[ChrisHarbison]

This really has little to do with parenting, but since most of the people in here are parents and that's my target audience, then I'm going to just ask in here.

I'm getting married in March and I'm trying to find the right health insurance. My company offers about 6 different plans and frankly, I'm as clueless as they come. My parents have told me what they think, so if your child asked you this question, what would you tell them? I don't want to end up paying too much, but at the same time, I want to make sure that I have sufficient coverage for both myself and my soon to be wife.

[Gracie Love]

I would say for now get the middle of the road plan and you can always up or downgrade later. When you have kids the top plan is most likely the best. Kids get sick a lot, not to mention check ups.

And if it is a boy endless numbers of stitches.

[Role Modlin]

Originally Posted by ChrisHarbison

This really has little to do with parenting, but since most of the people in here are parents and that's my target audience, then I'm going to just ask in here.

I'm getting married in March and I'm trying to find the right health insurance. My company offers about 6 different plans and frankly, I'm as clueless as they come. My parents have told me what they think, so if your child asked you this question, what would you tell them? I don't want to end up paying too much, but at the same time, I want to make sure that I have sufficient coverage for both myself and my soon to be wife.

If you post a summary of your options....I'll give you my opinion. You typically don't want one with a high out-of-pocket rate. You typically don't want one that requires you to name a primary care physician.

[ChrisHarbison]

The one I'm looking at is dead in the middle. It requires me to name a PCP, but I'm not required to go to him. If I do go to him, I don't have to pay any UCR balance, but I'm not restricted to only him. I'll post the options when I get to work. Thanks.

[Role Modlin]

Originally Posted by ChrisHarbison

The one I'm looking at is dead in the middle. It requires me to name a PCP, but I'm not required to go to him. If I do go to him, I don't have to pay any UCR balance, but I'm not restricted to only him. I'll post the options when I get to work. Thanks.

That doesn't sound too bad.

[ChrisHarbison]

Ok, the 3 options I'm looking at:

The HMO:
- Annual Deductible: $0
- Annual out of pocket max: $1500
- Primary Care Physician (PCP) visit: $25 copay
- Specialist visit: $35 copay
- ER: $100 copay
- Hospitalization (inpatient): $300 copay for days 1-5
- Hospitalization (outpatient): $300

The PPO:
- Annual Deductible: $500
- Annual out of pocket max: $4000
- Primary Care Physician (PCP) visit: $25 copay
- Specialist visit: $35 copay
- ER: 80% after deductible
- Hospitalization (inpatient): 80% after deductible AND $250/admission
- Hospitalization (outpatient): 80% after deductible

The middle plan that I had mentioned:
- Annual Deductible: $0
- Annual out of pocket max: $2500
- Primary Care Physician (PCP) visit: $25 copay
- Specialist visit: $50 copay
- ER: $200 copay
- Hospitalization (inpatient): 80% after deductible
- Hospitalization (outpatient): 80% after deductible

The monthly premiums:
- HMO: $62.75
- PPO: $137.75
- Middle: $89.75

I liked being a kid when my dad did all this stuff. Being grown up sucks sometimes.

[Role Modlin]

I definitely think the middle plan is the best of the three. Does that price include family, or is it just for you?

[ChrisHarbison]

Just for me. The montly premium with Wanda after we get married:
- HMO: $285.50
- PPO: $428.50
- Middle: $352.50

[Role Modlin]

Originally Posted by ChrisHarbison

Just for me. The montly premium with Wanda after we get married:
- HMO: $285.50
- PPO: $428.50
- Middle: $352.50

Whoa....that's crazy. That's more than I clear in a week.

[Gracie Love]

You might reconsider the HMO plan just for the pure fact that It has really good benefits.

Another reason to consider

The middle plan they will be taking out $103 and some change every week.
the HMO will be $83 and some change.

You both need to sit down and consider your budget in the desicion.

You get better coverage with less out of pocket with the HMO too and it is cheaper. So in the long run it will be cheaper all the way round.

[Pipercostal]

Move to Canada. Get free health care.

[ChrisHarbison]

Originally Posted by Pipercostal

Move to Canada. Get free health care.

I don't think that's an option, but it sounds good.

[KFBobInsanesMom]

Chris, double check if you typed out the plans info accurately on here. I say that because the PPO has higher deductible, higher out of pocket, and worse hospitalization ( that extra $250) , yet is the most expensive of the 3. Usually those things bring down the price of the insurance. In addition, is there a difference in life time maximum they pay or some other conditions that don't show here ( like benefits related to a pregnancy , etc ) ??

Of the 3 you have given, I would go with the HMO. Out of pocket is a big concern when you are just starting out, the HMO is lower. The $100 difference in ER won't really make much of a difference unless you are seriously accident prone , but it is lower on the HMO; as is the copay for a specialist . From what you have given , the only big factor between the HMO and the middle plan is the hospitalization.

Just for kicks say a 3 day hospital stay came out to be $30,000. With the HMO you would pay $900, with the middle plan you would pay $600.... that $300 is the difference in premium payments over a 6 month time period. So , if there was only one hospital visit in the year, you would be better off with the HMO.

The only real reason I can see to go with the middle plan and not the HMO, would be if you plan on children in the near future, in which case that difference in the hospitalization could be significant.

[Role Modlin]

Originally Posted by KFBobInsanesMom

Chris, double check if you typed out the plans info accurately on here. I say that because the PPO has higher deductible, higher out of pocket, and worse hospitalization ( that extra $250) , yet is the most expensive of the 3. Usually those things bring down the price of the insurance. In addition, is there a difference in life time maximum they pay or some other conditions that don't show here ( like benefits related to a pregnancy , etc ) ??

Of the 3 you have given, I would go with the HMO. Out of pocket is a big concern when you are just starting out, the HMO is lower. The $100 difference in ER won't really make much of a difference unless you are seriously accident prone , but it is lower on the HMO; as is the copay for a specialist . From what you have given , the only big factor between the HMO and the middle plan is the hospitalization.

Just for kicks say a 3 day hospital stay came out to be $30,000. With the HMO you would pay $900, with the middle plan you would pay $600.... that $300 is the difference in premium payments over a 6 month time period. So , if there was only one hospital visit in the year, you would be better off with the HMO.

The only real reason I can see to go with the middle plan and not the HMO, would be if you plan on children in the near future, in which case that difference in the hospitalization could be significant.

Wise words

[ChrisHarbison]

Well the deadline to pick one was 2 days ago, so I went with the middle plan primarily b/c the doctor and my fiance currently sees wouldn't have been covered otherwise. Thanks so much for everyone's input.