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Started By
Message
Which healthcare plan should I choose?
Posted on 12/14/14 at 9:22 pm
Posted on 12/14/14 at 9:22 pm
I thought I was smart enough to figure this out, but no dice. So can someone explain to me that if I go with the cheaper plan, I'll have to pay 100% up to $12550, but then I pay 40% until we hit just $250 more to get to the out of pocket max? I'm pretty sure this is true, it just makes no sense. Any help from OT experts will be greatly appreciated. Right now I am signed up for the BCBS plan on the right through a broker. I have 1 day to switch to the cheaper plan if I want to.
Left is United Healthcare, Right is BCBS.
(I know how lucky I am to have a healthy family. We have have never hit our deductible in 7 years (since a pregnancy, no more of those), 4 kids)
So it looks like the crappy plan on the left will be $2000 less per year (but those are before tax dollars), but if we max out, we'll be out $2800 more with the cheap plan.
Anything else to consider? TIA
(from healthcare.gov)
Left is United Healthcare, Right is BCBS.
(I know how lucky I am to have a healthy family. We have have never hit our deductible in 7 years (since a pregnancy, no more of those), 4 kids)
So it looks like the crappy plan on the left will be $2000 less per year (but those are before tax dollars), but if we max out, we'll be out $2800 more with the cheap plan.
Anything else to consider? TIA
(from healthcare.gov)
12
Posted on 12/14/14 at 9:26 pm to Kingpenm3
How often would you be using insurance? Anyone in your family use meds? Go to the doctor often? Major surgeries coming up?
Posted on 12/14/14 at 9:28 pm to dcrews
quote:
How often would you be using insurance? Anyone in your family use meds? Go to the doctor often? Major surgeries coming up?
Hardly ever, no, no, no. (Once again, I know how lucky I am). And we have a few years of max HSA contributions to cover pre-deductible cost as well.
Posted on 12/14/14 at 9:29 pm to Kingpenm3
quote:I stole her heart
I thought I was smart
I didn't think I'd lose but now I see
She's worse to him than me
Let her go ahead
Take his love instead
And one day she will see
Just how to say please
And get down on her knees
Oh, that's how it begins
She'll feel those needles and pins
hurtin her, hurtin her
Why can't I stop and tell myself I'm wrong, I'm wrong, so wrong?
Why can't I stand up and tell myself I'm strong?
Because I saw her today
I saw her face,
it was a face I'd loved
And I knew
I had to run away
And get down on my knees and pray that they'd go away
Still it begins
Needles and pins
Because of all my pride
The tears I gotta hide
Oh needles and pins
Needles and pins
Needles and pins
Posted on 12/14/14 at 9:34 pm to Kingpenm3
wait, so you get insurance.. but it only kicks in if you spend over $12k at the hospital?
Posted on 12/14/14 at 9:37 pm to Kingpenm3
What are the doctor's office copays? Are there out of network benefits for both plans? What are the RX copays? Does each family member have an individual deductible to meet or does it accumulate together?
Posted on 12/14/14 at 9:38 pm to Napoleon
quote:
wait, so you get insurance.. but it only kicks in if you spend over $12k at the hospital?
Yep! I've had a high deductible, HSA plan (I buy my own insurance) since I started working (7 years ago). 5 years ago with 3 kids, it was $450 a month, and had a $6000 deductible that matched the allowed pretax HSA contribution that I could make. Not good, but it at least made sense, make your HSA contribution, pay your insurance, and you could never be out any extra cash. Now I'm at either $820 or $1000, for a $12,800 or $10k deductible, and the HSA max is still around $6600 or so. So, so stupid.
Posted on 12/14/14 at 9:45 pm to iluvdatiger
quote:
What are the doctor's office copays? Are there out of network benefits for both plans? What are the RX copays? Does each family member have an individual deductible to meet or does it accumulate together?
Neither plan pays a dime until the deductible is met. Out of network benefits are so bad that you are pretty much forced in network. I actually can't find a good answer to this, but the name of the plan is the "United Healthcare Bronze 6275", so I think the individual deductible is 6275, but it might just be a group $12550. This is what I can't find for sure.
Posted on 12/14/14 at 9:48 pm to Napoleon
That's what I'm wondering... And 12k sounds like a lot for a deductible. I think I'm at a $grand
Posted on 12/14/14 at 9:51 pm to Kingpenm3
Cheaper plan has you paying 100% of doctor visits, meds, everything until you meet deductible. And then 40% after until you meet OOP. Total rip off for the premium. At least the second plan covers at 100% after deductible.
This post was edited on 12/14/14 at 9:53 pm
Posted on 12/14/14 at 9:53 pm to Kingpenm3
Insurance is just that, protection incase things go wrong. That being said, you have a reasonably healthy family so I would go with the cheaper premium.
Annual physicals will be covered regardless of the policy. If you rarely go to the doctor for more than that you should be fine.
Annual physicals will be covered regardless of the policy. If you rarely go to the doctor for more than that you should be fine.
Posted on 12/14/14 at 9:56 pm to drunkenpunkin
Are the doctors that you/your family see NOW on both plans? We have BCBS high ded but our ded is $6500 with a $10K oop ... 20% once ded is met. BCBS has ALWAYS been good to us .. 17 years we've had them and this will only be the 3rd time that we've met our ded. In the past 2 years, I've had 4 MRIs (don't ask), husband had surgery last year, son had surgery last year, I had knee surgery in Oct and another one on this Wednesday.
We've never had any trouble with any claims. Find out if you can from people about the other company's customer service.
We've never had any trouble with any claims. Find out if you can from people about the other company's customer service.
Posted on 12/14/14 at 10:06 pm to Kingpenm3
it sounds to me like your best bet would be to go with the cheaper plan, as you would save $2100 per year in premiums but would risk $2800 more in costs if you ever get the deductible met...if in the future you hit the deductible two out of every three years, you still come out ahead with the low deductible...
now, the biggie that I can't help with is the difference in the networks...as you say, you really don't have the option of going out of network, so you need to be sure that both networks include a good selection of doctors and hospitals in your area....
now, the biggie that I can't help with is the difference in the networks...as you say, you really don't have the option of going out of network, so you need to be sure that both networks include a good selection of doctors and hospitals in your area....
Posted on 12/14/14 at 10:10 pm to Kingpenm3
I was in the army but I never dug a trench
I used to bust my knuckles on a monkey wrench
Then I'd go to town and drink and give the girls a pinch
But I don't think they ever even noticed me.
I used to bust my knuckles on a monkey wrench
Then I'd go to town and drink and give the girls a pinch
But I don't think they ever even noticed me.
Posted on 12/14/14 at 10:11 pm to tiger91
quote:
Are the doctors that you/your family see NOW on both plans? We have BCBS high ded but our ded is $6500 with a $10K oop ... 20% once ded is met. BCBS has ALWAYS been good to us .. 17 years we've had them and this will only be the 3rd time that we've met our ded. In the past 2 years, I've had 4 MRIs (don't ask), husband had surgery last year, son had surgery last year, I had knee surgery in Oct and another one on this Wednesday.
We've never had any trouble with any claims. Find out if you can from people about the other company's customer service.
Yes, I checked and everyone we see now is in network with both (that would have made the decision easier).
We've never had any trouble, but my wife's cousin had to take their kids to an after hours clinic this morning, and they said they wouldn't take their BCBS. Not sure about that.
I'm just a little mad at BCBS (and this isn't actually their fault), but when our company in Texas dropped us (dropped all of LA), we switched to BCBS at $850/m starting at the beginning of this month. Then Friday I got a notice that it was going to be a $1k/m. After only 1 month!!!!!!!!!!! I'm sure they broker knew, but didn't want to say. This all sucks. All of it.
Posted on 12/14/14 at 10:12 pm to Kafka
I love the Searchers.
Posted on 12/14/14 at 10:15 pm to Kingpenm3
fwiw, we did have a couple of hospitals in north LA that would not take bcbsla...
eventually, my company was bought out by a texas company and everyone took bcbstx just fine...
eventually, my company was bought out by a texas company and everyone took bcbstx just fine...
Posted on 12/14/14 at 10:16 pm to drunkenpunkin
quote:
Cheaper plan has you paying 100% of doctor visits, meds, everything until you meet deductible. And then 40% after until you meet OOP. Total rip off for the premium. At least the second plan covers at 100% after deductible.
That's the trouble that I'm having. The 40% is crap, but the way I'm reading it, the deductible and OOP max are so close to each other, that the co-insurance part really doesn't matter.
Posted on 12/14/14 at 10:16 pm to Kingpenm3
Not the one with those frickers on 60 minutes tonight. They had doctors that refused up to 100% of all claims.
Posted on 12/14/14 at 10:18 pm to Kingpenm3
quote:
That's the trouble that I'm having. The 40% is crap, but the way I'm reading it, the deductible and OOP max are so close to each other, that the co-insurance part really doesn't matter.
that is the way I see it as well...
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