Health insurance choices - need to decide quickly!

amother

Aubergine

Tue, Aug 15 2017, 3:18 pm

I need to buy health insurance for the next 4 months. Due to a weird twist of bureaucracy I suddenly don't qualify for the "essentials" plan (basically what replaced family health plus under obamacare) but I can reapply for 2018. Note: The kids still have child health plus.

Option A: Low premium but covers pretty close to nothing. You pay everything out of pocket until a $4000 deductible, which over 4 months basically means that the only benefit is that if someone CV ends up in a hospital than the maximum out of pocket is something like 7000. But assuming you don't need much doctoring over the four months, you get off pretty easy with a low premium. The clinic I use for primary care has a sliding scale fee for doctor visits for people who are not covered, so that shouldn't be too bad either. But if I'd ever need urgent care or anything specialized it might be pricey. I also take a daily medication that costs about $60 a month.

Option B: Significantly higher premium but covers a lot. Generic drugs are all free, so are basic labs (think strep cultures and bloodwork), there's only a copay for sick visits and even urgent care and basic dental care without needing to meet a deductible. Granted the urgent care copay isn't that low but the option exists. A different plan with similar cost has a small copay for drugs, but gives you 3 free sick visits (other plan is $35 each) and a lower deductible. You get the idea - you still pay some out of pockets but it's much more limited, however the premium is higher. If there is a crisis, the max out of pocket is also lower than the cheap plan but in proportion to the cost of having a health crisis it's not such a big difference.

The overall difference is about $600 in total for the four months. That includes paying out of pocket for the medication I need on the lower plan. Do you think there are strong odds of needing more than $600 worth of out of pocket sick/urgent visits over the next 4 months, factoring in that my doctor would likely give a reduced rate for the sick visits? Part of me wants the better benefits but the other part of me says it's only 4 months so how much could that be worth anyway, and I can find more exciting things to do with $600.

No clue what to do. Please share thoughts and experiences because I have no experience with this, I never made enough money to have a choice before!