Quote:
Originally Posted by ibavly
Just moved from Canada to the US and need some help understanding my health insurance options. I'm used to just looking at what has the most massage $ and going from there, so no real clue what is considered important. I'm currently young and healthy.
I've been given 4 options from my employer. I'm not clear on if there are any costs from my end depending on which plan I take.
Feature | Plan 1 | Plan 2 | Plan 3 | Plan 4 |
| PPO | HMO | PPO | HMO |
Deductible | 200/400 | 0 | 2000/4000 | 0 |
OOP limit | 4000/8000 | 2700 | 5400/10800 | 4000 |
Preventative care | Free->> | | | |
Doctor Visit | $10 | $10 | 20% | $10 |
Prescriptions | 10% | 10% | 10% | $10 |
Lab | 10% | $10-200 | 20% | $20-150 |
Emergency | $200+10% | $100 | 20% | $200 |
Physio (will use this) | 10% | $10 | 20% | $10 |
Based on this it seems like I should go for one of the HMO plans to take advantage of the cheap physio, leaning towards plan 4. Any advice is appreciated.
I also get an FSA. I think that means I can use pre-tax $ to pay for health expenses, but lose anything I don't spend at the end of the year (with a small rollover). Risk/Reward doesn't seem great there so I'm thinking of only contributing a couple hundred.
Quote:
Originally Posted by unfrgvn
It's hard to give good advice without knowing how much each plan will cost you. Come back with that info. In the absence of that, choosing one that has the lowest cost of the service you know you will use makes sense.
Also, you can use the FSA to fund dentist, eyeglasses/Contacts, and prescription drug expenses in addition to medical. But yes, don't over fund it.
Yeah, give us the plan cost and ER contribution and we can help you better. This is literally my job, I price these plans so feel free to PM me or reply in thread. Without knowing the ER/EE contribution ratio, it's too hard to say. In general, those HMO plans are gonna give you a way better bang for your buck. Pre-auth, balance billing, OON referral's etc make PPO's a nightmare if you ever have a health problem.
That being said, Plan one looks reasonable, 200/400 ded? but what's the coinsurance level after deductible met? 70% vs 90% makes all the difference
I can almost guarantee you're being offered a slice plan with the company I work for based on that plan offering alone.