My Scary Health Insurance Choices

I figured since it was Halloween l would post about something really scary…My Health Insurance Options and Premiums.  Considering it is open enrollment for season I am sure most people are facing the same decisions.

My Health Insurance

In the 3 years I have been writing on My Journey to Millions I have not brought up the discussion of my health insurance once.  Growing up my mom worked for a hospital as a registered nurse (she still does) and so we always had amazing health insurance.  The Wife on the other hand had little to no health insurance growing up as her father was a small (but successful) business owner.  It was very important to me to never have the discussion of whether it was worth the co-pay/deductible to go see a doctor.  It was a personal decision and a very expensive one.

I just received notice that my plan choice (the highest one offered by my company) was going to increase to $1,265/month! If nothing was to change I would be paying over $15,000 a year for health insurance.  Research had to be done.

The Difference Between My Health Plan Options

The Wife and I had to take a look at our 5 choices from Oxford.

  1. Option Number 1 had a $2,000 In Network Deductible and a $2,000 Out of Network Deductible – Eliminated.
  2. Option Number 2 had a $1,000 In Network Deductible and a $1,000 Out of Network Deductible – Eliminated.
  3. Option Number 3 had No In Network Deductible, unlimited lifetime maximum, $15 – $75 for prescription drugs, $30/$50 for Office Visits.  No Mention of Out of Network Benefits.  Possibility and the cost is $898.06 for my family.
  4. Option Number 4 had an In Network Deductible of $500 and $1,000 for Out of Network, $25/$40 for Office Visits, Same Drug prices as Plan 3.  Possibility and the cost is $982.12 for my family
  5. Option Number 5 - Current Plan – No In Network Deductible, $750 for Out of Net work, $25/$40 for Office Visits, Same Drug prices.

After talking it out with The Wife we decided that our real options were keep it the same or downgrade a bit to Option Number 3 which had no deductibles but we were more or less limited to in network doctors.  The Wife called all our current doctors to make sure they were in network and since they were and we don’t foresee needing any specialists (but who does?) we are going to go with Option #3.

While I will still be paying over $10,000 a year for Health Insurance, Option Number 3 will lower our monthly premiums $367 a month which is great since I just increased my 401(k) Contributions another $150/month since I was leaving free match money on the table.

 

What open enrollment issues/decisions have you had to deal with? Are your health insurance premiums as expensive as mine?

25 Responses to My Scary Health Insurance Choices

  1. I don’t have any premiums since my employer pays for it. What I do have is a freakin’ $5000 deductible, with $35 co-pays. I can’t remember exactly how much the premium is but I’m sure I could get a better all-around deal if they would just give me the money that are spending as part of my salary, but that isn’t an option.

    • I wouldn’t be so sure. I have a $2,500 deductible, and have to pay 100% of doctors visits and prescriptions before that deductible is met. (Except for annual physical and OBGYN). Plus I pay a monthly premium of $35 already. So even if you go to the doctor every month with that copay, you are doing better than most people if your employer pays your premium.

    • Do you have kids? I only ask because I think I would rather the $5k Deductible IF I didn’t have to then think of that question “should I bring him to the doctor?” lol

      Yeah you aren’t going to get that option lol

      • That plan is for me alone, with no pre-existing conditions, without dental or vision coverages, and I hardly ever go to the doctor.

        I remember when I paid my own way it was a $1500 deductible with no copays and $310 bimonthly with BC/BS. Now THAT was a good plan for my needs.

  2. My employer continues to make a generous contribution to help offset risign costs and this year was no different. The health insurance provider hower in an effort to save soem cost on oru behalf basically put the screws to anyone that requires specialists or Tier 3 prescription drugs and passed savings along to the masses (I’m guessing). My family will struggle to make this work, but options are limited.

    • It is nice that your employer helps out, but I wouldn’t want to be questioned every time I need a Tier 3 drug (not that I have any idea what that even encompasses)

  3. Wow, that is expensive! Your company does not have consumer driven health plan? Those are typically quite a bit cheaper. Currently, I’m paying $50 for myself and baby RB40 in a consumer driven health plan. It’s worked out pretty well this year and I’ll probably stick with it for 2012.

    • Wow, that’s a good deal. For our healthplan, I know as soon as you add a kid you are paying hundreds and hundreds per month in premiums.

    • What do you mean consumer driven? Like a High Deductible Health Plan?

      They have those 5 options and then 2 others that didn’t look comparable.

  4. Since I’m self-employed I have to buy my own health insurance but it doesn’t look like I would save much money if I was getting it through your employer. My insurance has a $10,000 deductible which means I’ll only be going to the doctor if I’m seriously ill or injured.

  5. My husband and I are self-employed, so we buy our own insurance and it is expensive. Our premiums jumped up quite a bit this year, so I raised our deductible to $7500 to reduce them to below the original rate. One point about our deductible is that I have never not gone to the doctor to seek care because my deductible is so high. If we need care, we go. We have an HSA that we use to pay our out of pocket expenses. And we get the insurance discount when we go to participating providers.

  6. I typically refrain from discussions about health insurance since I don’t pay for mine, don’t have a deductibe and my co-pays are reasonable. I have no reason to complain. However, starting next July (start of the state fiscal year), I will have to pay $25/month regardless of which plan I choose. It’s not that I mind paying the money, or even that it’s a lot, it’s the principle of why I have to pay it.

    Since forever, my state has had a double state share for married couples who are both state employees. It’s actually cheaper to do it this way. However, because many constituents are pissed and don’t understand how it saves money, lawmakers agreed on a $25/month fee to satisfy those complaints.

    But it’s great that you and your wife figured it out together. That is essential.

    • Are you a State Employee? I know there are some HUGE problems up here in NY and NJ with teachers (very public example) not providing ANYTHING…which can enrage some people

      • I am a state employee but I’m not sure what you mean about NY and NJ employees notproviding anything. Right now, we pay $0 for medical but we do pay for dental and vision insurance (we’ve always had to pay for dental and we just got vision insurance this past year. So for 7 years, I had no vision insurance). Starting in July 2012, we’ll have to pay $25/month for medical as well. Although it’s cheaper for the state for us not to pay anything, it’s only $25. I’m not really going to complain.

  7. I think there’s one more factor: your health. If you have many needs to see a doctor out of network, option #4 might be a better choice.

    Of course, that brings up your network. How large is it? Do you have choices in all the areas you may need a physician?

    Your cost increase stinks, but it’s out-of-pocket cost at the end of the year that you’re really worried about, not the premium.

  8. I pay about $250 for the two of us (that doesn’t include dental insurance premiums) each month.

    I’m thrilled that’s all we pay and have relatively low co-pays ($10 for generic meds and $25 for office visits).

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