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Open Season on Health Care Options

By Anonymous November 22, 2008 - 2:19pm
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It is about that time when open season starts and it is time to change medical insurance providers. I have searched through several different carriers and it appears that I am basing my opinion mainly on the monthly price and not the benefits. What are the best benefits to look for? Co-Pay? Health Savings Plans? Can someone please give me advice?

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EmpowHER Guest

Thank you Allison and Susan for the great information. There are so many options out there that it is pretty overwhelming.

I am going to take both of your advice and hopefully make a rational decision.

November 23, 2008 - 9:56am

What a tough decision! I've decided to wait until this summer to look at our health insurance (and, to make any changes), as I'm hopeful that Obama will be working on some changes to healthcare. (Can't say that anything will actually change that benefits us by that time, or even in the next four years....).

To me, it was a numbers game:
Option 1: low monthly premium (probably) equals high annual deductible. Low coverage on Rx and specialty-doctors.
Option 2: high monthly premium (probably) equals lower annual deductible. (can't speak to Rx or specialists)
Option 3: there is probably something in-between

Last year, I opted for "Option 1", as we didn't know what our monthly expenses would be, so our only option was lowest monthly costs.

Now that we know what we can afford monthly, and what we're paying monthly for Rx and "specialists", I can see if there is a plan that has better coverage, with the doctors we like, that we may pay higher monthly premiums but pay less overall b/c more Rx is covered.

It depends on your situation: what healthcare you need covered, how many Rx you have (and how expensive they are), specialists, preventative care, and then what you can afford for monthly premium AND other monthly co-pays. Our high deductible has been irritating, but because I see an allergist who is not "in network", I pay for that out-of-pocket and will never reach the annual deductible. So, it's something I budget in VERSUS what I would pay for a higher monthly premium.

It looks something like this:
Monthly premium: $300 for family

Doctor visits monthly: $200
Rx monthly: $150
TOTAL: $350 (not including premium)

So, if I can find better health coverage that has a monthly premium of $350 or lower, then I would opt for that. If not, then our $300 monthly premium helps with knowing we have coverage for emergency visits, etc.

We did have a trip to the ER this year with my son, so I will see how much we paid for that vs. what we would have paid with a higher monthly premium.

Anyways...I hope I explained that so it is somewhat understandable. The other thing I found is that there are not too many options out there, at least for our circumstances and our state. The options are limited for you, so though it seems daunting, you may be looking at only 2-3 companies who have 2-4 policies each.

Do you know what your monthly expenses are for health care? Are you good with spreadsheets? :-)

November 23, 2008 - 8:20am
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