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Insurance Question - NBR (Sorry..kinda long!)

JessiRayeJessiRaye member
in Babies: 0 - 3 Months

My H's insurance is changing effective July 1 so we are currently going over the new options. The new options ALL SUCK pretty much.

They are offering the same plan we are in currently, but since they are phasing it out they are making the employees pay the full premium amount and not picking up any of the costs. Of course, that makes it astronomical!

One option we have to consider would be a high deductible plan to be used in conjuction with a Health Savings Plan. His company will put $600 in for the HSA and we can contribute whatever...(I think the max is close to $6000 for the year.) The cost of the high deductible plan is $170 per pay period (bi weekly) and the coverage is okay. The family deductible is $2600.

The other option is a typical HMO plan and has decent co-pays etc. But the catch is that it has one million dollar lifetime coverage maximum.....Which would be scary if we had a serious illness or accident on our hands.....It is $70 per pay period.

Would you be comfortable trying out the HMO with the $1M lifetime coverage max? For a year? Or would you just bite the bullet and go with the high deductible plan and expect to pay more out of pocket....

UGH! I used to work in payroll and benefits so this should be an easy decision. I hate the thought of paying out of pocket for every visit to the doctor until we meet the deductible. AND paying $170 pp while doing so....

Any thoughts you may have are appreciated:) I hate to post and run, but I have to grab Colin, who is screaming. I'll check back tonite though. THANKS ladies!

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Re: Insurance Question - NBR (Sorry..kinda long!)

  • LerxieLerxie member

    We bit the bullet on the HSA because the premium was so low. So far we haven't had to pay anything towards our deductible because ::knocks on wood:: all of our visits have been preventive. I figured after year 1 (barring anything awful happening) we will have accrued almost enough in the account to fully cover the family max if anything should happen.

    $1mil max doesn't scare me too much on the HMO but I'm also in benefits and know the statistics on catastrophic claims. It's not the most favorable but it's certainly not the worst.

    I'm all about HSAs though so I might be biased. LOL

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  • LerxieLerxie member

    Ok, sorry if that wasn't helpful LOL I just re-read it and was like "Lerx! You didn't even answer!"

    Here's my POV on HSA vs. HMO (or other traditional plans): Either pay it out to an HMO even if you don't use the benefit or pay it out to the providers through an HSA only when you need it, kwim? The higher premium is only worth it if you know you will utilize the benefits a lot.

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  • jll1881jll1881
    I'd do the HMO.  The chances of you having something at this point in your life that would cost a million to treat is low.  And you will probably be able to change plans within the next couple of years if something better comes along.
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  • Bubs06Bubs06 member

    imagejll1881:
    I'd do the HMO.  The chances of you having something at this point in your life that would cost a million to treat is low.  And you will probably be able to change plans within the next couple of years if something better comes along.

    That's probably what I would do too.  I work with insurance claims and I know how difficult it is for patients to follow all of their EOBs and see how things are billed and how much you owe, etc.  The HMO seems much less complicated. 

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