Hi all! I am hoping you can help me with a dilemma on the health insurance options my new job provides. I am currently on my husbands Kaiser plan until the end of 2021, but we will all be switching to my work benefits as a family (me, husband, 2 kids) for 2022. I am currently pregnant and due in 2022 and my husband wanted to get an MRI done on his shoulder and leg to see if he might need surgery. I will already need to start looking for a new doctor anyways, so now I’m just trying to figure out if EPO or PPO will be a better bang for my buck.
I would pay per month
EPO family – $430.44
PPO Family – $376.05
Deductible
EPO- $0
PPO- $1,000
Out of Pocket Maximum for Family
EPO- $5,000
PPO- $9,000
Imaging (CT/PET scans, MRIs)
EPO – $0
PPO- $20% coinsurance
Hospital stay
EPO- $250 copay per admission / physician/surgeon fee is $0
PPO- Facility and physician/surgeon fee – 20% coinsurance for both
Childbirth/delivery facility services
EPO – $250 copay per admission, deductible does not apply
PPO- 20% coinsurance
If anyone could give some clarity, I am also confused about the Coverage Examples both EPO and PPO show for having a baby:
EPO shows the total cost estimator would be $360
The PPO shows the total cost estimator would be $2,470
I assumed with the baby delivery (C-section) and hospital stay (3 nights minimum) I would definitely reach the $5,000 out of pocket.
submitted by /u/oliveyou10
[link] [comments]Hi all! I am hoping you can help me with a dilemma on the health insurance options my new job provides. I am currently on my husbands Kaiser plan until the end of 2021, but we will all be switching to my work benefits as a family (me, husband, 2 kids) for 2022. I am currently pregnant and due in 2022 and my husband wanted to get an MRI done on his shoulder and leg to see if he might need surgery. I will already need to start looking for a new doctor anyways, so now I’m just trying to figure out if EPO or PPO will be a better bang for my buck. I would pay per month EPO family – $430.44 PPO Family – $376.05 Deductible EPO- $0 PPO- $1,000 Out of Pocket Maximum for Family EPO- $5,000 PPO- $9,000 Imaging (CT/PET scans, MRIs) EPO – $0 PPO- $20% coinsurance Hospital stay EPO- $250 copay per admission / physician/surgeon fee is $0 PPO- Facility and physician/surgeon fee – 20% coinsurance for both Childbirth/delivery facility services EPO – $250 copay per admission, deductible does not apply PPO- 20% coinsurance If anyone could give some clarity, I am also confused about the Coverage Examples both EPO and PPO show for having a baby: EPO shows the total cost estimator would be $360 The PPO shows the total cost estimator would be $2,470 I assumed with the baby delivery (C-section) and hospital stay (3 nights minimum) I would definitely reach the $5,000 out of pocket. submitted by /u/oliveyou10 [link] [comments]Read Morer/HealthInsurance