Our new insurance options are out for open enrollment and I am trying to decide which plan makes the most sense. I want to choose something that would be good no matter how TTC continues to go so I am looking at delivery/prenatal care as well as infertility costs. If anyone is well versed in insurance please let me know what you would choose and why. The first option is more expensive, would be about $100 more per month that the second option.
Choice A - $1000 deductible and $6000 max out of pocket total for family. Women's Health (aka regular visits, breastfeeding support, contraceptive) are all no charge and deductible is waived as they are preventative. Inpatient maternity care (including delivery and postpartum care) are 10% OOP after deductible to the OOP max. All prenatal maternity care is no charge and the deductible is waived. For family planning we would pay 10% after the deductible up to the OOP max of 6k (this includes testing, treatment, IUI, IVF, and a bunch of other options I have never heard of, its a very comprehensive list.)
Choice B - $5000 deductible and $10,000 max out of pocket for family. There is an employer HSA that they contribute to. Everything is no charge after the deductible. This includes Women's Health (aka regular visits, breastfeeding support, contraceptive), Inpatient maternity care (including delivery and postpartum care), all prenatal maternity care, and family planning (this includes testing, treatment, IUI, IVF, etc).
Even at $100 more per month,your overall possible OOP is significantly less with option A. Unless I'm missing something it seems like a pretty clear choice
Even at $100 more per month,your overall possible OOP is significantly less with option A. Unless I'm missing something it seems like a pretty clear choice
I felt the same way but wasn't sure if I was missing something? It feels like a trick. lol.
Are there any lifetime maximums for the fertility treatments?
No:) My company is very progressive about family planning. We have paid maternity and paternity leave, pumping rooms in every pod, and really great coverage for prenatal and infertility.
Post by mandiespharm on Nov 3, 2014 21:34:21 GMT -5
How much does your employer contribute for the HSA? Because let's say for some random reason you don't use any of it or very little of it and don't go to the doctor and don't do further IF treatments it rolls over to the next year. Or so is my understanding. I use all of mine and meet my OOP max for the year bc of my husbands treatments every month.
Even at $100 more per month,your overall possible OOP is significantly less with option A. Unless I'm missing something it seems like a pretty clear choice
I felt the same way but wasn't sure if I was missing something? It feels like a trick. lol.
How much is your employer contributing to an HSA?
HSAs are awesome. I love mine.
ETA: I.... clicked on the wrong board. I do this all the damn time and I usually catch myself. Sorry! I'm still curious though, if the HSA contribution is good here, it may be a better option.
I'm trying to decide the same thing for the same reasons right now. I'm leaning toward the not HSA option because the OOP max is so much higher than the PPO option. The HSA plan has been a good option for us in the past as we were not big healthcare users but I think the PPO makes more sense in the long run given that it's looking like we'll be spending a lot more on HC in 2015 than is typical for us.
Thanks for the replies! I checked and the HSA contribution from my company is $2000. I am not sure if this changes things drastically or not.
That's a freakin awesome contribution. Mine is roughly $900. I'd do the HSA high deductible plan. Just my thoughts. Eventually they are all going to be that way anyways.
Thanks for the replies! I checked and the HSA contribution from my company is $2000. I am not sure if this changes things drastically or not.
I know this is 6 days in the future, but YES. I was leaning towards the HSA originally, but this absolutely solidifies it. Your individual max is $5k/year. That means with the $2k your company throws in, your cost will be a maximum of $3k for the year. AND if you put at least 3k in the HSA yourself, those costs will be paid for with pre-tax dollars, saving you even more money.