New to Medical Insurance

[Horees 2]

Hello friends,

I just want to take your opinion about medical plans with my company, I see it seems strange to me, but it may be logic to others, so I'm asking you here

The average health plan costs me $750 per month for family coverage for 3 persons (without vision or dental), in addition, there are $4000 deductibles in network or $8500 out of network, that I'll spend from my pocket per calendar year before the plan pay any medical costs (except preventive visits). after that the plan pay 80% of in network costs.

I feel this is strange concept, how comes I pay about $10,000 per year (750 per month), and I still pay $4000 before than insurance pay anything.

Which means $14,000 per year (which I mostly will never go up to this amount unless if I and my wife decided to have another baby)

BUT, you are experts here is US issues, and who knows, it may be good insurance relative to your experience.

Please advise me, is it good, regular, expensive, deserve?

I have to enroll within this week, otherwise, I'll have to wait 1.5 years to the next open enrollment

thank you

[Boiler 46,141]

On the basis of the very limited information you have provided I would say average.

What other options do you have.

[웃 910]

Seems high. I would shop around. I have Aetna and for 3 people it will be about half of what you are about to pay...

[Horees 2]

On the basis of the very limited information you have provided I would say average.

What other options do you have.

The 2 other options are

1- $1050 per month + $3000 deductibles

2- $580 per month + $9000 ded.

I forgot to add that the first plan I mentioned will qualify me for HSA (health saving account).

[Teddy B 17,252]

$750 per month seems on the high side. Does your employer help to pay a percentage? How old is the 3rd person on your family coverage (I'm assuming a child)? If the child is somewhat older, teenage years, maybe the lower cost plan of $580 with the higher deductible would be better for you, seeing that a teenager usually doesn't rack up the medical bills that a young child would.

What company is that insurance through? As a reference for you currently the cost of a family plan at my work with a $1000 deductible is $135.00 per week, or $540 per month, that's through Blue Cross.

[Boiler 46,141]

Is that the total cost or just your contribution?

[Teddy B 17,252]

Is that the total cost or just your contribution?

That would be the employee contribution. Sorry, I should have clarified that. My wife and I have separate single plans from our employers, that costs us $90 total per week.

Edited June 7, 2012 by Teddy B

[rocks 494]

Have you looked at BCBS? $750 seems high and the deductible seems very unreasonable.

[M&Pooh 12]

1. Those are so called high-deductible plans. Does your employer offer traditional PPO or HMO?

2. This kind of insurance isn't good. One of the deal breakers is whether somebody in your family has pre-existing conditions. If yes, it's generally better to stick with a group plan, even weak and expensive. If not, I'd shop around for an individual/family coverage NOT from the employer.

3. Other important numbers to be factored are out-of-pocket limit and annual/lifetime cap.

[And_Sam 44]

You may want to shop around for better rates. Sometimes you can find better medical/dental/vision insurance deals by going with an independant seller. Is the company you work for a small personal company? Alot of times smaller companies who doesn't have a large number of employees will choose an higher deductible insurances that the employee has to pay out. Shop around if you have time. We have an hmo that covers 3 people including 1 child and I pay out $350 a month with a set copay for doctor visits and prescriptions. That includes vision with it. Google some insurance companies that cater to your area to price them.

Good luck with your search!

[Horees 2]

$750 per month seems on the high side. Does your employer help to pay a percentage? How old is the 3rd person on your family coverage (I'm assuming a child)? If the child is somewhat older, teenage years, maybe the lower cost plan of $580 with the higher deductible would be better for you, seeing that a teenager usually doesn't rack up the medical bills that a young child would.

What company is that insurance through? As a reference for you currently the cost of a family plan at my work with a $1000 deductible is $135.00 per week, or $540 per month, that's through Blue Cross.

the baby is years old

The payments I mentioned is my contribution

The insurance with Blue Cross

Have you looked at BCBS? $750 seems high and the deductible seems very unreasonable.

I'll Look for this comapny...thank you

1. Those are so called high-deductible plans. Does your employer offer traditional PPO or HMO?

2. This kind of insurance isn't good. One of the deal breakers is whether somebody in your family has pre-existing conditions. If yes, it's generally better to stick with a group plan, even weak and expensive. If not, I'd shop around for an individual/family coverage NOT from the employer.

3. Other important numbers to be factored are out-of-pocket limit and annual/lifetime cap.

The company offer those plans only with deductible

annual max out of pocket is around 12,000 for family

lifetime unlimited

You may want to shop around for better rates. Sometimes you can find better medical/dental/vision insurance deals by going with an independant seller. Is the company you work for a small personal company? Alot of times smaller companies who doesn't have a large number of employees will choose an higher deductible insurances that the employee has to pay out. Shop around if you have time. We have an hmo that covers 3 people including 1 child and I pay out $350 a month with a set copay for doctor visits and prescriptions. That includes vision with it. Google some insurance companies that cater to your area to price them.

Good luck with your search!

the problem is that the company is a big company, and still expensive

Thanks for the advice, I'll look for something else

[Boiler 46,141]

Group schemes have the advantage of tax deductibility as well as economies of scale.

It is not possible to buy like for like on an individual basis, but even taking the cover differences it would be very unusual for an individual plan to be a better option.

[Teddy B 17,252]

You may want to shop around for better rates. Sometimes you can find better medical/dental/vision insurance deals by going with an independant seller. Is the company you work for a small personal company? Alot of times smaller companies who doesn't have a large number of employees will choose an higher deductible insurances that the employee has to pay out. Shop around if you have time. We have an hmo that covers 3 people including 1 child and I pay out $350 a month with a set copay for doctor visits and prescriptions. That includes vision with it. Google some insurance companies that cater to your area to price them.

Good luck with your search!

I have spent plenty of time researching purchasing an individual health plan on my own, I was not able to find one that came close to the plan my employer offers, both in coverage and premiums. All of them that had any type of decent coverage were well over $100 per week for a single plan, and $200 for a family plan. Is your HMO through your employer, if so, how much does your employer pay in?

[wendy&tamer 10]

You might also need to check into the coverage for pregnancy and well child visits....some insurances cover 100% of prenatal visits and well child check ups. I have Blue Cross but mine is federal and I have to say Im happy with mine...but check into other because I do agree it is HIGH.

[Shari 6]

Wow that is high for the premium and deductible!!

You said your wife has individual insurance. Would her company's be cheaper with a family plan than yours? Either way, one of you would drop your individual coverage and that approximately $360 a month would go towards the family plan to help with the premium, right? But that deductible - whoa!