Choosing insurance plans with chronic disease requiring DME coverage…

Hi, I am trying to choose an insurance plan for our family through my spouse. Spouse does not have chronic disease, I do. I have type 1 diabetes and am on a pump and CGM. I am well controlled and have never had to be hospitalized since diagnosis. This becomes intimately complex in most applications because I don’t know whether my pump or CGM is covered by “in network” providers. There are 3 options.

HDHP plan – $97/per pay period which is q2wks

The HDHP plan has ZERO out of network coverage. Deductible is $2000 for the employed person only, and $4000 for the whole family (which sounds like I’d have to hit a $4000 dedutible to get coverage for anything else). OOP max is $3275 for the employed person and $6550 for the family.

$1500 deductible plan – $284/ppp

In network coverage- Deductible is $1500 per individual and $3000 for family, in network. OOP max is $5000 for individual, $10,000 for family.

$6350 deductible plan – employer pays

In network coverage – Deductible is $6350 per individual, $12,700 per family. OOP max is $6350/individual and $12,700 per family.

I’m not sure if FSA or HSA applies to these plans.

I used to be able to figure out which one was best on my own, but in recent years I have found it impossible.

submitted by /u/Acceptable_Account45
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Hi, I am trying to choose an insurance plan for our family through my spouse. Spouse does not have chronic disease, I do. I have type 1 diabetes and am on a pump and CGM. I am well controlled and have never had to be hospitalized since diagnosis. This becomes intimately complex in most applications because I don’t know whether my pump or CGM is covered by “in network” providers. There are 3 options. HDHP plan – $97/per pay period which is q2wks The HDHP plan has ZERO out of network coverage. Deductible is $2000 for the employed person only, and $4000 for the whole family (which sounds like I’d have to hit a $4000 dedutible to get coverage for anything else). OOP max is $3275 for the employed person and $6550 for the family. $1500 deductible plan – $284/ppp In network coverage- Deductible is $1500 per individual and $3000 for family, in network. OOP max is $5000 for individual, $10,000 for family. $6350 deductible plan – employer pays In network coverage – Deductible is $6350 per individual, $12,700 per family. OOP max is $6350/individual and $12,700 per family. I’m not sure if FSA or HSA applies to these plans. I used to be able to figure out which one was best on my own, but in recent years I have found it impossible.
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