Clarity for a 26M who needs health insurance

Hi everyone. I recently turned 26 and got removed from my parents’ plan so I’ve got to get health insurance. I live in NJ and I’ve narrowed it down to two options based on the doctors I’ve already been seeing and what I can afford monthly. Right now, I see a cardiologist once a year for Mitral Valve Prolapse, and had to start seeing a Hematologist who draws blood every few months for low platelet levels. I also have stomach issues but am not seeing a specialist for that as I have been able to handle it pretty well with meds.

Hopefully my appointments with the Hematologist will become more spaced out but right now I’m worried the plans I’ve chosen won’t be enough. I’ve also had health issues in the past and needed 5 surgeries already so it wouldn’t be out of the norm for me to suddenly need emergency surgery. But I also don’t have the income to get more extensive plans. These are the plans I’m considering:

Horizon BCBS Omnia Silver:

Premium: $160

Plan type: EPO

Deductible: $1,400 and $250 for Drugs

Out of pocket max: $6,500

PCP Copay: $30

Specialist Copay: $50

Testing Copay: $75 after deductible

Horizon BCBS Omnia Silver HSA:

Premium: $140

Plan type: EPO

Deductible: $1,525

Out of pocket max: $6,350

PCP Copay: $10 after deductible

Specialist Copay: $20 after deductible

Testing Copay: $15 after deductible

I’m leaning towards Omnia Silver but $75 for testing (which I’m assuming includes bloodwork) is pretty high compared to the other (which has a lower premium). And the other copays are higher as well. And I’m also confused about the “$X after deductible”. Does this mean I’ll have to pay for everything up front until the deductible is met? I’m worried that seeing the hematologist often will end up becoming a pretty large bill if that’s the case.

I’m really sorry for my ignorance but I’m very lost and don’t know what to do. Any insight or advice would be really appreciated.

submitted by /u/Tired_ConfusedGuy
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Hi everyone. I recently turned 26 and got removed from my parents’ plan so I’ve got to get health insurance. I live in NJ and I’ve narrowed it down to two options based on the doctors I’ve already been seeing and what I can afford monthly. Right now, I see a cardiologist once a year for Mitral Valve Prolapse, and had to start seeing a Hematologist who draws blood every few months for low platelet levels. I also have stomach issues but am not seeing a specialist for that as I have been able to handle it pretty well with meds. Hopefully my appointments with the Hematologist will become more spaced out but right now I’m worried the plans I’ve chosen won’t be enough. I’ve also had health issues in the past and needed 5 surgeries already so it wouldn’t be out of the norm for me to suddenly need emergency surgery. But I also don’t have the income to get more extensive plans. These are the plans I’m considering: Horizon BCBS Omnia Silver: Premium: $160 Plan type: EPO Deductible: $1,400 and $250 for Drugs Out of pocket max: $6,500 PCP Copay: $30 Specialist Copay: $50 Testing Copay: $75 after deductible Horizon BCBS Omnia Silver HSA: Premium: $140 Plan type: EPO Deductible: $1,525 Out of pocket max: $6,350 PCP Copay: $10 after deductible Specialist Copay: $20 after deductible Testing Copay: $15 after deductible I’m leaning towards Omnia Silver but $75 for testing (which I’m assuming includes bloodwork) is pretty high compared to the other (which has a lower premium). And the other copays are higher as well. And I’m also confused about the “$X after deductible”. Does this mean I’ll have to pay for everything up front until the deductible is met? I’m worried that seeing the hematologist often will end up becoming a pretty large bill if that’s the case. I’m really sorry for my ignorance but I’m very lost and don’t know what to do. Any insight or advice would be really appreciated.
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