Hi, my wife and I had our first child last week, and I’m trying to decide the best way to get the kid covered. My wife and I are currently on separate single plans offered by our respective employers. I’ve broken down our options in the following table, but I’m having trouble interpreting what I’m seeing – hoping one of you fine folks can help make sense of this for me.
In the table below, CP = Copayment, CI = Coinsurance, DD N/A = Deductible does not apply. The “Dad” plans are Employee + Child, while the Mom option is a Family plan. I left out the Dad family plan options because my wife’s single plan is a $0 premium, and I think that means it wouldn’t make sense for me to move to a family plan given the Employee + Child option (maybe I’m wrong?). I’m assuming if we went with my wife’s family plan, I would drop my coverage and be covered under her plan (does that make sense?)
Dad 1 Dad 2 Dad 3 (HDHP) Mom Premium $2,425.92 $1,755.72 $1,380.60 $3,264.60 Deductible $4,000 $7,500 $7,000 $1,700 Out of Pocket Max $8,000 $12,500 $7,000 $3,400 Office Visit <19: $0; 19+: $25 CP <19: $0; 19+: $25 CP Deductible applies 20% CI, DD N/A Preventative Care Covered at 100% Covered at 100% Covered at 100% Covered at 100% Specialist $50 CP $50 CP Deductible applies 20% CI, DD N/A Virtual visit $0 CP $0 CP Deductible applies 20% CI, DD N/A Urgent care $75 CP $75 CP Deductible applies 20% CI, DD N/A Emergency room Deductible, 20% CI $250 CP Deductible applies 20% CI, DD N/A Facility services Deductible, 20% CI Deductible, 20% CI Deductible applies 20% CI Other notes None None HSA tax savings, $750 employer contribution None
Both Mom and I have been blessed with good health and rarely require medical care. I understand the basics of health insurance but am struggling to grasp which expenses count towards deductible / out of pocket maximum, whether “deductible does not apply” is a good or bad thing, and comparing 20% coinsurance to the various copays. I am feeling pretty lost and would appreciate any help and/or insight. Thanks in advance!
edit: some additional info, wife and I are mid-20’s, financially stable with a comfortable amount saved up for emergencies. I’m probably over thinking this whole thing but want to make the best decision for my family. Thank you!
submitted by /u/Immediate-Bus-5649
[link] [comments]Hi, my wife and I had our first child last week, and I’m trying to decide the best way to get the kid covered. My wife and I are currently on separate single plans offered by our respective employers. I’ve broken down our options in the following table, but I’m having trouble interpreting what I’m seeing – hoping one of you fine folks can help make sense of this for me. In the table below, CP = Copayment, CI = Coinsurance, DD N/A = Deductible does not apply. The “Dad” plans are Employee + Child, while the Mom option is a Family plan. I left out the Dad family plan options because my wife’s single plan is a $0 premium, and I think that means it wouldn’t make sense for me to move to a family plan given the Employee + Child option (maybe I’m wrong?). I’m assuming if we went with my wife’s family plan, I would drop my coverage and be covered under her plan (does that make sense?) Dad 1 Dad 2 Dad 3 (HDHP) Mom Premium $2,425.92 $1,755.72 $1,380.60 $3,264.60 Deductible $4,000 $7,500 $7,000 $1,700 Out of Pocket Max $8,000 $12,500 $7,000 $3,400 Office Visit <19: $0; 19+: $25 CP <19: $0; 19+: $25 CP Deductible applies 20% CI, DD N/A Preventative Care Covered at 100% Covered at 100% Covered at 100% Covered at 100% Specialist $50 CP $50 CP Deductible applies 20% CI, DD N/A Virtual visit $0 CP $0 CP Deductible applies 20% CI, DD N/A Urgent care $75 CP $75 CP Deductible applies 20% CI, DD N/A Emergency room Deductible, 20% CI $250 CP Deductible applies 20% CI, DD N/A Facility services Deductible, 20% CI Deductible, 20% CI Deductible applies 20% CI Other notes None None HSA tax savings, $750 employer contribution None Both Mom and I have been blessed with good health and rarely require medical care. I understand the basics of health insurance but am struggling to grasp which expenses count towards deductible / out of pocket maximum, whether “deductible does not apply” is a good or bad thing, and comparing 20% coinsurance to the various copays. I am feeling pretty lost and would appreciate any help and/or insight. Thanks in advance! edit: some additional info, wife and I are mid-20’s, financially stable with a comfortable amount saved up for emergencies. I’m probably over thinking this whole thing but want to make the best decision for my family. Thank you! submitted by /u/Immediate-Bus-5649 [link] [comments]Read Morer/HealthInsurance