If anyone's comfortable sharing? I have been on my husband's insurance since I stopped working 13 years ago, and when I had insurance his was my secondary. His insurance is practically unheard of now and it cost us nothing. He and my son can stay on his, but I will have to take them for me through my employer.
I will have 3 plans to choose from. It's confusing because I've never had to deal with coinsurance or HSAs. What do you look for when choosing a plan?
Does anyone also have a plan that acts as secondary? If so, does that ever cover co-pays or coinsurance? Thanks for any info you have to share!
We pay $93 biweekly for a family of 3. We have no deductible.
ETA: We have $5-15 co-pays and don't have any medical bills. Anything covered is covered at 100%. Emergency room co-pays are $100, but refunded if it was a necessary visit (it encourages urgent care use vs ERs).
Post by mysteriouswife on Oct 8, 2023 15:11:55 GMT -5
H pays nothing for his. He pays for ours and it’s PPO for $450 a month. No deductible and copays are cheap. $25 for regular office visits or urgent care. $40 for specialist. $150 ER. Don’t know the overnight rate. Out of pocket is $1,500 each or $2500 max per family yearly. I do not require a waiver or premium on H’s plan. I can get coverage at work. My work plan is awful with a HDP. I think my deductible is $4000 and OOP is $7500.
We pay nothing for Tricare, thankfully, but our dental coverage really sucks and we’re going to switch to dental through my husband’s employer during the next open enrollment.
We are insured through my H. We have a Kaiser HDHP with a deductible/max OOP of $3200 (eta changed - I didn’t realize this had also increased!). When he started there 10ish years ago, this plan was free. This year, our portion of the cost went up 250% from last year. We’re now paying around $4500/year for a family plan, plus up to $3200 if we meet the OOP max.
The current issue with our employer coverage is that their CBA specifies that they’ll cover 90% of the cheapest plan. For whatever reason this year, all of the options jumped in cost, except for the cheapest. So our plan cost went up quite a bit and the employer coverage didn’t change at all.
I keep hearing how crazy expensive it is, but these costs don't seem bad!
If that was all we had to pay maybe not, but that’s just our month premium. I also have a copay ($25 for doctor visit, $100 for an ER visit), a deductible (so insurance covers nothing until I cover my deductible which I believe is $3000 for 1 person) and co-insurance so even once I hit my deductible I still have to cover 20% of all medical costs until I hit my out of pocket max (which I have never hit but I believe is $6000).
ETA- I’m sure you have all that on your H’s current plan but it seems ridiculous when playing hundreds of dollars a month to also have to pay all of that.
Post by redheadbaker on Oct 8, 2023 16:18:44 GMT -5
$115 every other week for our family of three on an embedded* high deductible health plan.
We pay a $100/month premium to have H on my plan, because his employer also offers medical benefits. But we get a discount for getting a physical.
For in-network care, the individual deductible is $1,500, and the family deductible is $3,000.
I also contribute $230 every other week to our HSA account.
*For anyone not aware, an embedded deductible has two deductibles: the individual deductible for each family member covered and a family deductible. When one family member accrues enough medical expenses to the point that they meet their individual deductible, after-deductible health insurance benefits, like copays, coinsurance and cost sharing, will be provided by the insurer. However, these will be provided solely for that family member. Other members of the family would not yet be eligible for the same benefits.
Once multiple family members' medical expenses add up and surpass the family deductible, the insurer would begin to pay covered medical expenses for all members of the family, even if one covered member did not meet their individual deductible.
Post by underwaterrhymes on Oct 8, 2023 16:18:52 GMT -5
We have an HSA this year because I had multiple surgeries and if you have either low healthcare costs or high healthcare costs, HSAs make the most sense. I pay $187.85 every pay period (26 pay periods a year) for a family of four. It made sense for us this year but because I’m job hunting, it may make less sense for next year. I have to sit down to figure it out, but if we don’t do the HSA, we will do PPO 90. Under that model, it’s cheaper for H to pay for his insurance (which I think is $90 for him per pay period), and I would pay for me and the kids, which comes to $264 per pay period.)
$67 bimonthly for the 4 of us. We are super lucky. It’s a great plan with low deductibles and copays. What my company lacks in other benefits we make up for with health insurance. It’s part of why I took the job. I needed IVF.
Our mission is healthcare for all though so….
ETA: copays are generally $10-$20, annual deductible is $1,500 per person but really only kicks in if you need something more. Most things have been covered by my copay. I only hit the deductible in years of IVfF, child birth and my kid having surgery.
Post by thebreakfastclub on Oct 8, 2023 16:20:18 GMT -5
I pay $300/mo for medical and dental for a high deductible family plan. I get $500 annual contribution to my HSA.
Our only real medical use is my son's ADHD medicine at $30/mo and quarterly med checks for that. I go to the Dr for a well check maybe every other year and my mammogram is covered.
Nobody ever gets sick in my house so I'm just contributing to my HSA just in case and never spending it.
I am the only one on my insurance. Its excellent coverage and co-pays are almost all $10. It would be expensive to add kids. My kids are on XH’s insurance and it’s at a cost and a high-deductible plan. I hate it. I don’t know exactly the costs but I think they deductible is $3200 and used to be $5200.
I keep hearing how crazy expensive it is, but these costs don't seem bad!
If that was all we had to pay maybe not, but that’s just our month premium. I also have a copay ($25 for doctor visit, $100 for an ER visit), a deductible (so insurance covers nothing until I cover my deductible which I believe is $3000 for 1 person) and co-insurance so even once I hit my deductible I still have to cover 20% of all medical costs until I hit my out of pocket max (which I have never hit but I believe is $6000).
ETA- I’m sure you have all that on your H’s current plan but it seems ridiculous when playing hundreds of dollars a month to also have to pay all of that.
This makes sense, I thought people were meaning that the monthly cost was all they were paying. I haven't had a deductible or coinsurance, so I need to figure out what each plan offered truly costs. My husband's plan covers 100%. We have no co-pays for any visit or any prescription. It's half the reason he has stayed there.
Post by wanderingback on Oct 8, 2023 16:37:57 GMT -5
I insure myself, my partner and our daughter. It’s a little over $300/month if I’m remembering correctly. It’s def less than $400. Our copays are $25 and $40.
I personally go for the PPO and sign up for half the deductible to go in my HSA. My company pays the other half. HSAs are nice because its tax free money.
I forget what I pay per paycheck, but it’s something over $300 every other week for the family plan.
Post by dancingirl21 on Oct 8, 2023 16:46:24 GMT -5
Our family of 4 is all on DH’s insurance plan. We pay $330/month for medical, $7/month for vision and the company pays for dental. He’s been there for 8 years and they have never raised premiums. He was very casually looking a couple of years ago and a company made him an offer. We saw that insurance premiums for a family were around $1200/month. He wasn’t super seriously thinking about leaving his current company, but that certainly weighed into the decision for us.
ETA: we have a PPO. I generally look for that over an HMO, just because you can go to doctors in a lot of places and not have a set location or list. Considerations for us included deductible ($750 individual or $1500 family), and ability to FSA.
I am not sure of dollar amounts but I have done a good deal of looking into HDPs (high deductible plans) and of the 3 options at work, I choose the lowest cost (per month) HDP + add $$ to my HSA (health savings account). This works for me because the monthly payment is the lowest and I do not use my insurance for any special doctors or many medications (& those medications are reduced to the insurance price).
I put about $100 per paycheck into my HSA, so every year that totals about $2,600 dollars (we get 26 paychecks a year). I have been doing this long enough that I have about $10,000 in that account. If I have a major medical issue (ex. accident), my deductible is $5,000 and I plan to use my medical savings (HSA) to pay the deductible until I reach $5,000 and insurance kicks in. I like that I keep that money every year and it follows me to any new job and forever (so they say for now). Also, it is not taxed, so it lowers my tax liability on my income.
I also use this account for any qualifying out of pocket medical expenses like co-pays, and my portion of medication costs. I can also use this health savings account for me, my daughter, or H.
If I used the traditional PPO plan, I would pay more per month, have more coverage, and no HSA. You can have a medical flex account but that money has to be spent by December 31st or you loose it.
Each year, I re-evaluate. At the end of the year of not using my PPO, I prefer having money in my HSA. I feel safe, now, that I have enough savings to cover any deductible (which is the risk for a HDP).
I am not sure of dollar amounts but I have done a good deal of looking into HDPs (high deductible plans) and of the 3 options at work, I choose the lowest cost (per month) HDP + add $$ to my HSA (health savings account). This works for me because the monthly payment is the lowest and I do not use my insurance for any special doctors or many medications (& those medications are reduced to the insurance price).
I put about $100 per paycheck into my HSA, so every year that totals about $2,600 dollars (we get 26 paychecks a year). I have been doing this long enough that I have about $10,000 in that account. If I have a major medical issue (ex. accident), my deductible is $5,000 and I plan to use my medical savings (HSA) to pay the deductible until I reach $5,000 and insurance kicks in. I like that I keep that money every year and it follows me to any new job and forever (so they say for now). Also, it is not taxed, so it lowers my tax liability on my income.
I also use this account for any qualifying out of pocket medical expenses like co-pays, and my portion of medication costs. I can also use this health savings account for me, my daughter, or H.
If I used the traditional PPO plan, I would pay more per month, have more coverage, and no HSA. You can have a medical flex account but that money has to be spent by December 31st or you loose it.
Each year, I re-evaluate. At the end of the year of not using my PPO, I prefer having money in my HSA. I feel safe, now, that I have enough savings to cover any deductible (which is the risk for a HDP).
Tha k you, this is helpful. It's all so confusing!
I pay about $262/month for an employee + one HSA plan, plus I put $400/month into my HSA. I'm paid bi-weekly, but insurance only comes out of 24 of my 26 paychecks. If I had more than one kid I'd have to bump up to a family plan which is around $375/month. My family deductible is $3000/year, but my employer puts $1000 into the HSA for us. I believe the out pf pocket max is $6,000. I think my premium is about 15% of the cost, my employer pays the other 85%.
Post by killercupcake on Oct 8, 2023 17:02:46 GMT -5
I pay about $50 a month for just me. I have a low deductible and reasonable copays. No coinsurance anymore. It includes a dental HMO and a small life insurance policy.
H and the kids are on his plan through his company and it’s 100% covered by his employer. His plan is pretty much identical to mine. I am not on his at all as a secondary because my insurance is kind of a PITA when it comes to coordinating benefits and I don’t need that much care, thankfully.
I think it's about $240 biweekly for the two of us. We have no deductible and it's in network only, but the network is pretty good in this area. I think it's $30 for PCP, $40 for specialists, and $50 for ER. Most imaging and other tests are covered 100%, as is mental health.
It's fine, but I think it's a little expensive for 2 people. I think what saves us is the lack of deductible, but I'm not sure we would meet the deductible every year so it's hard to know if that actually results in lower costs overall. I like the fact that we don't have to decide whether or not a visit is worth the cost before making the decision to go to the doctor. When my H recently had an ER visit we paid $50, but may have waited if it was going to be like 2k!