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Need opinion on insurance ASAP, please
Old 06-07-2006, 09:01 AM   #1
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Need opinion on insurance ASAP, please

Here is the situation: I am going to try to make is as concise as I can

My job is changing medical benefits. Right now I have 90/70 plan with no deductibles and pay about $43 premium semi montly. It is for individual coverage.

Now I have a choice of the following:
1. 100/80, no deductibles, I pay $62 premium semi monthly
2. 90/70, $200 deductibles, I pay $47.50 semi monthly.

I don't usually go to doctors except for annual check ups and womanly stuff once a year. However, we are thinking of trying to get pregnant in the next year. So, I am trying to do the math of higher premiums vs paying deductibles vs just deciding what is the best way, i.e. less costly, way to go

I also do Medical Flex Account that gives me $600 / calendar year

So, what do you all think?? I need to make an election by 4pm today!!

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Re: Need opinion on insurance ASAP, please
Old 06-07-2006, 09:14 AM   #2
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Re: Need opinion on insurance ASAP, please

In a fit of analysis a few years ago I looked at premiums vs deductables and found... wa-la, it was a push (Federal programs).

I think you need to look at the coverage, participating providers, and 'hassle factor' of their claims processing.* These factors are much more important to your quality of life than any $150 you might save over a year when only considering premiums and deductables.
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Re: Need opinion on insurance ASAP, please
Old 06-07-2006, 01:05 PM   #3
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Re: Need opinion on insurance ASAP, please


If you don't have to change physicians with either new policy, it boils down to out of pocket.

For a guestimate, figure out approximately what your out of pocket would be for those 2 or so visits each year...for eah of the two plans Then pick which one looks best to you.

I would be more concerned about changing physicians and how that is a moot point here.
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Re: Need opinion on insurance ASAP, please
Old 06-07-2006, 01:44 PM   #4
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Re: Need opinion on insurance ASAP, please

Well, medical bills ran about $32K for my wife when she gave birth 3 months ago. Only complications were that the baby was readmitted for jaundice for a couple days. Barring that, cost would have been $30K or so.

I would suggest checking each plan to see what they pay for maternity services if you are planning on having a child.
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Re: Need opinion on insurance ASAP, please
Old 06-08-2006, 08:36 PM   #5
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Re: Need opinion on insurance ASAP, please

You're fortunate to have such an employer .. your premiums are quite low.

Based upon your pregnancy note, I'd suggest #1 ... only $29/month difference, and if you have an FSA, that probably means you also pay your premiums in a section 125 plan ... thus, they would effectively be deductible for income tax / FICA purposes, probably making that $29 difference more like $20 after tax.

As Bimmerbill notes, the maternity benefits are key in your case, based upon your comment. When folks have premature babies (always a possibility), the bills can run into hundreds of thousands.

Best of luck.
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