https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Thu, 14 May 2026 20:44:07 +0000 https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2339390 Thu, 29 Oct 2015 18:36:20 +0000 littlejoy 2339390@https://boards.hellobee.com/ <p>@jedeve: Same about the pregnancy ... but I don't plan on becoming pregnant in the next year, so I feel like the 0 deductible plan is better. </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2339135 Thu, 29 Oct 2015 14:57:17 +0000 jedeve 2339135@https://boards.hellobee.com/ <p>@ms.line: that's weird!! I didn't notice, just assumed.</p> <p>If I was pregnant I would consider the high deductible. That's a pretty high out of pocket max on the zero deductible one. </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2339104 Thu, 29 Oct 2015 14:28:34 +0000 ms.line 2339104@https://boards.hellobee.com/ <p>@jedeve: The zero deductible plan is *cheaper*! :shocked: </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2339102 Thu, 29 Oct 2015 14:26:15 +0000 jedeve 2339102@https://boards.hellobee.com/ <p>@littlejoy: generally I would say if you are healthy, go for a high deductible plan. BUT if the difference is only $150, I would do the no deductible plan. That's pretty much one unexpected doctor trip where you need an X-ray or blood work or stitches, and you've made up the difference. If you were single and childless that's one thing. But kids always seem to have their own plans. </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2339092 Thu, 29 Oct 2015 14:21:11 +0000 littlejoy 2339092@https://boards.hellobee.com/ <p>@ms.line: Thank you. I believe this no deductible plan has no co-insurance. I believe you just pay the co-pay until your OOP is reached. Like, an x-ray is $50, an MRI is $500, and bloodwood is $50. </p> <p>I see the difference, thinking back to things I've used insurance for over the past two years: birth, gallbladder removal, blood tests, office visits, etc. </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2339074 Thu, 29 Oct 2015 14:15:01 +0000 ms.line 2339074@https://boards.hellobee.com/ <p>@littlejoy: Co-insurance is the new "trend" on low or no-deductible plans. They bill you for a percentage (usually 10% or 20%) of any tests or procedures (but not exams), capped at your out of pocket max. But if you don't see co-insurance percentages listed anywhere then that company probably doesn't use them. </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2339056 Thu, 29 Oct 2015 13:58:33 +0000 littlejoy 2339056@https://boards.hellobee.com/ <p>Thank you, ladies. This is great input. @ms.line: I'm sorry, but can you explain the co-insurance piece you mentioned? </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2339024 Thu, 29 Oct 2015 13:39:31 +0000 Adira 2339024@https://boards.hellobee.com/ <p>@Ms.Badger: I was just going to say that.</p> <p>The hospital stuff has a co-pay that's HIGHER than the high-deductible plan's deductible, so if you end up having any hospital charges, you'll probably spend more on the 0 deductible plan.</p> <p>My kids have food allergies and asthma and Xander was hospitalized for 3 days last year due to that respiratory virus that was going around, so for me, I'd go with the high deductible plan. But if you have a pretty healthy family and can't foresee any reason to go to the hospital, you might be safe with the 0 deductible plan. </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2339013 Thu, 29 Oct 2015 13:36:00 +0000 Ms.Badger 2339013@https://boards.hellobee.com/ <p>It's a $5,000 co-pay for hospitalization and $4,500 co-pay for out-patient care - if there's any health issues (including pregnancy), it's smarter to use the high-deductible plan plus a HSA. So if I were planning to get pregnant and could set-up a HSA, I think the deductible plan is better </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338934 Thu, 29 Oct 2015 12:58:48 +0000 yoursilverlining 2338934@https://boards.hellobee.com/ <p>@ShootingStar: Oh, I think I wasn’t clear. I didn’t mean that HD plan visits are $35 – other way around. It would take a lot of $35 visits under the Simple Silver plan to theoretically reach that 0% you would be responsible for if you met your deductible under the HD. Like, if you really only go to the doctor 3x a year, paying the $35 co-pay sounds a lot better than waiting to reach your $3k deductible (even at a couple hundred per visit). Unless you had something major happen right at the beginning of the plan year, I can’t see a normal healthy person getting a better deal out of the HD plan. </p> <p>Probably not explaining myself very well - but looks like we agree on the outcome - HD plan doesn't make sense. </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338914 Thu, 29 Oct 2015 12:50:00 +0000 ShootingStar 2338914@https://boards.hellobee.com/ <p>@yoursilverlining: When you have a high deductible plan, the visits don't cost $35. They cost more like $150-200+. </p> <p>If you ever look at an explanation of benefits, or a bill, there will be several columns. You'll see how the much doctor charged, then you see the contracted rate. So the doctor might charge $500, but has negotiated with the insurance that for it's members, the charge is $300. If you have a plan with copays, you pay the copay amount and the insurance pays the rest. With a high deductible plan, you pay $300 for that office visit (or whatever the rate is). </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338906 Thu, 29 Oct 2015 12:45:57 +0000 ms.line 2338906@https://boards.hellobee.com/ <p>I would definitely go with the zero-deductible plan!</p> <p>ETA: Totally agree with @yoursilverlining - at those premiums, I don't see how the high deductible plan would ever make sense. Unless the zero-deductible plan has coinsurance? Or your employer will put money into an HSA for you? But even still. </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338902 Thu, 29 Oct 2015 12:44:29 +0000 yoursilverlining 2338902@https://boards.hellobee.com/ <p>I would go with the regular plan, not the high deductible one. With the HD plan you have to pay for everything out of pocket until you hit $3k. That’s a LOT of $35 co-pay visits! Unless you have something happen that lets you hit your deductible early in the year, I don’t see how that plan could make more sense (?) </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338885 Thu, 29 Oct 2015 12:36:15 +0000 littlejoy 2338885@https://boards.hellobee.com/ <p>@Adira: I believe that all of that must be covered by order of the Affordable Care Act. I know that all well-visits are free -- same with physicals. </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338883 Thu, 29 Oct 2015 12:35:50 +0000 ShootingStar 2338883@https://boards.hellobee.com/ <p>So in your case, the high deductible plan does not make any sense. Years ago I had a similar plan and normally the appealing part is that it's far cheaper than a regular HMO/PPO. You will not only need to pay for the monthly amount, but you will need/want to contribute money to the HSA, so you can pay your medical expenses with that money (since it's tax free).</p> <p>For example, at the time I had that plan the individual HMO plan was about $45/paycheck. The high deductible plan was $10/paycheck ($1350 deductible), plus the company put $250 in your HSA. On top of that I contributed an extra $30/paycheck to my HSA. The total for me per paycheck was $40, vs. $45 for the HMO. </p> <p>When I had medical expenses, the provider would bill me at the contracted rate they had negotiated with my insurance company. And then I paid those expenses out of my HSA. The year I did fertility treatments I had already reached my deductible, which really helped a lot. </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338847 Thu, 29 Oct 2015 12:25:09 +0000 Adira 2338847@https://boards.hellobee.com/ <p>@littlejoy: I'd like more information about the high deductible plan. Are things like pediatric well-visits, physicals, and immunizations covered? Or do you have to pay for them until you meet your deductible? </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338843 Thu, 29 Oct 2015 12:24:06 +0000 littlejoy 2338843@https://boards.hellobee.com/ <p> [attach=5603/15/nwzsc7.487x600.Screen-Shot-2015-10-29-at-9.58.29-AM.png] https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338834 Thu, 29 Oct 2015 12:21:18 +0000 littlejoy 2338834@https://boards.hellobee.com/ <p>@Bao: In that situation, our ER deductible would have been $500, and the ambulance would be $250. Still a savings vs. having to pay all of that towards the deductible of the other plan. *I'm sorry you went through that!!!* :( </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338829 Thu, 29 Oct 2015 12:19:21 +0000 littlejoy 2338829@https://boards.hellobee.com/ <p>@catomd00: That's a good way to think of it. It's difficult to imagine something catastrophic happening, but I guess that's important to consider when thinking of the max OOP. </p> <p>If I did get pregnant, we'd try for another home birth, which would not be covered. We'd pay OOP, direct to our midwives. BUT, if I needed hospital care, or a c-section, that would probably max us out. </p> <p>An ER visit on the 0 ded. plan is $500, but I think that means anything beyond that is covered? </p> <p>All of this makes my head spin!! </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338826 Thu, 29 Oct 2015 12:16:51 +0000 Bao 2338826@https://boards.hellobee.com/ <p>I would do no deductible! $35 co pay is much less than if you had to pay out of pocket first. I just got an ambulance bill for $635, and an ER bill for $245. Could you imagine having to pay that upfront if your 3k wasn't met? Luckily our deductible is only $300 so we met that, but I wasn't planning on LO falling down a flight of stairs either. Things happen! I vote no deductible :) </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338821 Thu, 29 Oct 2015 12:13:46 +0000 catomd00 2338821@https://boards.hellobee.com/ <p>It depends. Will $12k send you into financial ruin? If so, I'd chose the plan with the lower OOP Max. Otherwise, I'd take my chances and go with the $351/mo plan. I'd rather pay copay's here and there then get big bills after every appt. until I reach the deductible. I don't like the way that plan has individual deductibles either. I prefer a plan with a family deductible. </p> https://boards.hellobee.com/topic/health-insurance-deductible-vs-no-deductible-plans#post-2338815 Thu, 29 Oct 2015 12:10:27 +0000 littlejoy 2338815@https://boards.hellobee.com/ <p>I'm going to be switching health insurance companies during open enrollment. </p> <p>I found a local company (highly recommended) that offers a plan with no deductible, and another that has a $3,000 deductible. </p> <p>I'm so confused about what would really be best. </p> <p>We are a really healthy family. LO visits the doctor for checkups, but rarely needs emergency care or sick appointments. I am not planning to have a baby next year, and I'm obviously hoping to not break anything or need surgery. I do plan on visiting the chiropractor and/or acupuncturist. DH has his own insurance through work. </p> <p>I've attached a screenshot of the super-basic overview. My questions come into the co-pay part ... the 0 deductible plan has co-pays for nearly every service, and the plan w/ a deductible pays for nearly everything once you've reached the deductible. I don't know which is best??</p> <p>Obviously, both have premiums, but the difference is only $150 over the course of a year. </p> [attach=5603/15/nwzrpf.600x352.Screen-Shot-2015-10-29-at-9.56.56-AM.png]