Hello!
Wife and I have a wonderful newborn son. We are upon 25 days and need to enroll him in health benefits. We are both covered under our respective employers plans. My plan does not allow the addition of my spouse if she’s eligible elsewhere but does allow for the addition of my son.
Below are the plan terms, looking for advice on which one is best. Wife had an unexpected c-section and son was in the NICU for 2 days so we’re expecting some big bills coming through:
Wife’s Plan:
Aetna EPO – Current Premium: $95.11 (Wife) / $153.71 (with baby) – (per pay period)
Deductible: $1k Individual / $2k with Baby
Co Insurance: 80%/20%
Max Out of Pocket: $3.5k Individual / $7k with Baby
PCP: $30 co-pay / $50 Specialist
Husband’s Plan:
Cigna HDHP with HSA – Current Premium: $23.69 (husband) / $79.07 (with baby) – (per pay period)
Deductible: $1.5k Individual – have paid $0 so far this year / $2,800 with baby
Co Insurance 90% / 10%
Max Out of Pocket: $2,600 individual / $4,400 with baby
PCP/Specialist: Deductible + 10%
Currently have HSA on track to max out at $3,600 for the year, this includes $500 contributed by employer. My understanding is with my son added, HSA limit moves up to $7,200 with $750 total contributed by my employer. I have enough room to ramp up HSA contributions through the end of the calendar year to land close to the $7,200.
From my perspective, my wife is maxed on her out of pocket for sure, and no matter the plan, my son will max it out too. I feel like this is simple math, but I am “too close” to it to see the forest for the trees. Just looking for a little objectivity. We’re in HCOL area of NJ if that matters.
Thanks!
Edit: So far newborn son is perfectly healthy.
submitted by /u/mjrkwerty
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Hello! Wife and I have a wonderful newborn son. We are upon 25 days and need to enroll him in health benefits. We are both covered under our respective employers plans. My plan does not allow the addition of my spouse if she’s eligible elsewhere but does allow for the addition of my son. Below are the plan terms, looking for advice on which one is best. Wife had an unexpected c-section and son was in the NICU for 2 days so we’re expecting some big bills coming through: Wife’s Plan: Aetna EPO – Current Premium: $95.11 (Wife) / $153.71 (with baby) – (per pay period) Deductible: $1k Individual / $2k with Baby Co Insurance: 80%/20% Max Out of Pocket: $3.5k Individual / $7k with Baby PCP: $30 co-pay / $50 Specialist Husband’s Plan: Cigna HDHP with HSA – Current Premium: $23.69 (husband) / $79.07 (with baby) – (per pay period) Deductible: $1.5k Individual – have paid $0 so far this year / $2,800 with baby Co Insurance 90% / 10% Max Out of Pocket: $2,600 individual / $4,400 with baby PCP/Specialist: Deductible + 10% Currently have HSA on track to max out at $3,600 for the year, this includes $500 contributed by employer. My understanding is with my son added, HSA limit moves up to $7,200 with $750 total contributed by my employer. I have enough room to ramp up HSA contributions through the end of the calendar year to land close to the $7,200. From my perspective, my wife is maxed on her out of pocket for sure, and no matter the plan, my son will max it out too. I feel like this is simple math, but I am “too close” to it to see the forest for the trees. Just looking for a little objectivity. We’re in HCOL area of NJ if that matters. Thanks! Edit: So far newborn son is perfectly healthy.
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