA MAU KA EA O KA AINA IKA PONO O HAWAII

 

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15 mins ago, pakalolo said:

Try being self employed and paying the whole fecking thing !  $ 1,740 per month plus a 6 K deductible EACH for my bride and myself. Obamacare fecked us up. 

The bane of many peoples existence.   Celebrating the end of mortgage payments was wonderful until health insurance costs put an end to that.  

 

Crushing small businesses and self employed folks is part of the plan.  

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