Health Insurance for me and the kids

[Thirteen]

The Enabler says yes to all the baby having during training. 😎
DS1 was free, free, free - no copays, nada. Prenatal care, L&D, and post natal care.




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[SoonerTexan]

Likely you are going to have a tough time finding a provider in the HMO. Check the deductibles on the other plans.

I realized yesterday if we want to have another baby during residency, we are going to have to come up with at least $5k out of pocket and we better not have a pregnancy over 2 plan years. 😒


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[scrub-jay]

Yea, the good old days of free residency babies seem to be coming to a close. Won't be happening for us on the resident insurance plan. At least we've got an HSA, but L&D will clear it out.

[OrionGrad]

Our residency babies weren't entirely free, but the hospital did give employees a bonus on their next paycheck for delivering there. Just a couple hundred dollars, but still very much appreciated!

[oceanchild]

Likely you are going to have a tough time finding a provider in the HMO.

This is what I was going to say, but I've found that the easiest time to get into a really restrictive HMO is when you're new to a place. You haven't had a chance to become attached to any providers yet. But you definitely still want to understand the network and its limits. For instance, we basically have to go to the university hospital, which is fine for us because we also live near there, but it would be annoying if we lived on the other end of town.

The only good way I've come up with to assess insurance plans is to find a thing I know I need (a certain prescription, a sick kid visit to the pediatrician) and figure out how much it will cost. There are some forms required by the ACA now that make this easier. (From our employers they are called Benefits Summary documents. I don't know whether this is standard language, but you should have something like this for each plan you're considering. There's a "coverage examples" page that I think is really useful.)

[SoonerTexan]

[MENTION=1310]MDPhDWife[/MENTION] I sent you a PM with a doc that might help with the HMO decision. It has your location so I didn't want to post it here in a public forum

[Howfunitis]

Something else to look forward to! Yippee!! Hubby has his own insurance. And the baby and I are on state insurance which had me sweating bullets up until delivery because I had heard of how much $ it cost to have babies in hospitals. Had to pay $100 out of pocket and it was covered. Now that I'm in a different state, don't know what I'll have to pay but I had told hubby. I really wanted to get better insurance for better medical care.


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[MDPhDWife]

So I think we're going to pull the trigger on one of the BC/BS private plans that I found. However, after talking with the payroll lady we noticed that the difference in net paycheck is only $650 more by dropping $1000 insurance off. Apparently that's because the insurance is taken out pre tax, therefore that extra money is taxed, thus only netting us $650 more. If we're going turn around and pay between $650 and $700 on a private plan, then all my savings is negated plus some. 😣 Does anyone know if we will get a tax credit when we file for having purchased insurance with post tax dollars? We need to make a decision today for the payroll lady. 😁

[spotty_dog]

So I think we're going to pull the trigger on one of the BC/BS private plans that I found. However, after talking with the payroll lady we noticed that the difference in net paycheck is only $650 more by dropping $1000 insurance off. Apparently that's because the insurance is taken out pre tax, therefore that extra money is taxed, thus only netting us $650 more. If we're going turn around and pay between $650 and $700 on a private plan, then all my savings is negated plus some. �� Does anyone know if we will get a tax credit when we file for having purchased insurance with post tax dollars? We need to make a decision today for the payroll lady. ��

No, you will not get a tax credit I don't think, and you can only take a deduction if your health care expenses are more than 10% of your gross income, if I read this right: http://www.irs.gov/taxtopics/tc502.html

[MDPhDWife]

Bummer. Ok so since we won't be saving any money by purchasing a private plan once you consider the pre vs post tax situation, I am now wondering if it is still worth an extra $13-$50 per month to have a $0 deductible as opposed to a $1500 deductible. WWYD?

[MDPhDWife]

FWIW, I checked out the providers and hospitals (Thanks ST! &#128516 on the HMO and there appears to be sufficient choices for providers. Especially considering we are new to the area and don't have any doctors we are established with/prefer yet.

Don't have many major health concerns (knock on wood) other than DD being in lots of contact sports and prone to fractures. With that in mind, we chose to purchase Aflac accident coverage.

[SoonerTexan]

You might want to call some if you are interested and see how open their schedules are just in case. It might be a "oh yeah, we can take you in 3-5 months" situation...

[OrionGrad]

Bummer. Ok so since we won't be saving any money by purchasing a private plan once you consider the pre vs post tax situation, I am now wondering if it is still worth an extra $13-$50 per month to have a $0 deductible as opposed to a $1500 deductible. WWYD?

If I was choosing between those two options, I'd go with the $0 deductible.

[spotty_dog]

So, in any year that you only need preventive care, you're saving $300 on the non-HMO plan. But on the HMO plan you might not find it easy to get providers. But any year you have a major illness you're ahead with the HMO plan. It sounds evenly matched to me. Are there differences in copays or prescription coverage that might tip the balance? Do you usually go to the doctor for stuff like ear infections and cough, or do you wait it out/consult your own dawkter in-house?

[HouseofWool]

And if you travel at all (the girls go to see their dad) coverage for out of net can get tricky.

Personally, I would ensure that you have some out of net coverage. A PPO or POS plan.