DH is changing jobs... Benefits?

[riaketty]

We just got the 'new hire' blah blah packet for DH's new job. It's got his benefits guide in it. They use Blue Cross Blue Shield (who i've had great experiences with) and the prices don't seem all that bad, considering we always only get catastrophic insurance.

I would love some input on what to get this time around, though. Here's out sitation:

Family of three, about to be a family of four. Homebirth baby due in January and DD is 15mo. She's not vax'ed and the new baby won't be either. We do tend to get well-baby checkups just for peace of mind.

We're all healthy with no pre-existing illnesses or conditions. None of us take medication except vitamins. Our biggest 'safety' issue is driving an hour each way to school or work. I don't work, and DH has a cushy job that involves a bit of heavy lifting but really no danger.

We eat good and we're financially stable at the moment. We have about a month's worth of savings and are adding to it every paycheck. We have solid no-touch emergency-only (as in, life-threatening emergency) of about $4k.

The biggest thing I am looking for is coverage in case this homebirth goes wrong and I get transfered. I wouldn't mind trying to get some of the birth costs covered but it's not a priority.

So, with that in mind, here's the plan options:
1. PPO, no deductible, $2k out of pocket max, 2mil/person lifetime max. 95%-100% coverage on everything listed and a copay system on 'scripts.
$461/month

2. PPO, $750 deductible, $3k out of pocket max, 2mil/person lifetime max.
80-100% covered on everything listed after deductible is met, copay 'script system.
$316/month

3. Tradition plan, $3600 deductible, $7500 out of pocket max, %100 percent covered (even before deductible is met) on preventitive physicals, screenings, prenatals, and well-child care. Everything else, including scripts, is 70% covered after deductible.
$171 a month

So, looking at this now, it seems like #3 would be the best. Since we don't need scripts regularly and we don't do more than preventitive doc visits, it would make sense to have only catastrophic insurance, right? We could pay the deductible out of pocket right now if we absolutely needed to (and this deductible is STILL $3k less than the one at DH's current job, not to mention the plan is about $50/month cheaper).

Also, a question about HSA plans... plan 3 says that it 'allows you to set up a HSA account' but you set it up through your own bank or whatever, not through the plan... so if we didn't WANT a HSA, do we still have to have one? We were talking about this a few days ago, and our HSA has become a pain in the rear and I really don't want to continue it.

Thanks! Looking forward to opinions!

[nd_deadhead]

I don't know why you wouldn't want a HSA, but I am a big fan of free money! Ours is very easy to use, which no doubt colors my opinion. I never put enough in - it seems like every year we have emergency room visits or some unexpected dental expense.

I am a big believer in insurance, so I'd probably go for #2, especially with two kids. Even perfectly healthy, normal kids can end up with things like hernias, undescended testicles, stitches and broken bones (speaking from experience!)

[kijip]

Originally Posted by riaketty

1. PPO, no deductible, $2k out of pocket max, 2mil/person lifetime max. 95%-100% coverage on everything listed and a copay system on 'scripts.
$461/month

2. PPO, $750 deductible, $3k out of pocket max, 2mil/person lifetime max.
80-100% covered on everything listed after deductible is met, copay 'script system.
$316/month

3. Tradition plan, $3600 deductible, $7500 out of pocket max, %100 percent covered (even before deductible is met) on preventitive physicals, screenings, prenatals, and well-child care. Everything else, including scripts, is 70% covered after deductible.
$171 a month

You do not have the savings to pay a $3600 deductible + 30% coinsurance on one serious accident or hospitalization. What is your back-up plan? Without more savings you are exposing yourself to a huge risk with plan #3. Even saving the difference each month is not going to be enough for few years or more to allow you to avoid a financial crisis at the same time you have a medical crisis.

Young, healthy people don't tend to realize they are not necessarily going to stay that way. Just my two cents. I'd pick number #2 at the very least with kids.

[techno_dara]

We are a family of 5 with a high deductible plan and a HSA. Fees on the HSA are payed by my employer. I deposit pre-tax dollars in my HSA up to my deductible. The HSA rolls over every year, so no use-it-or-lose-it. This has worked really well for us. Before deciding to go this route, I added up all the costs (cost of all visits, scripts, etc before insurance pays) of the previous years. No year was ever more than the deductible and each was less than the amount I spent on premiums. Made financial sense for us to go this route. Good luck with your decision and congrats on the new job!

[LittleBirdy]

In regards to the HSA - no, you do not "have" to have one. Our company offers this in conjunction with our high deductible plan and even then you can waive it - which always blows my mind because we contribute $900 a year for those with family coverage!

[llamalluv]

Originally Posted by kijip

You do not have the savings to pay a $3600 deductible + 30% coinsurance on one serious accident or hospitalization. What is your back-up plan? Without more savings you are exposing yourself to a huge risk with plan #3. Even saving the difference each month is not going to be enough for few years or more to allow you to avoid a financial crisis at the same time you have a medical crisis.

Young, healthy people don't tend to realize they are not necessarily going to stay that way. Just my two cents. I'd pick number #2 at the very least with kids.

Do you know something she didn't put into the OP? The stop loss is $7500 per year - she can put that away over 2-3 years in the HSA. Granted, if something terrible happened within the first few months, they might be hard pressed to come up with their deductible and the additional $3900.

[AuntNi]

Plan #2 sounds almost exactly like what we have, down to the $300/month. I've really liked it so far. You'd only be saving $1740/year with Plan #3 over Plan #2. That's like the co-payment on one MRI. I know, trust me. I fell walking around the block (I'm super clumsy.) Wound up with a herniated disk and many many bills. Even with the insurance paying 80%, it was still an expensive fall.

I just don't think the cost difference between the two plans is worth the risk.

[lmonter]

Well, before getting into the health insurance, does your hubby also have job-specific disability insurance through the job or do you have it elsewhere?

#1 - What's the copay on prescriptions? A certain amount or a percentage?

#1 - When you say everything listed, you mean all the procedures and such that the insurance company will cover rather than reject?

#3 - Would scare me a bit. I don't know about you, but I don't have $37,500 easily available to me in the event of a car accident or something - which is the OOP cost that it'd be for my family of 5.
I would like that all the preventative stuff is covered, but really, a WBC isn't typically going to break you at $50-$90/pop. It's going to be the pediatric cardiologist to the tune of $2300/visit or a broken leg or something else just as unexpected. Now if you make enough money that large amounts like that aren't a problem, color me jealous. Plus the fact that it's a traditional plan, which to me, means you can only go see certain doctors/hospitals and aren't covered one bit if you use someone else not affiliated with them. But it's also been a while since I've had to mess around with stuff like that, so don't quote me (our insurance company, while full of red tape, is pretty good about the claims we've had, even if they are really pokey about paying us back for the midwife).

Honestly, I'd probably go with #2. But I have two boys and a girl - boys who are daredevils to some degree and have a tendency to try to run in front of moving vehicles. :
Oh, and don't even get me started on dental - I'm hoping my "temporary" filling will last until January when I can use insurance again to get it refilled and a crown put on over the root canal I had in August.

[shayinme]

Unless going with option 1 means you can't pay bills, that's the option I would go with. Yes, you are healthy now but the thing is as I am learning insurance is for the unexpected, and the last thing you want to deal with if something comes up is figuring out how to pay bills. My Mom was relatively healthy, she had a nasty cough that didn't go away, turned out she had lung cancer. Thankfully my folks had good insurance and she was able to get treatment right away, sadly she passed but my guess is if she had not had the insurance she had, things would have been worse.

I have had mostly catastrophic coverage for years because we are self-employed and at over $300 a month, its all I can afford and still make my bills. At the very least I agree with those who are suggesting #2 as a option.

Insurance IMO is one of those things I wouldn't scrimp on unless it affected my ability to pay for other essentials. Yes, it could be seen as throwing money away but the fact is we never know what is going to happen.

Shay

[sewingmama]

I'd want to check on what the family deductible would be. If, as someone mentioned, there is a big car accident, with #3, would you have to meet that $3600 deductible for each member of the family, or is there a limit? That would probably make a big difference. We have something similar to #3, and over the nearly six years we've had it, it's worked well for us. We can see anyone we want who takes our insurance, and we need no referrals. They cover well child checks and occasional checkups for adults too. When we have had expenses, they've been very minimal, compared to how much more we'd pay in premiums each month for other plans, but we've also been very, very fortunate. Nobody's broken a bone or needed surgery, no hugely expensive medications, and the one birth we've had on that plan thus far was an uncomplicated homebirth and therefore very inexpensive. But it's a big gamble, and you really have to weigh that for yourself.

[shelbean91]

I'd go w/option 2. It's the middle ground and even healthy people get sick and/or hurt. Ds2 broke his elbow by falling about a foot and a half at a playground- just landed on it wrong. Then he broke his other elbow 6 mos later falling off a chair- ended up needing surgery to fix it, even though it didn't look too bad at first. That's just me. You decide what is the right risk for yourself.

[Logan's Mom]

If I could afford it, I'd choose #1 - at the least #2 --- looks like some great insurance for your family is being offered...good for you! :

[grniys]

At the very least I'd go with option #2. Yes, you are healthy, but you never know when someone might be diagnosed with something. It happens all the time. Healthy young people find out they have something that costs boat loads to treat. So, at the very least, I suggest #2. If you can afford it I'd do #1, but #2 is a nice middle ground.

[milletpuff]

Just curious, but what didn't you like about having the HSA?