Help! What health care should I get?!?!?!?!?!?!?!

[rg200amp]

Hello all. I have a question for you all. More like a what would you do?

The company I work for is changing there health plans (all plans are from Keystone).

I get to keep what I have or change over to the new plan.

HERE are the details:

Right now, I have an HMO. I pay $4.50 a pay check (paid bi-weekly) for this Plan. My deductibles are: $35 for doc, $50 for specialist, and $135 for ER.

Now. I have the option to go to a DHP-PPO.

If I go with the DHP-PPO, I will no longer pay $4.50 a paycheck for health care. And my company will give me a $1000 bonus check just for going with this plan.

It is a PPO. However, I have to pay a high deductible.

So. It's a $3000 deductible. However, I do not pay the whole thing. My company pays half. It works out like this:

I pay the first $300. Then they cover the next $1500. Then I have to cover the next $1200. Then, anything after that is covered 100% by the insurance.

So, doctor visits would be on my dime for the first $300, then my company pays up to $1500 of any health care bills I rack up. If that gets eaten up, then I would have to cover $1200. Once that $3000 deductible is hit, any and all health care is free (to me) and covered for the year.

So it boils down to if I go to the ER, I am going to have a $1500 hospital bill.

It's a PPO. I dont have to be in network. No "getting referrals" to see specialists.

But, I would have to put more money out upfront (if i need it).

Now, I don't have any health issues. I am not a regular at the doctors or ER.

But, you never know when stuff might happen.


Please note:

I do not need the $1000 bonus. And, while a $1500 hospital bill (in the event I go to the ER) would suck, I could pay it off fairly easily.

I just don't know what to go with!!
lol

What would YOU do if you where me!?!?!?!?!?!?!?!


THANKS GUYS!!!!

 

[meangreen01]

$4.50 per paycheck? Are you sure you're not missing some zeros in there? Is this a private company you work for?

 

[rg200amp]

Originally Posted By: meangreen01
$4.50 per paycheck? Are you sure you're not missing some zeros in there? Is this a private company you work for?


No, I contribute $4.50 a paycheck for my current HMO.

I work for a non-profit.

 

[meangreen01]

What is your deductible for your current plan? What you listed are your co-pays.

Either way, your choices are so ridiculously low priced(in the second case you will actually be getting paid for being provided with health insurance?!) that any hand wringing over your decision is really unnecessary.

 

[dparm]

Medical stuff is expensive. Even something you consider minor is thousands of dollars. Frankly I do not think you should take one of those high deductible ones. Even if you are in perfect health, accidents happen and suddenly you have a bill for several thousand dollars in your mailbox. My brother got some weird tonsil infection and wound up owing something like $3500.

Unless you have some wicked savings, and earn a sizeable amount of interest on them, I would stick with the $4.50 option. Most people would kill for insurance that cheap...mine is 10x that, and I think that is cheap since I'm young and single.

 

[tenderloin]

Originally Posted By: rg200amp
Originally Posted By: meangreen01
$4.50 per paycheck? Are you sure you're not missing some zeros in there? Is this a private company you work for?



I work for a non-profit.


Someone is making a profit so you can have healthcare at $4.50 a check.... Just sayin

 

[Drew99GT]

Are they hiring? If so, I'm heading to Philly.

$9 bucks a month in premiums for health insurance with only co-pays and no deductible? Am I reading that correctly? If so, I'd stick with that!

 

[rg200amp]

Originally Posted By: meangreen01
What is your deductible for your current plan? What you listed are your co-pays.

Either way, your choices are so ridiculously low priced(in the second case you will actually be getting paid for being provided with health insurance?!) that any hand wringing over your decision is really unnecessary.


I just have co-pays with my HMO I have now.

As you said, I can't complain. Both options are fine with me. I am just unsure what one I should go with. lol.

 

[Drew99GT]

This is a no brainer. Stay with what you have!

 

[meangreen01]

Originally Posted By: Drew99GT
This is a no brainer. Stay with what you have!


+1

 

[crw]

If it's truly $4.50 per paycheck, stick with what you have!

But, somehow I doubt you have the full story.

When they changed me over to the high-deductable plan, it was like getting a $100 raise per paycheck. But I have a high-deductable plan, so I need to personally fund an Health Savings Account... So if I have big expenses I'm covered by my personal account. If I go a while with nothing major, I could cut down the contributions to the HSA and keep that money.

 

[The_Jeff]

Get the PPO. Just check to see if stuff like lab tests are covered; bloodwork for a routine physical can be a couple hundred bucks.

 

[meangreen01]

Originally Posted By: eljefino
Get the PPO. Just check to see if stuff like lab tests are covered; bloodwork for a routine physical can be a couple hundred bucks.


Yeah, PPO's are nice from the perspective of not having to stay in-network. I like the option of going to any doctor I choose.

 

[JHZR2]

I have an HDHP and it is beneficial cost-wise to stay in network. Given the outrageous prices charged, the percentages can leave you with a big bill.

My costs for a non-hdhp are much higher, so for us the HDHP is a better deal. For this situation, I think staying with the current setup is cheaper.

 

[rg200amp]

Originally Posted By: crw
If it's truly $4.50 per paycheck, stick with what you have!

But, somehow I doubt you have the full story.

When they changed me over to the high-deductable plan, it was like getting a $100 raise per paycheck. But I have a high-deductable plan, so I need to personally fund an Health Savings Account... So if I have big expenses I'm covered by my personal account. If I go a while with nothing major, I could cut down the contributions to the HSA and keep that money.


No, I pay only $4.50 a pay check.

I don't want to get to detailed about my personal life. But I work for a VERY strong non-profit in the behavior health field.
So, as I said, I can't complain about my situation or my choices!

I was planning to stick with my HMO. However, there are rumors trickling down from the top floor that next year (2013), there will be no choice and the DHP-PPO will be the only choice. And so, there will be no $1000 bonus next year, when your forced into the DHP-PPO.

So that is playing on my mind as well. I dont want to miss to cash boat if I am going to end up with the DHP-PPO anyway. . . . .


As you see. My mind has been boggling this non-stop!

 

[mmab]

I would go with the PPO if I had no kids. I would have taken the 1000$ and taken good care of myself. I never go to the doctor for a small cold or fever anyways.

With kids is a bit of a gamble there.

 

[PandaBear]

I have a health savings account going with a HDHP this year, and I can say that unless you have PERFECT health and do not do anything involving risk (skiing, biking, home improvement, etc) you are not going to get much out of it.

I'm 33 and have some neck and back problem and would need chiropractor once every 2-3 weeks, and the $500 my company give me is used up within 4 months, turning originally a potential $300/yr savings into a $300/yr out of pocket expense.

The biggest problem with PPO is the deductible that isn't finite, but a percentage. Unless you need a specialist out of network (i.e. certain chronic condition that only a few specialists you've visited know how to deal with), stay with an HMO plan with only copay and no percentage deductible.

Now if your health care cost is $500 per pay period instead of $9, then you may want to reconsider what is better. Mine is $35 per month for HMO and I'd pick that over HDHP next year.

 

[crw]

Quote:

I was planning to stick with my HMO. However, there are rumors trickling down from the top floor that next year (2013), there will be no choice and the DHP-PPO will be the only choice. And so, there will be no $1000 bonus next year, when your forced into the DHP-PPO.


OK, now this is starting to make sense.

First, the idea that you'll be forced into the high deductible plan next year,... you can pretty much take that to the bank. It WILL happen.

So, when I said that I got an extra $100 per pay check when I switched, for you it's the same (sorta) when you get the $1000. The deal is, the company was up-front with me in what I was paying before I switched. For you, you think you only pay 4.50, but in reality the company is putting money in on your behalf.

I hope an HSA is part of this. If you don't have any immediate health concerns, I think you should take the $1000 and put the entire amount into an HSA, and then start saving part of each paycheck to it. Well, you haven't mentioned an HSA... I would not want to be on a high-deductible plan without it. If they aren't giving you that option, wow, I don't know what I'd do.

 

[Al]

Your maximum costs are 450 for the PPO where you can choose your own docs and apparently have no co-pay. That balanced against the Doc/Specialist/ER costs for the HMO.

If the Preventative medicine, Hospital costs, and drugs are exactly the same Its a no brainer. Go with the PPO. I am guessing you are missing Hospital, drug, and maybe preventative costs for the HMO..I'd bet on it.

One sickness out of system (out of your territory) and you are screwed with HMO. Also you are limited to In-network Doctor Skills

 

[Cujet]

It's quite difficult to see the entire situation from here.

I can add this: Insurance should ideally be tailored for the individual. For example, why pay the insurance company to "compensate" you for typical expenses? You cannot come out ahead in that one, due to the huge overhead costs at the insurance company.

Put another way, doctors visits and common prescriptions (if you can afford them) should not be on the plan.

Catastrophic coverage is what insurance is good for. It prevents financial disaster.

My insurance costs me over $22,000 per year. I have no real choice in plans with my situation. I'd much prefer a $10,000 plan with catastrophic coverage. Quite simply, I'd come out ahead.