Health Insurance Decision

[dfchelbay]

Hi everyone. I'm considering switching health insurance either in December or the first of the new year. In october they raised my premiums 28% PER MONTH. Currently, my coverage is:

$310.00 per month premium, $0 deductible, $2500 Max. Out of pocket per year and 70%/30% coverage, only allowed 2 doctor visits/up to $500 per year.

I'm considering:

$250.00 per month premium, $1500 deductible, $1500 co-insurance max, out of pocket per year $3000, 80%/20% coverage

or, go the least expensive emergency only coverage, which is:

$96.00 per month, $3,000 deductible, $2500 co-insurance max, $3750 Out of pocket max per year, 80%/20% coverage, lab and x-ray covered with a surgery only.

Physicals, Gynochology and mammography are 100% covered for all plans.

I have been paying these premiums for years, for insurance I do not use. I've been scared into thinking that some horrible emergency or sickness MAY happen and so I am covered. I get my covered physical, OB, mammograms...and that's it. I've never really used the insurance I've been paying for. I'm grateful for that, but do feel like I'm wasting a lot of money each month.

Let me know your thoughts. Maybe I'm forgetting something, or don't know some things you all may know. I am leaning toward the emergency only coverage. I want to somewhat be sure that my switching is not completely motivated by the 336% per year increase my insurance carrier just put in place. It is quite a bitter pill to swallow.

Thanks for your time budget friends.

 

[allyphoe]

If it's the math that's bugging you, percentages don't work like that. A 28% bump is a 28% bump, whether you figure it per month or per year.

On the high-deductible plan, I'd be concerned that labwork and X-rays (I suspect it actually says "diagnostic imaging," which includes CT scans and MRIs) are excluded except when surgery is involved. Those things can add up fast, and you've have both unlimited exposure and no insurance-negotiated discounts. If not for that, I'd go with this plan.

(I personally have a $10k deductible, with everything paid at 100% after that. So a high deductible doesn't bother me much. But the exclusion does.)

 

[Skatermom23]

Honestly I would stay with the $310 plan and no deductible. The lowest would be the $250 plan...anything less than that would be inadaquate. Your age might be a major factor as well but I still wouldn't go with just the emergency only plan. Health insurance is one of those things that you may never use...but if you need it, you want it to be good coverage.

 

[Toad_Passenger]

I'd stay with the $310 plan, also. You say that you feel that you've been paying for coverage never used, well you know what Murphy's Law will say once you cut back on that coverage right?

If you can afford it, keep the top plan.

 

[wdwfan16]

Keep what you have. Really $310 is not bad.

 

[bridget]

Keep what you've got!!!

I am 34, and healthy as a horse I teach reading, and last year besides my annual dr. appt, I went to the doctor one time. I'm not having any more babies, so why would I need expensive insurance at this age (I thought)???? Well, I ened up getting a mole removed at my annual appt and it was melanoma! I don't even want to see the bills!!!! I have a $2500 out of pocket and am sure I will meet it! Between 2 surgeries, lab work and a CT scan, it will be a small fortune!

I have my own insurance and my husband has he and the children on his policy. My insurance is free, so we thought it was a great deal. It saved us about $100 a month in premiums. For 2 years, I saved $2400, and this year it will all be paid to my doctor and the hosptial!! The bad thing is that my $2500 is just for my coverage, and the family doesn't get any benefit. At my husbands next open enrollment, we will go back to family.

My doctor pretty much saved my life! However, I will be going to the doctor so much more now!

 

[Ava]

I'd switch to the $250 plan - you will save $720/year in premiums, but the difference in your OOP max is only $500. So even if you meet the OOP max of $3000 you will still save $220 for the year. Also does the $250 plan have the same 2 doctor's visits per year restriction? If not that's another reason I'd switch to it; I have visited the doctor twice just for one illness in the past, if the first antibiotic they gave me didn't clear it up.

I wouldn't risk the emergency only plan. Even though you are healthy, things can happen. And like a PP said, there are many reasons you could need x-rays or lab work done that do not involve surgery - broken bone, UTI, etc etc. That exclusion would be a deal breaker for me for that plan.

 

[allyphoe]

I'd switch to the $250 plan - you will save $720/year in premiums, but the difference in your OOP max is only $500.

Except that if she had $1,500 of medical expense, on the $310 plan, she'd pay 30%, or $450 out of pocket. On the $250 plan, she wouldn't have met the deductible, and would be $1,500 out of pocket.