Is this a crappy insurance plan?

Question

$1500 deductible for husband and self. $40 copay for brand name drugs and $10 copay for generics. An extra $400/year covers all physicals, pap smears and immunizations. Husband is paying $280 per month to his employer to maintain this health coverage.

We are young, healthy, and not interested in children. He's had a staph infection that required a few office visits and some skin testing, all of which came out to about $800 which we are paying out of pocket. I'm just wondering if we have a crappy insurance plan compared to everyone else's. If anyone's interested, he works at an insurance company.

Answer 1

If you're young and relatively healthy, that doesn't sound like a bad deal.

I presume that when you say that you have an "extra $400/year for physicals, pap smears, and immunizations" you mean that your deductible doesn't apply to those preventative services?

Here's why that setup isn't a bad plan for a healthy person...you're only paying for the services as you use them.  Rather than paying a substantial premium ever month for coverage that you may rarely use.

You can still get the annual physical to make sure you're staying healthy, which is a positive thing.

If either you or your husband had a chronic health condition, a different plan would probably be better for you.  But since you're both young and relatively healthy, you're paying less automatically out of pocket each month (for premium) and only paying when you happen to use services.

This year may have been a fluke for you, with your husband's staph infection.  But in a typical year, do you really have that much done, aside from an annual physical or pap smear?  Probably not, based on what you said.

Would you rather pay more in premium every month (which would happen if you had a lower deductible)?  Or would you rather hold onto that money and only spend it if/when you end up getting sick.  :)

Answer 2

Wow, I'd LOVE a $10 copay for generics.  

You've got a pretty good plan.  We pay almost double that premium, and DH's employer contributes the rest.  But we don't have that deductible, either.  

Answer 3

It's not good.  It's not bad if you have a hospitalization but otherwise it's not good.

Answer 4

I have met this sort of situation before,here is the resource I found helpful.http://health-insurance.tips4free.info/h...

Answer 5

Depends on where you live and how old you are.  If you live in NJ or NY you have a fantastic plan.   If you live anywhere else it's not that great at all.  In MD a 25 year old could get a $1000 deductible for $100/month and get $35 office copays - $15 generics and $30/$60 brand.  The savings from that alone would cover the deductible for one of you.

You have to be careful when you're 'young' getting on a group plan.  First of all GROUP IS MORE EXPENSIVE than individual plans AND group is usually based on the age of the group.  So if you're 25, you are the one bringing down the cost for everyone else.  Even if your boss is paying half the cost, you could still end up paying alot more than if you got it on your own.

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