Health Insurance…don't know what to pick!

posted 3 years ago in Pregnancy
Post # 3
Member
6644 posts
Bee Keeper
  • Wedding: June 2011

It all depends on what is being offered to you.  Most plans should be picking up materenity/labor deliverly cost at some percentage.  I know for ours the 4 plans offered all but 1 was 80/20.  And the HSA you can take with you and carry over year to year and if you leave your place of employment. 

Post # 4
Member
11668 posts
Sugar Beekeeper
  • Wedding: November 1999

@PacNWxLove:  Personally, I love a high deductible plan.  I’m relatively healthy and don’t use miuch care, so I’d rather only pay for it when I need it.  But, it depends on your situation. For me, my employer covers the high deductible plan 100% (and contributes $1000/year to the HSA) but only covers 80% of the premium for the traditional plan.  

 

Honestly, since you’re pregnant and will be using quite a bit of services over the next 1-2 years (during pregnancy, birth and for all the 1 year visits for baby) whether you have a traditional plan with a higher premium or a high deductible plan with a lower monthly premium isn’t a huge issue (assuming they both cover the same services), you still end up paying about the same. It’s just a matter of preference if you want to pay smaller monthly chunks out of your check pretax or pay larger chunks when you use services.   

If you go with a high deductible plan I definitely recommend layering it with an HSA so you can contribute pre-tax $ to the HSA to cover your deductible. Otherwise, you’re using after tax money to pay the deductible.  Also, HSA’s earn a little bit of interest and who doesn’t love some free money?! 😉

 

 

 

Post # 5
Member
116 posts
Blushing bee
  • Wedding: July 2008

@PacNWxLove:  I’m glad you asked this question because I’m in the same boat as you, except I have 3 more weeks to make a decision!  I have never had a high deductible plan before but am starting to look into it more carefully since the tax benefits are pretty substantial.

@MrsWBS:  Wow your employer is offering you a very nice package!  I have a PPO and HSA plan option that both have expensive premiums (the HSA plan premium costs about 5% less).  But my employer also puts $1200 into the HSA. 

Although my family and I are healthy, I’m more concerned about the costs of routine exams, prescriptions, emergency visits, and god forbid a serious medical condition/accident in the future with the HSA plan since there is a % coinsurance for all services as opposed to a min/max amount that I could expect to pay with the traditional plan. 

It feels to me like an HSA is trickier to manage financially;  when you’ve reached the end of your plan period, you brace yourself for any medical issues that suddenly pop up since your deductible resets to the high amount.  So you have to make sure your HSA is adequately funded at all times. 

Despite that, I love that the HSA is triple tax-advantaged (no tax going in, on growth, or when it comes out) and that you can keep it forever which is useful in your aging years when your health is more likely to fall apart, assuming you have alot of money in there to begin with. 

I’m still not convinced the HSA is a slam-dunk for my family and I.  Hoping some other posters can tell of their experience with the HSA…

Post # 6
Member
11668 posts
Sugar Beekeeper
  • Wedding: November 1999

@HelpfulMarriedGirl:  I would feel much less comfortable with a % coinsurance, as well.  Luckily, the plan we have covers 100% after the deductible for pretty much everything.  Have you looked into the out of pocket max for your plan?  Alot of people aren’t aware of it or don’t remember to check it out.  For mine the out of pocket for myself is $4000 ($8000 for a family) so I know that I will only ever be expected to pay that much (and includes the deductible) so it gives a bit more certainty into things.

 

Post # 7
Member
416 posts
Helper bee
  • Wedding: April 2011

I’m a pretty risk-averse person, so I always go with a low-deductible type plan.  I’m healthy and don’t usually use much, but it just takes one broken ankle or ruptured appendix, and there you go.  Especially now with a baby on the way, I just wouldn’t want one more thing to worry about.  Luckily though, my employer covers a huge portion of my insurance, so it’s not actually a huge cost difference for me.  But still, it all depends on how much health care you’re planning on using, and then how much of a cushion you have for disasters.

Post # 8
Member
116 posts
Blushing bee
  • Wedding: July 2008

@MrsWBS:  Yes the out-of-pocket max for a family is about the same for both  ($6K with the PPO and $5700 with the HSA plan, assuming within network for both). 

Post # 10
Member
9137 posts
Buzzing Beekeeper
  • Wedding: November 2013 - St. Augustine Beach, FL

An HSA was great when I was younger and rarely went to the doctor.  Plus, my employer paid the premium 100%.  It covered an annual well woman visit and pap smear at 100% and other than that the only medical expense I had was my birth control pills.

Now that I am a little older and planning to TTC, I prefer having the PPO plan with copays for office visits ($15 for PCP and $25 for specialist).  I have an 80/20 coinsurance with a $250 deductible and a $2500 out of pocket maximum.

Working for a doctor’s office really opened my eyes regarding different medical plans.  Right now my premiums are the same whether I pick an HSA, PPO, or HMO, so the PPO is definitely the better deal.  In the future I may reconsider if the premiums for the PPO are significantly higher than for the HSA (especially if the HSA premium goes into the HSA account for me to use for medical expenses.)

Post # 11
Member
419 posts
Helper bee

@PacNWxLove:  You didn’t mention this as an option, but when we started ttc I went on my husband’s work provided family plan so we would all be on the same plan. Like 30 dollars more a month, but easier to deal with and baby is covered

 

Post # 12
Member
5697 posts
Bee Keeper
  • Wedding: August 2012

I”m pretty good at plan comparison because I work for a PPO network and have been exposed to many different plans. I’m happy to look at your forms if you want to PM me.

An HSA is nice because it allows you to set aside pre tax money for expenses, but it isn’t always the best option compared to other plans beacuse of the huge ded. I’ve been on a high ded +HSA for 8 years and just switched to a lower ded plan without HSA that they finally started offering. The HD can be really hard to swallow, but you should hit it fast since you are PG, really it depends what the other benefit levels are of each plan after the ded, and how much disposable income you have to spend on paying quite a few visits at 100% at first.

Post # 13
Member
416 posts
Helper bee
  • Wedding: April 2011

@PacNWxLove:  I should mention too that the out-of-pocket maximum is the big number we looked at this time (usually is in line with the deductible).  My personal OOP max is $2000, and our family’s will be $4000, so no matter what happens in that hospital, what the baby needs, etc, that is the max we’ll pay.  And then we’re done for the year, so everything else is free (except copays).  I’m going in thinking that we’ll have to pay that much, and if it’s anything less then we’ll be thrilled.

Leave a comment


Sent weekly. You may unsubscribe at any time.

Find Amazing Vendors