Need health insurance guidance (unhealthy)

Hi guys I’ll get right to the chase.

I’m 25 years old and have 2 chronic illnesses. I recently started a new job and they are offering me some health insurance options. Once COVID is under better control I will have to travel out of town/state frequently (>3 days a week some months) for work which I am factoring into my decision.

My medical history: Last year I had a pretty major surgery that was billed at around $100,000 before my old insurance kicked in. I also went to the ER 3 times. While those were some pretty major expenses, my doctors and I don’t expect things to be this bad the majority of the time (it may occasionally, maybe every 5-10 years). Throughout the last 5 or so years (except last year) I usually go to the doctor once a year, and a LOCAL specialist three times a year that occasionally orders some bloodwork.

Currently I’m leaning towards the EPO 2000 plan because it has the lowest cost of ownership if I don’t have any major episodes, and even if I do, it will only cost me around $1,000-$2,000 more MAX than the other plans. I’m saving close to that amount in a year of ownership provided I am reasonably healthy otherwise. There’s also wiggle room considering if my expenses end up somewhere in the middle, it would still be cheaper than or very comparable to the others. I have what I deem to be a relatively decent emergency savings of ~6 months of expenses.

There are more plans outside of these but I would prefer to stick to the EPO ones considering the travel I will have to do in the future, they have good hospital coverage out-of-town which is what I’m looking for.

  • EPO 0
    Monthly premium: $534.80
    Yearly Deductible: $0
    Coinsurance: 0%
    Out of pocket max: $2,000
    Misc: Office visits $20 copay, Hospital $250 copay, Surgery $250 copay (100% covered after copay)
    Max pay per year (including premium): $8,417.60, although I realize I probably wouldn’t hit the out of pocket max because that would be 3-4 hospitalizations + surgeries in a single year
    Min pay per year: $6,437.6

  • EPO 1000
    Monthly premium: $324.80
    Yearly Deductible: $1,000
    Coinsurance: 30%
    Out of pocket max: $4,000
    Misc: Office visits $30 copay, Specialists $50 copay (local only)
    Max pay per year: $7,897.60
    Min pay per year: $4,077.6

  • EPO 2000
    Monthly premium: $257.80
    Yearly Deductible: $2,000
    Coinsurance: 30%
    Out of pocket max: $5,500
    Misc: Office visits $30 copay, Specialists $60 copay (local only)
    Max pay per year: $8,593.60
    Min pay per year: $3,303.60

submitted by /u/okdudeyeah
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Hi guys I’ll get right to the chase. I’m 25 years old and have 2 chronic illnesses. I recently started a new job and they are offering me some health insurance options. Once COVID is under better control I will have to travel out of town/state frequently (>3 days a week some months) for work which I am factoring into my decision. My medical history: Last year I had a pretty major surgery that was billed at around $100,000 before my old insurance kicked in. I also went to the ER 3 times. While those were some pretty major expenses, my doctors and I don’t expect things to be this bad the majority of the time (it may occasionally, maybe every 5-10 years). Throughout the last 5 or so years (except last year) I usually go to the doctor once a year, and a LOCAL specialist three times a year that occasionally orders some bloodwork. Currently I’m leaning towards the EPO 2000 plan because it has the lowest cost of ownership if I don’t have any major episodes, and even if I do, it will only cost me around $1,000-$2,000 more MAX than the other plans. I’m saving close to that amount in a year of ownership provided I am reasonably healthy otherwise. There’s also wiggle room considering if my expenses end up somewhere in the middle, it would still be cheaper than or very comparable to the others. I have what I deem to be a relatively decent emergency savings of ~6 months of expenses. There are more plans outside of these but I would prefer to stick to the EPO ones considering the travel I will have to do in the future, they have good hospital coverage out-of-town which is what I’m looking for.
EPO 0 Monthly premium: $534.80 Yearly Deductible: $0 Coinsurance: 0% Out of pocket max: $2,000 Misc: Office visits $20 copay, Hospital $250 copay, Surgery $250 copay (100% covered after copay) Max pay per year (including premium): $8,417.60, although I realize I probably wouldn’t hit the out of pocket max because that would be 3-4 hospitalizations + surgeries in a single year Min pay per year: $6,437.6

EPO 1000 Monthly premium: $324.80 Yearly Deductible: $1,000 Coinsurance: 30% Out of pocket max: $4,000 Misc: Office visits $30 copay, Specialists $50 copay (local only) Max pay per year: $7,897.60 Min pay per year: $4,077.6

EPO 2000 Monthly premium: $257.80 Yearly Deductible: $2,000 Coinsurance: 30% Out of pocket max: $5,500 Misc: Office visits $30 copay, Specialists $60 copay (local only) Max pay per year: $8,593.60 Min pay per year: $3,303.60

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