health insurance - how did you make your decision

[luvmyfam444]

on which plan? High deductible, less montly out of pocket, low deductible, more monthly payment?

Dh's job has like 5 plans to choose from - he's looking @ changing jobs & I'm trying to figure out if he'd be making the same kind of money - when figuring the benefits into it all. Of course the numbers are all over the board.

We are a healthy family with no preexisiting conditions & don't want the maternity (too old! HA!)

What should we do? Typically we only make it about 1time a year each to the dr (that's the kids too) but naturally this year they've already hit that - with tests that needed to be run (on one dd for scolosis - came back fine) - that's the dd that hadn't been to the dr in 4 yrs.

We were spoiled once upon a time with a company that paid for the insurance completely for the family & we just paid cheap copays - neither company is like that.

 

[Nik's Mom]

DH's job had 3 plans to choose from, all ppo's. The first was a low monthly premium with high deductlible, next was a montly payment a little higher than the first opition, with a mid sized deductible, next was a high montlhy premium with low deductible. We took the 2nd option. It didn't take a large chunk from his paycheck, but didn't require us to pay a large deductible, in case someone did get hurt or sick.

 

[golfgal]

If you are good with excel, make a spread sheet of overall costs, premiums, deductibles, out of pocket expenses, etc. and usually you can come up with one that is a clear winner for your family. I would say that if you have the money in the bank to cover the higher deductibles, chances are that plan, from what you have said, would be the most cost effective since you don't really use your medical insurance all that much.

In our state preventative care is covered at 100% even with a high deductible plan so that takes that out of the equation for us but a consideration for you if that is not the case.

From a retirement standpoint, if the company adds money to a Health Savings Account (HSA) for your, jump on the chance to go with that plan if you can afford the deductibles and leave the HSA money alone. It is a beautiful tax free way to save for future medical expenses in retirement.

 

[Nik's Mom]

Come to think of it,dh's job had a great calculator on their website. See if your dh's job has something like that. It really helped us a lot.

 

[tvguy]

Unless you have a chronic health condition, the key to the best insurance tends to be the highest deductable you thing you can afford. Insurance is to pay for catastrophic costs, not every little thing.

 

[bettymae1121]

Unless you have a chronic health condition, the key to the best insurance tends to be the highest deductable you thing you can afford. Insurance is to pay for catastrophic costs, not every little thing.

Ditto. With a healthy family a higher deductable is usually the way to go. But don't just look at the deductable either, one plan may have more/better hospitals and doctors to choose from or have other coverages included or excluded that could factor in as well. I agree with the spread sheet idea, but include the pros/cons for each plan like "Plan A is the lowest out of pocket expense each month, but we'd have to use the hospital one town over that we don't like very much".

Also try and find out if the plans have a good reputation for customer service in your area. One of the big reasons why DH and I are on my plan through my employer instead of DH's employer is the service from his employer's plan flat-out sucks, mine has never once denied a claim or hassled us over anything. That on it's own is worth some extra $$$ (though actually the other reason we are on my plan is that it's cheaper than his, so we get the best of both worlds).

 

[Nik's Mom]

Ditto. With a healthy family a higher deductable is usually the way to go. But don't just look at the deductable either, one plan may have more/better hospitals and doctors to choose from or have other coverages included or excluded that could factor in as well. I agree with the spread sheet idea, but include the pros/cons for each plan like "Plan A is the lowest out of pocket expense each month, but we'd have to use the hospital one town over that we don't like very much".

Yes, really read through the plans. With our insurance, the one with the highest deductible also did not cover medications until the deductible was met. Our youngest ds takes 2 medications a day, so it was not a good option for us. For others, it may not be a problem though.

 

[luvmyfam444]

Thanks for your opinions. I'll go back thru the choices...UGH! It's terrible trying to decipher all the jibberish! LOL

The place dh is looking @ going will pay for his health insurance but noone elses, but we can still get it for the rest of us - or take out a plan independently.

Yes - that's something to check out - the meds being covered - haven't looked @ that. Though the meds we typically get are the $4 antibiotics - so we'd be okay I guess.

Actually they all may be plans from Blue Cross - gotta go look again.

 

[Mandychelle79]

Ive had both.

I prefer to pay higher premiums because I dont miss it when it comes out of my check, however I do miss it if I have to pay the deductible all at once. I dont go to the dr often either, usually once a year for a physical, with blood work. But that year I had to have moles removed and biopsied, and other things that werent normal for me. Luckily they let me pay on a payment plan.

 

[disfan07]

My dad has 3 PPO plans and 1 HMO plan to choose from.
We chose the most expensive PPO plan. Anthem BC/BS Premium PPO. We have a $500 deductable per person or $1500 max deductable (we have 4 people on teh plan) and $8000 OOP max per person.

For us it was necessary because I have asthma, eczema, allergies, and a heart condition. I also ended up havign brain surgery this year. I have 1 primary care and 7 specialists. For us, we choose the lowest deductable because we end up with hundreds of thousands of medical bills a year so we want them to start covering it ASAP. This past year (September-July) we racked up almost $500,000 in medical bills just for me. ever with the low deductable and low OOP, we still pay almost $20,000/year because of things that are not covered. We'd be heading towards bankruptcy if we had a higher deductable or OOP.

I only know about looking for health insurance with pre-existing conditions. Unfortunately, I know nothing about finding health insurance if your family is healthy

I agree with the PP who Mandychelle79. With the higher premiums we know exactly what is coming out of teh paycheck so we budget for that. It's much easier to budget for that than it would be to suddenly have to pay a huge chunk OOP for an unexpected medical expense.

 

[FireDancer]

Unless you have a chronic health condition, the key to the best insurance tends to be the highest deductable you thing you can afford. Insurance is to pay for catastrophic costs, not every little thing.

This is how I decided. I have no on going health issues or prescriptions and have insurance to cover an emergency.

 

[golfgal]

Thanks for your opinions. I'll go back thru the choices...UGH! It's terrible trying to decipher all the jibberish! LOL

The place dh is looking @ going will pay for his health insurance but noone elses, but we can still get it for the rest of us - or take out a plan independently.

Yes - that's something to check out - the meds being covered - haven't looked @ that. Though the meds we typically get are the $4 antibiotics - so we'd be okay I guess.

Actually they all may be plans from Blue Cross - gotta go look again.

Even if they are all Blue Cross plans they still may not have the same network of doctors. The names will vary from state to state but one plan may have "Open Access" which pretty much means you can go to any doctor without a referral, others might be "Select Access" meaning you have to select a primary care physician in a certain network and then go through that doctor for referrals and then the list of specialists are smaller too.

 

[The Mystery Machine]

on which plan? High deductible, less montly out of pocket, low deductible, more monthly payment?

Dh's job has like 5 plans to choose from - he's looking @ changing jobs & I'm trying to figure out if he'd be making the same kind of money - when figuring the benefits into it all. Of course the numbers are all over the board.

We are a healthy family with no preexisiting conditions & don't want the maternity (too old! HA!)

What should we do? Typically we only make it about 1time a year each to the dr (that's the kids too) but naturally this year they've already hit that - with tests that needed to be run (on one dd for scolosis - came back fine) - that's the dd that hadn't been to the dr in 4 yrs.

We were spoiled once upon a time with a company that paid for the insurance completely for the family & we just paid cheap copays - neither company is like that.

We are the opposite of you. Preexisting conditions and some medical things going on.

However the first thing we look at is freedom to choose doctors & specialists, that is our top priority.

After that it is about the numbers. We choose the high deductible plan in which we pay the first 2000 and after that we pay 10% of the bill. No copays.

DH also has the "flexible spending account" that he sets up for the yr based on what we think we are going to use.