health insurance while TTC

posted 3 years ago in TTC
Post # 3
3813 posts
Honey bee
  • Wedding: August 2013 - Brookfield Zoo

Not covering drugs is a pretty big deal, especially if one of the few times you go to the doctor is to get a prescription.. I would go with plan 3 (unfortunately the most expensive) as you don’t have to meet your deductible until you (potentially) have a baby.

Post # 4
305 posts
Helper bee
  • Wedding: July 2014

I’d go with the 314.

Post # 5
3119 posts
Sugar bee
  • Wedding: August 2012

Until I saw the lack of drug coverage I was thinking plan 2, but with that, I’m recommending plan 3. Covering drugs is a big deal to me as they can be incredibly expensive. It’s tough to know what to do as you don’t know exactly when you’ll be getting pregnant, though! 

Post # 6
11588 posts
Sugar Beekeeper
  • Wedding: November 1999

Does your company have separate prescription drug coverage?  My medical insurance doesn’t cover prescription drugs, but they have a separate pharmacy plan that does at no extra cost.  I don’t fully understand the set-up of it, but it works.

Anyway, I think what you need to consider here are a few things:<br />(1) Out of Pocket Maximum – After you meet your deductible, this is the total amount you *should* be billed per year for any allowable medical expenses.  <br />(2) Deductibles – you’ll pay up front for all medical procedures until your deductible is met, aside from 100% covered things, like annual physicals or a well woman exam at the GYN.  If you’re okay with a larger deductible for other benefits, that’s always a good option.

Personally, I think a 40% coinsurance for a hospital stay is extremely high for any medical plan costing that much.  I don’t think I’d be able to stomach that and agree to that plan for that reason alone.  I would avoid the doctor’s at all costs, knowing that it could end up costing me thousands and thousands of dollars.

How did you get the numbers for the ER visit in your first two plans? Those seem very high for ER copays. 

And my final point – if you’re TTC right now, the cost of births on each of these plans may not even matter.  If you don’t end up getting pregnant in the next few weeks, your delivery could very likely be in calendar year 2015, which may have entirely new insurance plans (Unless your company doesn’t follow the calendar year schedule, in which case, this whole point is moot). 

Insurance sucks.  Good luck navigating it!

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