Is anyone feeling bored to the point where comparing health plans sounds fun?
6I need to choose a health plan, and I have no idea what to go with.
They’re all aetna.
I haven’t had insurance in over 10 years and I’ve been fine, but getting a few things checked out probably wouldn’t be a terrible idea. The only prescription medicine I currently take costs $6/month without any insurance at all.
As far as differences in family/single goes I’m single and plan on remaining that way for the foreseeable future.
health options:
Choice advantage point of service, $65/month
Consumer choice point of service, $50/month
M36 = Basic Consumer Choice Point of Service with UFund HSA, $25/month, max HSA contribution: $2,950
dental:
(none) $0
dental plan, $10/month
vision:
(none) $0
standard, $4.64/month
Max FSA contribution: $2,650
- 7 comments, 16 replies
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I really appreciate the honesty in health plans naming themselves POS.
Vision:
If you wear glasses, get the more expensive plan. I have it, and it’s awesome. Every eye place I go to say it’s the best out there for glasses.
@RiotDemon I don’t, but maybe I’ll get contacts or something. I probably should- my vision is just barely good enough to pass the driving test.
@Seeds it’s not as good for contacts. If you can barely pass the driving vision test, maybe you need glasses.
I can cheat on the driving test by squinting, but I wear glasses all the time.
I looked at the receipt from one of my pairs of glasses. It would of cost over a grand for them. With the insurance, $15.
One thing I do right away when comparing plans is look at the costs annually, since the deductibles are annual:
$780/year for a $500 deductible
$600/year for a $1,500 deductible
$300/year for a $2,500 deductible
There’s other differences, but an easy starting point is “will I hit that $500 deductible?” If not, go for the cheapest plan, since at that point you’re mostly just covering for catastrophe. If you think you will hit the $500 deductible, then you’ve got to do more math on what you save after that vs the additional cost, but looking at these differences, I’d say it probably means go for the highest one (with the $500 deductible). HSA on the cheapest one does affect this some, but I’m not sure how to truly compare that value.
IMPORTANT: I don’t know what I’m talking about, I’m in no way an expert, everyone feel free to overrule me.
@dave hmm… that makes sense to me. There were a couple specialists I wanted to see over nagging issues that have accumulated over the years. I’ll have to figure out what it costs to see them.
@dave you and I think a lot alike, you poor bastard!
@Seeds some plans will have a higher co-pay for specialist visits (like $25-$50 per visit), but I don’t see that here… They only copayments I see is for the prescriptions. Unless I’m missing it…
@medz I figured I’d have to pay for them until I hit the deductible. No?
@Seeds Yeah, seems you’ll have to pay 100% of office visits until you the deductible and then you’ll just pay 10% or 20% of it after hitting the deductible. No office visit co-pays.
@medz Gotcha. Yeah, my thinking is if the specialist visits are expensive it might make sense to go with the $500 deductible plan for the first year until I get those taken care of.
@Seeds What you could do is make an effort to get everything taken care of in one year and buy the plan that comes out the “cheapest” for all costs included. Then gamble the next year that you can ignore most of that stuff and buy the cheapest premiums.
I make a giant spreadsheet of annual premiums, deductible, out of pocket, how much I will have to pay, total, to clear the max out of pocket. Then I compare. Of course in my case with multiple medical issues I usually max out everything, but some years I haven’t. The year of 2 cancers I so maxed it out that I did a bunch of things you only do once in a while since they were effectively “free” then.
BUT you also have to look at your intended providers and see what they accept. They may not accept all Aetna choices, for example. Also look at your best local hospital and see what they accept incase of worst case. Paying out of network adds significantly to what you will owe.
Then you need to think through how you will strategically pay for all of this with the new schedule A bar for deductions. I paid some dental expenses in advance last year so I could deduct them since this year likely I won’t clear $10,000 bar on schedule A.
@dave If you don’t go to the doctor much/ever and the insurance is mainly for a “catastrophe” and can actually contribute to the HSA it can be very valuable. Contributions are tax free. But you can also invest the money and all earnings are tax free if spent on health care. We’ll all need money for healthcare when we retire. So banking that money now and letting it grow. And getting it all completely tax free. Could beat 401Ks/IRAs where you have to pay taxes upfront or on withdrawal.
@dave I do this calculation too, but for the last 4 years the plans available to me have had the same out of pocket costs for my predicted health spending level (which is fairly high).
The big difference is that the high deductible plan that I’m offered is eligible for an HSA. So I pick that plan and put the monthly difference in the HSA. The tax savings are good and if I have a good year then I bank the leftover money.
FWIW, I work for NY City (tho paid by NY State) and my union welfare fund covers my dental, vision and drug plans for a $0 premium plus varying copays for services. I have several health plans available from different companies with varying levels of coverage. (See here and here if you are curious about the details.)
I’d opt for your more spendy vision plan in a heartbeat since its $141/year premium+copays is less than half of what I pay every two years (my plan covers one new pair of glasses every other year).
Your dental plan seems to be better coverage than mine, but with my $0 premium and low copays on routine preventative care, I’ll pay less than $50/year unless I need something major.
BTW- Do not skip routine dental care, especially if it will only cost you $120/year. I skipped the dentist for over 15 years (while I had coverage, so DUH!!!) and I was very lucky that it cost me less than $1000 to get things fixed. (Tho I guess that works out to only $66/year, so maybe don’t follow this advice.)
I’d opt for the lower deductible on the health insurance but I have some heath issues and a low deductible works in my favor. My Aetna EPO plan costs over $2400/year in premiums, but has a $0 deductible and fairly low copays, plus includes some things (like CPAP machine and supplies) for $0 copays. I have a $20 copay each year for ~$4K of heart tests, my copays for insulin and diabetes supplies are less than $250/year, the CPAP is free and a new pacemaker with overnight hospital stay in March had a $75 copay. There are plans with $0 premiums, but my out-of-pocket expenses would be at least as much and likely more with any of them.
Good luck with whatever you decide.
This is depressing looking at the rates some of you are getting. Since I’m not working, I have no employer paying any part of mine and I feel lucky to pay $600 a month with a $3500 deductible. The insurance company doesn’t pay a penny until I hit that deductible and I usually have enough bills to reach that.
So that’s paying them $7,200 a year and then having to pay $3,500 out of pocket for a total of $10,700 before they pay anything.
The biggest benefit I get from insurance is a negotiated rate on services. My doctors bill $289 for each visit but my insurance negotiated a rate of $86 so I only pay $86 for each visit.
They also help with prescriptions. I don’t have to pay the full retail cost but do pay $10 for generic and $50 for brand name. There are many drugs the insurance company refuses to pay for even when the doctor fills out all the paperwork to show it’s medically necessary.
If doctors would charge fair and customary rates and everyone would pay those same rates, I could go without insurance. I’d much rather just pay $86 direct to the doctor a visit than pay my insurance company $600 a month to get that negotiated rate.
Regarding the medicine, the VA pays the least amount and the pharmacy should charge everyone the same rate they charge the VA. It should be illegal to charge customers different rates depending if they have insurance or not and which insurance they have.
@support Gosh that’s relatively cheap. When I had to pay for individual insurance I was paying $1119/mo with $7250 out of pocket/deductible. “Obama” care wasn’t much cheaper and I would have been able to get medical care only in 4 counties. Between that and dental I had $23,000+ in expenses in 2016. More than my income. So then I got audited by the state for that. I suspect the feds will audit me as well since I had negative income that year.
@Kidsandliz I’m on COBRA right now so this is still a group plan. I hate to see what my individual rates will be after COBRA runs out.
I don’t qualify for Obama care because you have to make at least a minimum amount and since I’m not working, I don’t meet those requirements.
@support Yeah I had exactly the same problem too (and will have it again when my COBRA runs out unless I can find another job first). Lived in a state with no medicaid expansion and didn’t make enough to qualify for obama care. I was comparing full price Obama care with what I was paying even though I didn’t qualify. Curious if it was cheaper being a government “group”. Not much discount there for being in a so called “group” and seriously limited access to care (eg only 4 counties, no accepted by 3/4 of the medical facilities locally, etc.).
@Kidsandliz This is where the “medicare for all” plan should happen. Use the government as one of the insurance companies where citizens can pay into it even before they become of age. Medicare seems to be accepted anywhere and are pretty good rates. The government doesn’t pay as much as my insurance company does.
Doctors are pretty much forced to accept Medicare today if they want to make it in that business. Many of the people using the healthcare system are the elderly and are on Medicare. Expand that to allow paying younger people and that can fix the high costs of healthcare for us.
@support yes.
Not bored enough. Can we talk about cars or sports?
I am personally a fan of good and fairly comprehensive coverage.
That lets me “set and forget” (when I can get that sort of coverage).
I don’t have then to think so much about setting aside extra money to handle whatever the insurance does not or might not cover that way.
Also it means I’m less worried if I have an expensive medical “event”.
If you treat insurance as coverage for unexpected catastrophies, and cover the up front medical costs yourself within the deductible, you can game the finances some, and save some money that way in some scenarios. But it means calculating and keeping track.
Re vision. Get it. You get negotiated rates that way. Only there are things the policy won’t cover or won’t cover well. Be prepared to make up the difference if needed.
Same for dental. The policies usually suck. But you get negotiated rates. Again, expect to cover large portions of your costs yourself.
Read the policies. Understand them before you go for services or treatment or tests.
Try to get the best internist you can get. Get recs and follow up. Get a referral if you can. The quality of the internist matters. And the better physicians are more easily able to refer to the best specialists if those referrals are needed.
You prob know most of the stuff below, but here goes:
Stay healthy if you can. This means, among other practices:
moderating drinking and other intoxicant use to healthy levels. Living very sober or entirely sober can be very nice.
Keeping blood sugar and blood pressure quite healthily lowish. These are huge factors.
Eating healthy (very little sugar, whole foods only, moderate complex woke foods starches, lots of veggies)
Keeping healthy weight if can
Getting decent sleep,
caring for your own emotional well-being.
Keeping lots of friends who will actually step up. And who you will step up for.
Staying emotionally connected to the people you care about.
Staying physically reasonably active and fit.
Learning how to keep your emotional boundaries (internal, incoming, and outgoing emotions) in a good place.
Learning how not to be too open, and how not to be too closed off.
Being nice. Getting people to be nice to you. Being honest and carefully moderately open, yet not too vulnerable.
Respecting the boundaries of others. Getting others to respect your boundaries.
Not being “needy”, also not being “independent” to the point of non-connectedness.
Not tolerating other persons’ emotional or financial or time/energy abuse or manipulation or gaslighting.
Learning how to have equinamity and self-possession and self-respect and yet not being arrogant or an asshole.
Lifelong learning.
Implementing all this both at home and at work.
Tra La.