Hi everyone
We are picking our new insurance plans and our company is pushing their RBP plan hard as opposed to their open access OAP and HDHP plans. On the surface the RBP looks the best, but nothing really seems like a winner. It also includes copays for primary care/specialist/prescriptions which my spouse likes because he has about 3-4 predictable pcp visits for refills a year and predictable monthly meds. On the other hand we are planning for a pregnancy next year so I will likely max out the deductible and out of pocket. My concern is about balance billing. Does balance billing for these plans count towards the out of pocket or can I be surprised with giant hospital bills after reaching my out of pocket? Besides the pregnancy I’m a moderate healthcare user and see several specialist regularly for chronic conditions have a few prescriptions and occasional imaging/extra labs.
Plan options:
Option1 RBP: $106 prem per paycheck; $500/$100 DD; $5000/$1000, OOP. $35/$65 copays, 20% co-ins after after DD. Out of network included as in-network.
Option 2: OAP – $177 prem pp; $5,000/$10,000 dd; $6,600/$13,200 OOP; 30% Co-ins; No out-of network benefits except emergency.
Option 3: HDHP – $96 prem pp; $6,000/$12,000 dd; $6,000/$12,000 OOP; 0% Co-ins in network; 50% Co-ins out-of network capped at 20k/40k oop; HSA compatible – Employer does not contribute
Option 4: HDHP – $214 prem pp; $3,500/$7,000 dd; $3,500/$7,000 OOP; 0% Co-ins in network; 50% Co-ins out-of network capped at 20k/40k oop; HSA compatible – Employer does not contribute
Any advice is appreciated
submitted by /u/djpeanutnose
[link] [comments]Hi everyone We are picking our new insurance plans and our company is pushing their RBP plan hard as opposed to their open access OAP and HDHP plans. On the surface the RBP looks the best, but nothing really seems like a winner. It also includes copays for primary care/specialist/prescriptions which my spouse likes because he has about 3-4 predictable pcp visits for refills a year and predictable monthly meds. On the other hand we are planning for a pregnancy next year so I will likely max out the deductible and out of pocket. My concern is about balance billing. Does balance billing for these plans count towards the out of pocket or can I be surprised with giant hospital bills after reaching my out of pocket? Besides the pregnancy I’m a moderate healthcare user and see several specialist regularly for chronic conditions have a few prescriptions and occasional imaging/extra labs. Plan options: Option1 RBP: $106 prem per paycheck; $500/$100 DD; $5000/$1000, OOP. $35/$65 copays, 20% co-ins after after DD. Out of network included as in-network. Option 2: OAP – $177 prem pp; $5,000/$10,000 dd; $6,600/$13,200 OOP; 30% Co-ins; No out-of network benefits except emergency. Option 3: HDHP – $96 prem pp; $6,000/$12,000 dd; $6,000/$12,000 OOP; 0% Co-ins in network; 50% Co-ins out-of network capped at 20k/40k oop; HSA compatible – Employer does not contribute Option 4: HDHP – $214 prem pp; $3,500/$7,000 dd; $3,500/$7,000 OOP; 0% Co-ins in network; 50% Co-ins out-of network capped at 20k/40k oop; HSA compatible – Employer does not contribute Any advice is appreciated submitted by /u/djpeanutnose [link] [comments]Read Morer/HealthInsurance