https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Sun, 17 May 2026 18:47:11 +0000 https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2333452 Mon, 26 Oct 2015 06:47:26 +0000 looch 2333452@https://boards.hellobee.com/ <p>@Mamasig: That is exactly how I feel...my thought is that no matter what you pick, you are going to end up paying at some point.</p> <p>It shouldn't be this difficult to make a decision and feel good about what you chose. That's where I struggle. </p> https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2332958 Sun, 25 Oct 2015 12:23:54 +0000 Littlebit7 2332958@https://boards.hellobee.com/ <p>High deductible. We switched to one several years ago and haven't looked back. Our premiums are sooo much lower. Yes our deductible is high, but when you're looking at the negotiated rates, it really takes using a lot of medical care to even hit the deductible. We've only hit it once, and that was with the birth of LO. What you are saving in premiums will twice-over pay your deductible.<br /> Do they allow you to do a HSA (not a FSA)? They are fantastic and roll from year to year. Thats what we use to pay our deductible.<br /> I also like the fact that I am much more aware of what I am being charged, what tests are performed and any errors that arise. With my old PPO, I'd just pay my co-pay and not pay attention to anything (even when they were billing incorrectly and things were denied) because I felt so removed from the entire process. </p> https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2332954 Sun, 25 Oct 2015 12:18:06 +0000 Mamasig 2332954@https://boards.hellobee.com/ <p>@Eko: that's how my insurance is. Well visits and shots are covered 100%. But you pay for regular visits until you reach your deductible, then 20%. But you pay the agreed upon price so not the full cost someone would pay if they didn't have insurance. A normal office visit costs about $60 before any tests for us. </p> <p>Also just want to say I feel like you never know if you picked the right plan. I'm always wondering if I'm getting screwed somehow! </p> https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2332953 Sun, 25 Oct 2015 12:15:04 +0000 lawbee11 2332953@https://boards.hellobee.com/ <p>I would do the highest deductible plan.</p> <p>ETA: There is only a 1K or 2K difference in Max OOP between the $350 plan and the $1500 plan, but you're saving almost $5K in premiums. </p> https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2332946 Sun, 25 Oct 2015 12:01:41 +0000 catomd00 2332946@https://boards.hellobee.com/ <p>I'd pick the highest deductible plan. All Of baby's well visits will be covered (aside from copays) so you'll only be on the hook for sick visits OOP until you meet the deductible. Will your LO be in daycare? If so, you can probably expect a few sick visits. As long as a $6k medical expense won't be financially catastrophic, I think it's fine to choose that option. You might want to consider taking the money you spend now on the more costly plan and putting it aside in a savings account just in case unexpected medical costs come up.. </p> https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2332941 Sun, 25 Oct 2015 11:42:52 +0000 honeybear 2332941@https://boards.hellobee.com/ <p>Would a $3000 or $6000 bill be disastrous for your family? If not, pick the highest deductible and save the difference in premiums. Insurance is for unplanned catastrophes, not predictable expenses that you can plan and save for. </p> https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2332935 Sun, 25 Oct 2015 11:32:23 +0000 Eko 2332935@https://boards.hellobee.com/ <p>@regberadaisy: yikes! </p> <p>If that's the case I would first find out if normal office visits for DD are covered. Overall though I would pay the $800 deductible over the higher deductible. I've already had so many extra doctor visits that if I didn't have a copay it would add up quick. The premium difference isn't that great and I think you would make that up in cost in reaching your deductible. I would also maybe look into what @regberadaisy suggested. </p> https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2332933 Sun, 25 Oct 2015 11:24:49 +0000 Foodnerd81 2332933@https://boards.hellobee.com/ <p>I would really dislike not just having a copayment for office visits. I know when C was really little I brought her to the doctor so much to be checked for little things and I would have been really annoyed to pay $200 or something for them to look in her ears. Babies just get little things so much the first year or so, especially with daycare. </p> <p>That said, I don't know, maybe you are still better off with the higher deductible. So I'm just chiming in to say, you will have more ped visits than you would think. </p> <p>Also I'd made sure her routine visits are covered but I think they usually are. </p> https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2332928 Sun, 25 Oct 2015 11:14:16 +0000 regberadaisy 2332928@https://boards.hellobee.com/ <p>@Eko: some plans are like that now! The one I'm on now through work is like that. I just started a few months ago and open enrollment is December 1 so we went with the cheapest premium for now.</p> <p>You pay 20% until you meet your OOP Max. </p> https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2332927 Sun, 25 Oct 2015 11:13:13 +0000 Eko 2332927@https://boards.hellobee.com/ <p>I am a little confused about the copay. Does the insurance not cover anything until you meet your deductible then you're responsible for 20%? </p> https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2332924 Sun, 25 Oct 2015 11:08:23 +0000 regberadaisy 2332924@https://boards.hellobee.com/ <p>I guess it depends on your plans. Deductible plans differ now. Some are just coinsurance from the start. Some are completely OOP until you meet your deductible.</p> <p>Do you know if your Lo's routine visits, vaccines are covered in full or do you have to pay OOP for those? I'm not sure if those are under preventative care.</p> <p>Does your employer offer a individual &amp; spouse plan? If they do, look into NY Child Health Plus for your LO. It's a income based monthly premium. Unless you're Donald Trump, pretty much everyone qualifies. I pay $30/month for DD and I've yet to pay for anything on top of the premium. She's had ER visits and urgent care visits, etc. </p> https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2332922 Sun, 25 Oct 2015 11:05:07 +0000 Mamasig 2332922@https://boards.hellobee.com/ <p>I don't know tons about insurance, but I will say that with kids there are always unforeseen costs. Babies get sick a lot and you never know what bigger expenses may be down the line. By the age of 2.5, DS1 has had two sets of tubes and DS2 already got his 1st set. </p> <p>Would you rather have a smaller deductible and make up the difference with a bigger premium or vice versa? </p> https://boards.hellobee.com/topic/open-enrollment-insurance-confusion#post-2332920 Sun, 25 Oct 2015 10:59:23 +0000 LindsayInNY 2332920@https://boards.hellobee.com/ <p>We're nearing open enrollment time for insurance. Previously, it was semi-easy because we were either TTC, dealing with IF treatments or pregnant. For 2016, we have no anticipated expenses - I'm not on prescription BC, not undergoing IF treatments, won't be delivering a baby (and don't anticipate being pregnant), etc. That being said, DH and I have limited planned medical costs. Unplanned is always uncertain, I get that. And now we have DD to include in the mix so I don't know what insurance plan is the best choice for us.</p> <p>To help:</p> <p>$350 deductible ($700/family)<br /> $2,000 individual/$4,000 family OOP max<br /> Copays = $15/30<br /> Tests, etc. = 20% coinsurance after deductible<br /> Premium = $9,100.92/year for all 3 of us (DH, myself and DD)</p> <p>$800 deductible ($1,600/family)<br /> $2,400 individual/$4,800 family OOP max<br /> Copays, tests, etc. = all 20% coinsurance after deductible<br /> Premium = $6,873.12/year ($2,227.80 less than above)</p> <p>$1,500 deductible ($3,000/family)<br /> $3,000 individual/$6,000 family OOP max<br /> Copays, tests, etc. = all 20% coinsurance after deductible<br /> Premium = $4,170.36/year ($2,702.76 less than above)</p> <p>So basically the $800 and $1,500 deductible plans are the same aside from costs (so coinsurance and everything is the same). I don't feel like we need the $350 plan this year given our expected costs. But I don't know whether the $800 or $1,500 plan is better. Does it make a difference with a child now? Are there costs I'm not anticipating with her? She's 4 months now. </p>