[snizzle]

So, what I'm basically looking for is thoughts on BCBS only covering 80% vs. CHM not being 'as legit' as BCBS.
-shane

[Nate]

Seems odd that you wouldn't be able to find a 100% (+copay / deductible) plan in this day and age. They seem to be the norm anymore.

Aetna seems to have two "high deductible" (either $3,000 or $5,000 per individual per year) plans with 100% coverage. No maternity, though.

Humana One has a couple of 100% plans at various deductibles. I did a bogus Birmingham family for a quote and it was reasonable. Maternity?

You need to compare apples and apples. There are 100% plans out there. If an 80% plan is out of the question, then make it out of the question.

Once you start looking at the benefits / risks of regulated 100% plans vis-a-vis the CHM plan, you should be able to decide a little more easily.

It might really help you to try to find some kind of health insurance broker (or is there such a thing? I'd think there would be) in your area.

[Nate]

Originally Posted by snizzle

We've been fine without insurance, but we are getting it because we are looking to have kids soon and we want to be covered if I cut my leg off or something. That's it. We don't need frills.

See, that's just the thing... when the "big one" comes, God forbid, you need to know that the money is going to be there. Maybe it would be worth it to cover your wife under the CHM plan if you can't find a reasonably priced 100% maternity plan with a normal insurer, so that you could at least hope to get some help for a pregnancy, and then cover yourself under a high deductible / low premium 100% plan. It seems really dangerous, though noble I guess, to place the burden for an unexpected accident on a company that consists of volunteer "gifts" and "sharing."

I don't know. This is really bordering on a decision about which nobody is going to be helpful in giving you advice. It's certainly a really lovely idea, a non-profit "volunteer cost-sharing program," but it just doesn't seem practical or safe. If an insurance company goes belly up, somebody buys out their contracts. If a volunteer cost-sharer goes under, I'd imagine all of your premiums would be pretty much laid to waste. Personally, that's a risk I wouldn't want to take, especially if I'm getting insurance only for big emerencies (when you need security that the money will be there).

[snizzle]

We've had really hard times sorting through insurance. I wish there was an insurance broker, but I certainly haven't found one.

I did contact CHM again and was told that they have never not paid a claim in 27 years. I'm still a little uneasy, but I feel an equal (yet different) uneasiness when I look at insurance companies. Whatever plan we have has to have maternity and has to be 100% coverage.
-shane

[Napoleon17]

Here's a site that is legit and will help you find licensed health insurance agents near you. If they don't sell products compatible with your situation (i.e. if they only sell to super rich people) then they might know who does sell products that would be helpful to you. It can't hurt to talk to an agent before making the decision.

Originally Posted by snizzle

Whatever plan we have has to have maternity and has to be 100% coverage.

Basic medical expense policies have no deductibles and no coinsurance. There are different kinds of basic medical plans that cover different types of things:

Basic hospital expense insurance reimburses you for the cost of hospital confinement (room and board), as well as some of the costs associated with having to stay in a hospital, such as: drugs, X-rays, lab fees, use of the operating room, etc.

Basic surgical expense covers costs associated with the use of a surgeon's services. If you had to have open heart surgery, the plan would cover that, as well as post-op care.

Basic physician's expense covers expenses associated with seeing a physician for a non-surgical reason, such as office visits.

Since these plans have no deductibles and no coinsurance, you'd think they'd be more expensive than major medical plans, such as the common plans today that have deductibles and coinsurance, but since the basic medical plans limit the type of costs covered, I think they are affordable (not sure though). I'm not sure where maternity would fit in there, either.

So yeah, talk to an agent near you, and see if they can help you with a plan that covers maternity and has no coinsurance. My guess is if they are able to find a product that matches those criteria, it would be some form of a basic medical expense plan. Or it will be a major medical plan with a $10,000.00 deductible.

[Epaphras]

Originally Posted by snizzle

Whatever plan we have has to have maternity and has to be 100% coverage.

By this are you saying you don't want to / can't afford to pay any more than $1 toward the pregnancy?

If so, your income level might qualify you for Medicaid programs through your state. In our case, there is a Michigan program that pays 100% for prenatal, delivery, and postpartum care for mother and baby for something like $10 a month. All it requires is that our adjusted gross income stays below $22,000 during that time (200% of poverty for our family size). If we get pregnant before April 2010 we will go on that until I get my first "real" job out of grad school, where hopefully my employer would provide insurance (if not, we'll have more disposable income to put in our HSA).

Otherwise, if you have an uncomplicated pregnancy and expect a problem-free delivery, you can save $500-$1000 a month (extra job) for 9-10 months and have a good chunk of change saved up to pay for a birthing center delivery (Registered Nurse-Midwife attending, MD on call) with cash.

Also, even with a hospital delivery, if you find out you're pregnant and go to them and explain your situation, they will help you find a way to pay for it.

[snizzle]

Originally Posted by Epaphras

By this are you saying you don't want to / can't afford to pay any more than $1 toward the pregnancy?

If so, your income level might qualify you for Medicaid programs through your state. In our case, there is a Michigan program that pays 100% for prenatal, delivery, and postpartum care for mother and baby for something like $10 a month. All it requires is that our adjusted gross income stays below $22,000 during that time (200% of poverty for our family size). If we get pregnant before April 2010 we will go on that until I get my first "real" job out of grad school, where hopefully my employer would provide insurance (if not, we'll have more disposable income to put in our HSA).

Otherwise, if you have an uncomplicated pregnancy and expect a problem-free delivery, you can save $500-$1000 a month (extra job) for 9-10 months and have a good chunk of change saved up to pay for a birthing center delivery (Registered Nurse-Midwife attending, MD on call) with cash.

Also, even with a hospital delivery, if you find out you're pregnant and go to them and explain your situation, they will help you find a way to pay for it.

I'm cool with paying the deductible, but we can't afford more than that. I got mega screwed a few years ago with an 80% plan and wound up having to pay quite a few thousand dollars. We can't afford to throw down $1500+ during a pregnancy on top of the deductible and all the other baby related expenses.
-shane