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Started By
Message
Health Insurance Coverage help
Posted on 11/3/14 at 11:58 am
Posted on 11/3/14 at 11:58 am
MT Board-
Someone posted something similar to this last week and got some pretty good responses, so i've copied his style and changed it to reflect my situation. My wife and I are expecting our first child in February and we need to choose from either her plan offered through her work or my plan through my work. I'm sure there's some things that i'm missing, but i'm hoping that i've put the important info below. Thoughts? TIA.
MY OFFERING (MONTHLY)
------------------------------
Monthly insurance cost:
Independence - $294
Freedom - $516
Annual Family Deductible In-Network
Independence - $5,000
Freedom - $2,800
Out of Pocket Maximum In-Network
Independence - $8,250
Freedom - $5,475
Office Visit In-Network
Independence - 20% coinsurance after deductible
Freedom - 20% coinsurance after deductible
HSA Seed Amount
Independence - $250
Freedom - $250
MY WIFE'S OFFERING (MONTHLY)
------------------
Monthly insurance cost:
PPO - $480
HSA - $324
Annual Family Deductible In-Network
PPO - $1,500
HSA - $3,000
Annual Family Deductible Out-of-Network
PPO - $3,000
HSA - $3,000
Out of Pocket Maximum In-Network
PPO - $8,500
HSA - $6,500
Out of Pocket Maximum Out-of-Network
PPO - $17,000
HSA - $6,500
Office Visit In-Network
PPO – Pay $25 copay; deductible waived
HSA – Pay 20% after deductible
Office Visit Out-of-Network
PPO – Pay 40% after deductible
HSA – Pay 40% after deductible
Someone posted something similar to this last week and got some pretty good responses, so i've copied his style and changed it to reflect my situation. My wife and I are expecting our first child in February and we need to choose from either her plan offered through her work or my plan through my work. I'm sure there's some things that i'm missing, but i'm hoping that i've put the important info below. Thoughts? TIA.
MY OFFERING (MONTHLY)
------------------------------
Monthly insurance cost:
Independence - $294
Freedom - $516
Annual Family Deductible In-Network
Independence - $5,000
Freedom - $2,800
Out of Pocket Maximum In-Network
Independence - $8,250
Freedom - $5,475
Office Visit In-Network
Independence - 20% coinsurance after deductible
Freedom - 20% coinsurance after deductible
HSA Seed Amount
Independence - $250
Freedom - $250
MY WIFE'S OFFERING (MONTHLY)
------------------
Monthly insurance cost:
PPO - $480
HSA - $324
Annual Family Deductible In-Network
PPO - $1,500
HSA - $3,000
Annual Family Deductible Out-of-Network
PPO - $3,000
HSA - $3,000
Out of Pocket Maximum In-Network
PPO - $8,500
HSA - $6,500
Out of Pocket Maximum Out-of-Network
PPO - $17,000
HSA - $6,500
Office Visit In-Network
PPO – Pay $25 copay; deductible waived
HSA – Pay 20% after deductible
Office Visit Out-of-Network
PPO – Pay 40% after deductible
HSA – Pay 40% after deductible
3
Posted on 11/3/14 at 12:34 pm to CHiPs25
Thoughts?
Yeah, the "Freedom" deductible is too high given the $516 monthly premium or vice versa. I personally would eliminate that as an option.
Just looking at what you've given, your wife has the better options. Since you're expecting a child soon, the lower deductible PPO looks safest. Otherwise I'd go with the HSA, because I love HSA's.
Yeah, the "Freedom" deductible is too high given the $516 monthly premium or vice versa. I personally would eliminate that as an option.
Just looking at what you've given, your wife has the better options. Since you're expecting a child soon, the lower deductible PPO looks safest. Otherwise I'd go with the HSA, because I love HSA's.
Posted on 11/3/14 at 12:43 pm to CHiPs25
dont forget to check to see if your current family doctors accept the insurances you are looking at.
Posted on 11/3/14 at 1:02 pm to bayoubengals88
I'm just learning about the HSA and I am liking what I see so far. From what I understand, all funds deposited into the HSA are tax free and need to be used for approved medical expenses. After the age of 64 (i think) all funds can be removed (tax-free) and used for whatever you want. The trick is to pay for medical expenses out of pocket and then reimburse yourself for those expenses. I did a calculation of a hypothetical situation where I spent $10k in medical expenses this year.
My Independence - $3,528 (premium) + $5,000 (deductible) = $8,528 spent on the $10k.
My Freedom - $6,192 + $2,800 = $8,992
Wife PPO - $5,760 + $1,500 = $7,260
Wife HSA - $3,888 + $3,000 = $6,888
So, if that's right I would spend $6,888 on that $10k hypothetical number which would be the best scenario.
Am I looking at that correctly?
My Independence - $3,528 (premium) + $5,000 (deductible) = $8,528 spent on the $10k.
My Freedom - $6,192 + $2,800 = $8,992
Wife PPO - $5,760 + $1,500 = $7,260
Wife HSA - $3,888 + $3,000 = $6,888
So, if that's right I would spend $6,888 on that $10k hypothetical number which would be the best scenario.
Am I looking at that correctly?
Posted on 11/3/14 at 1:03 pm to tigeraddict
quote:
dont forget to check to see if your current family doctors accept the insurances you are looking at.
I know that they take my wife's because she's been using her insurance this year and it's all been approved.
Posted on 11/3/14 at 5:13 pm to CHiPs25
So it appears your two offerings are basically the same type of plan, just one has higher deducitbles/max than the other.
Do either of your employers match HSA contributions, outside of the "everyone gets" amount?
Looking at your two plans, the difference in OOP max is $2,770, and the difference in premium is $2,664. If you contribute premium difference to an HSA, and have a major medical event (having a baby can certainly turn into that if something happens), you will probably turn out about the same under each of your two plans.
On your wife's plan, is the out of pocket max really more for the PPO and the HDHP? If you did her HDHP, you'd probably easily hit the HDHP deductible just on the birth alone. Premium difference is $1,872 which covers the additional deductible for the HDHP.
Outside of the doctor visits, what is the co-insurnace for the PPO? Is it 20 percent for everything else?
Do either of your employers match HSA contributions, outside of the "everyone gets" amount?
Looking at your two plans, the difference in OOP max is $2,770, and the difference in premium is $2,664. If you contribute premium difference to an HSA, and have a major medical event (having a baby can certainly turn into that if something happens), you will probably turn out about the same under each of your two plans.
On your wife's plan, is the out of pocket max really more for the PPO and the HDHP? If you did her HDHP, you'd probably easily hit the HDHP deductible just on the birth alone. Premium difference is $1,872 which covers the additional deductible for the HDHP.
Outside of the doctor visits, what is the co-insurnace for the PPO? Is it 20 percent for everything else?
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