Which health insurance plan do you think is a better choice money wise?

Question

I am on the fence about two insurance plans through Blue Cross and I just need a little input as to what people think is the better option. Both plans are HMOs...

The first one is $260/mo with a $250 deductible, but 35% coinsurance

The second is $271/mo with a $1500 deductible, but 20% coinsurance

Now I know people will suggest which would be best for me and whatever health concerns I have and I understand that, however, I am looking at which would benefit my bank account really. I feel like these two plans are pretty much a wash considering what, if anything, happens to me health wise and payment methods.

Thanks for any and all input!!

Answer 1

You don't provide enough information. How much is the doctor co-pay on each plan and do you get the doctor visit for the co-pay with or without having to meet the deductible? Do you get lab and X-ray for the co-pay or are these procedures subject to the deductible? Most individual plans you do not need to meet the deductible first while many group plans you do.

How much is your maximum out of pocket expense for the co-insurance? If the first one has a maximum of $10,000 you are paying the 35% co-insurance until you've paid $10,250; if the second one has co-insurance maximum of $3000 you are paying the 20% co-insurance until you've paid $4500 with deductible. In this case the second is best for catastophic accidents and illness.

Answer 2

that one

Answer 3

This is easy - the first one.

Both plans are not HMO's .

I bet money both are PPO's as HMO's typically do not have deductibles and co insurance (the percentage)

You are far more likely to hit the $250 deductible than a $1500.

You need to find out what the MAX OUT OF POCKET IS (the amount when the insurance company kicks in 100%)

It would also have been helpful to know which company you are talking about.  They are not created equal and all have underwriting qualifications.

Answer 4

Short term with no expected major catastrophes and limited office visits, the first choice.

Answer 5

Really depends on how much you go to the doctor.  The deductible is actually an amount you have to pay out of pocket b/4 the insurance pays the physician.  So if you don't go to the doctor that often the lower deductible would be better.  Then you also need to find out what your out of pocket maximum is per contract/calendar year.  This is all that you have to pay out of your pocket to the doctors.  Usually once you meet the out of pocket, the insurance will pick up @ 100%.  Each insurance plan is a little different. just ask alot of questions.

Answer 6

I'd go with the first one b/c then it's only $250 out of your pocket before they start paying.  Also it's cheaper per month..

Don't worry about the 35% coinsurance.

Insurance is very confusing.  I hope that what I've told you isn't completly wrong.  Good luck deciding.

Answer 7

Just using the information you gave...

Personally, I would get the one with the lower deductible.  Even though the premium is a little more, it is safer plan. For example lets say the week you get the policy, you need costly surgery all of a sudden and you had the plan with the higher deductible, you would be stuck owing  $1500 plus 20% of the allowed amount on the claim, this would apply all one one bill, If you had the other plan you would only owe 50% plus $35 percent on one bill. And would not be stuck with a big bill to pay all at once. Here is an example.

surgery- contractually agreed amount between provider and your insurer is $6,000

Plan with  $250 deductible, but 35% coinsurance--

You would owe $250 + 2012.5 (this is 6000-250 take the result and take 35%) the total you would owe is $2262.5.

The second is $271/mo with a $1500 deductible, but 20% coinsurance--Y you would owe $1500 +900(this is the 6000-1500 take the result and take 20%) the total you would owe is $2400.

With the first plan,  yes you pay $132  per year, but if you use the given senario the first claim alone you already saved $137.5 on the first claim.

Therefore the plan with the smaller deductible is actually a cheaper plan. Also, when a policy has coinsurance, there is usually an out of pocket limit, (this is the amount that once your coinsurance equals this, then claims are eligible at $100 of the contractually agreed amount with the provider.) The out of pocket limit may also help you decide which  plan is best for you.

You should also review the amounts of copays on the policy, and which types of services apply to deducible versus copay. Depending on which type of service you use the most, this could help you decide. Remember copays are usually not subject to your deductible. So if you have copays, they do not accumulate toward satisfying your deductible. Plus, not all services have copay or deducible, most have one or the other, but some services may be covered and not subject to copay or deducible. These are all thinks to keep in mind when making your decision.

Answer 8

1) This one is cheaper, if you visit the doctor's office frequently, because the deductible at $250 is low.  Once you reach the $250---for most tests/doctor's visits etc.---you are done.  The coinsurance is usually only used when you go into the hospital---so you'd be paying 35% of your hospital bill (after your deductible of $250 is met).  If you don't forsee an immediate need of having to go to the hospital for anything (having a baby etc.)---not that you can, but if it is extremely unlikely---this plan is probably the better option for you.  The second would probably be better in a crisis type situation (such as if you got into a car accident---and in the hospital a LONG time)---20% vs. 35% (even with a 1500 deductible) is still going to be cheaper.  They are both quite expensive (so if you are able to get through an employer, do!)---but will save you in the long run!