Health Insurance for me and the kids

[MDPhDWife]

Health Insurance for me and the kids

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?

Geez, we haven't had to deal with an ear infection/cough/cold that required a dr. appointment in several years (knock on wood). But I betcha now that I've said that, I've jinxed us! The PCP visits are a $30 co pay on both plans, but the specialist visit is $50 on the POS vs $30 HMO. The most concerning thing to me is DD14 gets a bad fracture/break that requires sx since she's so athletic and prone to those kinds of things. With the HMO we'd only be out the $30 office visit or $75 urgent care co pay, but with the POS we'd be responsible for $30 visit plus 100% cost of outpatient sx and any advanced scans she might need up to $3500 which is the out of pocket max.

Kris brings up a valid point about DD14 visiting her dad in NM. She rarely visits anymore because he hasn't stepped up to the plate to make travel arrangements (whole other long story, Kris and I could spend days trading horror stories). I wonder though if he could add her to his Medicaid plan so she would have that coverage during the rare occasions she is in NM...

I think we're going to try out the HMO for the girls and I for the time being. DH will do the POS plan since the job pays 100% of his premium and that will allow us an opportunity to compare both plans in reality.

[SoonerTexan]

If it sucks, you can always change next year

[HouseofWool]

How long does she spend with her dad? Usually the process of getting added to Medicaid isn't easy and she likely won't be eligible because he isn't the primary home.

[Deebs]

In DH's last job, we paid $1200 per month in deductibles with a high out of pocket max, okay coverage, and horrible med coverage. I was spending over $500/ month for DD's allergy mess, after tweaking them to find some that were less expensive. Here, our portion of premiums is $300 per month. We would pay $0 in co-pays if we used only DH's hospital's providers, but it's about an hour away. Instead, I'm using preferred providers and spending about $25 per visit, allergy med costs have dropped to about $200 OOP at the very worst. Granted, DH took a huge paycut for this job, but it's nice to know that we aren't going to have medical bills completely kill us. It's much, much easier to have emergency funds and know they'll actually cover what we need.


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[Pollyanna]

Hey Charlene! You've received great advice so I don't really have anything to add other than I'm with you in missing the healthcare policies offered at UA. Looking forward to hearing how you and the family is doing!

[gcuthbe1]

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?

Definitely worth it to go with zero deductible. Removes the headache. Plus $50 x 12 months = $600. So really you could be saving $900 (1500 deductible less 600 per year in plan cost)

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[spotty_dog]

Definitely worth it to go with zero deductible. Removes the headache. Plus $50 x 12 months = $600. So really you could be saving $900 (1500 deductible less 600 per year in plan cost)

I knew I could trust an accountant to catch me on my math! <-- Physics major, means that if it's within an order of magnitude, we're good.

We actively avoid going to the doctor, even though we can afford it and have budgeted for it, because of the headache of having to pay. So that's why I asked if you go to the doctor for things like fevers and ear infections. If you typically prefer the peace of mind of getting things checked out, less out-of-pocket cost is definitely the way to go!

Sounds like you've decided for now, hope it works out. Insurance is such a mess!

[MrsInTheMiddle]

Does your husband have the option to enroll in FSA or HSA? The money is taken out pre-tax. I always elect a nice chunk of money for FSA since I wear contacts and glasses. It's nice having that money for co-pays and meds without having to budget for it.


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[MDPhDWife]

Just when I thought I had made a decision and was enrolling online, it asked me to select a PCP. I researched and called a few on the list of providers only to discover more than half of the listed providers don't in fact accept the HMO insurance. Total fucking bait and switch by the insurance company! Glad I made those calls prior to enrolling! So you guys were right after all about having a hard time finding a doc. Ugh, so with that being the case, we'll stay on the employer sponsored deductible POS plan. Every time I see POS plan I think piece of shit not point of service. Am I the only one?

MITM, nope no HSA available at DH's job unfortunately.

[MAPPLEBUM]

Just when I thought I had made a decision and was enrolling online, it asked me to select a PCP. I researched and called a few on the list of providers only to discover more than half of the listed providers don't in fact accept the HMO insurance. Total fucking bait and switch by the insurance company! Glad I made those calls prior to enrolling! So you guys were right after all about having a hard time finding a doc. Ugh, so with that being the case, we'll stay on the employer sponsored deductible POS plan. Every time I see POS plan I think piece of shit not point of service. Am I the only one?

MITM, nope no HSA available at DH's job unfortunately.

Hey! Not to hijack your thread but how's life after training fellow ophtho wife?

[MDPhDWife]

Hey! Not to hijack your thread but how's life after training fellow ophtho wife?

Hey Mapplebum! Life after training is pretty close to how the ladies here described it would be. I joked that we were moving from hell (112 degrees in AZ on moving day) to high water (tropical storm had just blown through our new city in TX). DH's licensing paperwork got severely delayed so although he was supposed to start work on 8/1, he didn't actually start until 9/17. While it was nice having him around while we worked on small projects on the new house we bought, we blew through our entire nest egg plus some. It's incredibly frustrating to have "made it" and feel broker than ever. I keep reminding myself of what the ladies here had always said about the first year out of training being one of the hardest. Really though I'm not gonna complain too much because the hours so far (only 1 week in) are amazing and I know the money will eventually follow. Your DH is a senior this year right? Is he still planning on applying for a fellowship?

[SoonerTexan]

Can you get an HSA outside Of the employer? I have no idea


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[spotty_dog]

Can you get an HSA outside Of the employer? I have no idea

Only if you have a HDHP, which is a minimum $2600 family deductible.

[Vanquisher]

Insurance is the devil. Medicare for all. We need national health.


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[HouseofWool]

Insurance is the devil. Medicare for all. We need national health.


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So much word!