Insurance debate

TaraGoldenCO

So I am in open enrollment period and have to pick a health plan for family in 2017. 

I have two plans to choose from. One plan costs $836 a month (for whole family) and states that hospital admission for birth is only $250, no dedudible. (Kaiser).

The other plan is also Kaiser and costs $526 a month for family and $1000 deducible/80% coinsurance on hospital costs.

Both plans have a $2,000 ind/4000 fam. annual max. 

I am debating which plan to sign up for.

If I sign up for the first plan, I would cancel it and go to the lower plan when the baby is born as I could not afford that amount for the whole year, but then my deducible starts over. (I have been advised I can do this due to the new enrollment period due to the baby.) 

Anyone else debating whether to sign up for premium plan for January and then switching to a cheaper plan once the baby is born? I'm torn on what to do.

sarah1198

Hey!
I had the same debate over my plans - one is a $2600 deductible plan with lower premiums, the other is a $900 deductible with almost double the premium. I decided to stay with the high deductible because my company contributes to my HSA (approx $1500) if we go with the high deductible. Since he's due in january, I will immediately hit the deductible and everything for the rest of the year will be 10% which I am fine with. I just don't want to have to restart that $2600 deductible after the delivery, it will take forever to meet, and I don't want to risk not getting some of the contibutions to the HSA!
It's so tough to think about especially when there are so many other things to decide!!
Best of luck!!

therealfrizzle

Not an expert on insurance, but my workplace doesn't offer switching post baby. I can add baby, but once the open enrollment is closed, what I have is what I get. I'd talk with your HR department to be 100% sure first or a representative from Kaiser (at least at my workplace, we have reps here weekly during open enrollment to ask all these questions).

sarah1198

Having a baby is considered a life event and I'm pretty sure you can change anything. But always good to double check!!

ashanne88

Like @PMForbie I'm not actually sure you can change you policy, just add or remove people for life events.  I would ask your insurance representative though to be sure.  Figuring out and dealing with insurance is a huge pain, especially during pregnancy.

AlabamaRedhead

Make sure and get it in writing that you can change your policy. Do not just go by words. One of my friends was told her prenatal visit co-pays would be $35. Nope, $200 a pop and a $5k deductible. 

momof2girls+?

Like other pp have said, our insurance can only add or take away a family member after open enrollment. 

KRB22

Agree with PPs that you should definitely confirm
whether you are allowed to change plans mid year / post baby. I am only allowed to switch plans during open enrollment, regardless of any life events. 

Either way, I would try to get an estimate of how much you'd be billed for delivery and hospital stay under the lower premium plan. Depending on how much that amounts to, there could be a big benefit to meeting your deductible and OOP max early in the year. 

If you can't switch, I'm not even sure if the higher premium plan is worth it. Don't know what your coinsurance would be in general under that plan, but that premium alone will cost $3700 more out of pocket over the course of the year. If your OOP max under the lower premium plan is $2000, then that's the most you can expect to pay for delivery and hospital stay, right? So that's $1750 more than what you'd pay under the higher premium plan... Basically meaning all other things being equal you'd end up paying about $2000 more for the year with the higher premium plan. 

TaraGoldenCO

Thanks for advice, I will get it in writing that I can switch, they told me on the phone. I have been duped before with advice by insurance companies on the phone.

BrennansMom2012

My insurance closes for plan changes after the open enrollment but I have 30 days after birth to add my son to our insurance. It's easy to forget such an important item--one of my friends didn't add his daughter during the 30 day period and they had to wait 10 months to add her and pay a couple sick visits out of pocket.