Friday, October 10, 2014

Insurance decisions

   The enrollment information for health insurance arrived ... and as expected, it's going up again.

    DH and I have always carried our own insurance, since it was less expensive, among other factors.  That will continue for a few more months, until my severance runs out.  

    Once it does, if I haven't found a job with benefits, we'll have to make a decision:  go on DH's plan or continue my insurance through COBRA.   Premium-wise, it makes sense to go on DH's plan -- the cost for both of us would likely equal what I would have to pay alone.

   But the rub is we're both on high-deductible plans, and the maximum out-of-pocket costs for the family plan are double those   for a single. If I'm understanding correctly, should one of us became seriously ill or injured, we'd be on the hook for something in the neighborhood of $10,000.

    I'm going to have to figure out what makes the most financial sense -- pay higher premiums to hold down costs in a "worst-case" situation, or pay lower premiums and gamble that we'll stay well.


CTMOM said...

DW-sorry that you find yourself in this difficult situation/decision. My information is that COBRA is ridiculously expensive. I am a public teacher, and 85% of my ins premiums are subsidised by the Board of ed. If I were to take COBRA, as of the last investigation, it would cost something like $18,000/year. Um-no. A friend recently retired early due to medical issues, becoming a widow, family issues etc. Since she is not yet 65, she is in a similar situation. Last I heard, she was applying for Ohama care. Luckily, it would be for a single, not a family/married plan. Even WITH insurance, I have a high deductible plan. We are in the "honeymoon" stages, however, with the employer putting in 50% of (in my case with a family plan) $2000 of the $4000 deductible. Read the proposed plan carefully to see what would be covered, regardless of the status of the deductible. For example, all physicals, well woman care, dental cleanings are paid at 100%. Yes, I still have to meet the high deductible, which we readily did last year, and it looks like we're in the same boat this year. Once you hit the deductible, life is golden-everything is covered @ 100% as long as we are "in plan." I schedule appointments/precedures based on this info. For example, a colonoscopy would be a covered expense towards the deductible but the endoscopy that I had the same day would not, even if there was a medically necessary note from the MD and a history of gastro issues. @@ Since I had hit the deductible, both procedures were covered in full. Since polups were discovered/removed, it was now "surgical"-that day cost about $140000! and that is with the in plan discount. Once medical accident/procedure is all it takes for a huge bill to creep up. Life happens. Good luck-there is no one size fits all answer to this.

CTMOM said...

DW-adding to my last reply: While I am fortunate to have only* a $4000 deductible for our family plan and that my employer is paying $2000 of that, I still come up with the additional $2000 out of my pretax paychecks (we live off of take home pay). That said, when you compare the cost difference between your choices, I vote to bundle onto DS's due to the cost savings there AND use the "savings" plus additional savings from your budget (hopefully) and stash $10,000 away, Just in case. BTW- should there be a medical crisis up to $10,ooo deductible, most hospitals will work with you to go on an interest free, repayment plan. This has been my experience. HTH

DW said...

Thanks Carol ... I appreciate the input. The insurance plan is in stages ... we'd pay the first $3,000, then the insurer would pay 80 percent of costs until we hit $10K out of pocket ... then they'd cover everything. So that might mitigate the potential hit. (And we've made sure to fund the HSAs)

CTMOM said...

DW, well then my advise remains to go with DHs plan, stash $3000 of pretax monies into the HSA (you can anticipate using that-regardless and it DOES roll over-you can't lose that money). If at all possible, I'd also aim to have an additional $7000 set aside, ideally in the HSA with pretax monies (remember-it rolls over from year to year, and you take it with you when you retire-see IRS info on line, if DH's employer doesn't provide that). Also, check if the ins plan will cover some basics as mine does: all annual physicals and associated blood work/tests, well woman exam and mammogram, 2 annual dental cleanings per person. What I have to apply towards the deductible then, is any illness/accident/therapy etc. I hope that helps.