Posted: Wed Oct 31, 2007 2:26 pm Post subject: Employer Provided Health Insurance
Hi Jeannie,
There really isn't an "obvious" answer, based on the information you have provided:
Quote:
Option 1: Monthly premium $106.00
Deductible $4000 / family
HRA fund $2000 / family
Annual out-of-pocket max $6000
Co-insurance 80%
I can only assume that your employer is only offering two types of health coverage, either "Individual" or "Family", is that correct? Is there no "Employee and Children" option?
Are there any "Co-Pays" with this option - doctor visits, out-paitient surgery, emergency room, prescription drugs, etc.?
I would think that you are a young person, having a 3-year-old. Are you both in excellent health? If so, the majority of your medical expenses woud most likely involve doctor visits, prescription drugs, and of course, the emergency room. I have spent a lot of time there with my kids.
Under this option, you would obviously pay 20% of all eligible expenses up to $6,000. These would be expenses other than co-pays, like hospitalization, specialized testing, etc. You show a deductible of $4,000 for two people. Does the quote say you have to satisfy two deductibles per family? There is something missing here.
Quote:
Option 2: Monthy premium $236.00
Deductibe $3000 / family
HRA fund $1000 / family
Annual out-of-pocket max $6000
Co-insurance 100%
Right up front, this one costs you $1,560.00 per year more. That's a lot of money. How many deductibles must a family satisfy here?
The 100% co-insurance is an attractive feature of this option, but is it worth the added cost to you? Again, does this one have co-pays for doctors, etc.? What do you expect the majority of your medical expenses to involve? Of course, we never know what can happen. What have you spent on healthcare in the past three years?
This is a very important decision and you should sit down with the insurance agent who handles the insurance program for your employer.
Look at all parts of the plan, not just the "co-insurance" and let him/her help you make the best decision for you and your child. _________________
Well here is how I look at this. The first plan which is the cheaper plan....you have more out of pocket expense later on when you are going to use the insurance...For example in the first plan the insurance company is going to pay 80% of the bill which we the bill amount can vary depending on what happened etc.
In the second plan you are paying more monthly but the insurance company is pay 100% of the bill, also you have a lower deductible etc. so you pay more now and less later.....
It comes down to cash flow and what you feel comfortable with. How I look at it is you pay for what you get. I personally pay a higher premium each month but if anything ever happens to me medically I know that I am not going to have to put out a ton of money...
Does this make any sense? _________________ ~Monique~
Posted: Thu Nov 01, 2007 5:55 am Post subject: I chose option-2
Yupp...in my opinion too...at the first glance the option-1 would always seem the better one, if you take into account the lesser premium, the HRA funding or the yearly expenses. But when you think of the co-insurance gap that would truly count a lot when you're in trouble. Again as nique1221 rightly pointed out you may have to pay more now but it would come down with time.
So if paying twice the premium is worth supporting you when you need it...then I'd personally opt for the option-2.
Thanks,
Fatman
