Ladies, annual enrollment at my place of employment closes on Tuesday and I need advice on choosing my healthcare.
Background: I'm a 21 yr old single female, covering only myself under whichever plan I choose. I want kids but have absolutely no plans on that happening in the next year, and when the time comes, I'd switch over to a healthcare plan that covers more before I start TTC.
My work provides 3 choices: a free PPO with high deductible and OOP expenses, a PPO that's $50 per month with lower but still fairly high deductible and OOP expenses, and an HMO that's $65 per month with a $500 deductible/max OOP per year.
Right now I have the PPO that's $50/month and I think the deductible is $1200 with max. OOP annual expenses at $2500. I don't go to the doctor, last time I went was 4 years ago and that's because I had to get mandatory forms filled out to live in the college dorm. Everyone at my work raves about the HMO and how much it covers, but to me it's only a good deal if you USE the plan. All of these people who love the HMO are covering their entire families (themselves, spouse, and 1-4 kids) on the plan. I know they use it frequently and so they love the low OOP costs. I'm on a tight budget trying to pay down my student loans and build savings. It feels like throwing away money to me spending $50-65 per month on healthcare when I rarely go to the doctor.
The free plan has like a $3500 deductible and OOP maximum of $5000. If some major medical event happened to me in the next year, I could cover these OOP expenses with my emergency fund, though it would be significantly depleted. I'm also currently putting away $60/month into my own medical sinking fund, which would help with the deductible but wouldn't fully cover it. I could cover a couple hundred of medical expenses before tapping into the emergency fund, though. The plan would basically work as disaster coverage should anything huge and unexpected happen.
I'm just looking for thoughts on paying more per month for coverage I don't use vs. taking a bit of a calculated risk and getting the free healthcare plan, but I'd be a little screwed if I suddenly needed major surgery or something. Any thoughts?
I always err on the side of being insured. In fact, I've never NOT had insurance. $65/month is a drop in the bucket compared to what you would owe if you needed an emergency appendectomy or physical therapy from an injury or accidentally got pregnant.
My husband and I don't plan on dying anytime soon, but we still have life insurance. It's the things you don't plan for that are the most expensive. Insurance is precisely for that.
Sounds like your medical usage is similar to mine. I have always gone with the lower cost/higher deductible plan and that is what I would recommend for you too. Especially given that you have an emergency fund that *could* cover the max OOP for the free plan, I wouldn't hesitate at all. Its not like you are choosing to be uninsured, you are weighing your needs/usage against the risk of something happening, knowing that if something major did happen you could actually still take care of it. Sounds like a pretty low risk option to me.