health insurance decision

[misstenacity]

Ok, I am putting it all out there.

Two plans to pick -
1. $20 monthly out of pocket. PPO, $30 copay for 2 visits annually, $2500 deductible after $300 in preventative care. $1000 drug deductible. 80/20 coverage, max out of pocket $5000
2. $68/mo, HMO, $35 copay no limit, no deductible, no preventative care. $20 generic drugs, $3500 max out of pocket. Better hospital coverage but no choice of hospital.

Sooooo, me. 30s, fit, never sick. But, I need lab work, tests, and bone density scan all for hormones/amennorrhea.

Whew. Thoughts?

[Espi]

Maybe worth it checking out what it would cost you either way including possible expenses?

Perhaps someone can chime in who was in a similar situation?

[misstenacity]

Yes, also looking into HSA to augment either plan for tests that might not be covered.

1. $240/year is my total cost if I don't need anything other than routine checkup and perhaps one test.
2. $900/year is my total cost for the same situation with the better insurance.

But - a BMD scan is $300. Bloodwork is about $400. More than two doc visits on plan 1 and I'm right into my deductible. Or if I need any prescriptions, that's out of pocket.

So... with "minimal" extra stuff, a few tests as outlined above, the costs to me is going to be about the same for EITHER plan - $900 or so for a year.

The drawback in that case for plan 2 is that my employer is paying a lot more per year on my behalf. Cutting costs in a business also means not spending more than you need to.

The benefit with plan 2 is the "what if". More extensive testing/care/labwork or anything serious would impact me financially much less.

It's still kind of looking like "plan 1" is best for me, especially if I add a separate HSA.

More thoughts are WELCOME!

[DanceDiva]

I would agree that as a healthy individual the first plan is seems more appropriate.

One thing I think you should check is whether you can get a doctor to order you a BMD test. They are not routinely ordered for healthy women until you are 60+.

[misstenacity]

Thanks for the advice.... I did stick with my lower-cost plan. I have had a BMD ordered already under this plan and had to pay for part of it, so I'm not too worried.

I might do my own bloodwork, though: mymedlab.com has good prices and lots of tests.

[eastcoastsurfer]

You also need to define 'better'. So many people think lower co-pays, etc... are better while they have very little serious illness coverage. Look at health insurance like car insurance. Would you use car insurance for oil changes? I hope not. Instead you need insurance for something serious (surgeries, cancer, etc...) so find a high deductible plan that gives you the most coverage in those situations.

[LisaS]

Originally Posted by eastcoastsurfer

Look at health insurance like car insurance. Would you use car insurance for oil changes? I hope not. Instead you need insurance for something serious (surgeries, cancer, etc...) so find a high deductible plan that gives you the most coverage in those situations.

hey - you're young and most of your systems are under warranty and unlikely to breakdown - when you get older something is always breaking or falling off - not accidents just non-warranted upkeep - and insurance can help with that as well.