Can afford health insurance but not deductible/out of pocket

thegiver

Thu, Nov 16 2017, 12:06 am

What do you practically do if you can afford paying your monthly premium but not the deductibles, co-sharing 20-30 percent of hospital bills, or of pocket maximums? (Ex labor and delivery, ambulance services etc)

Practically what's a solution besides making more money. Our savings/bonus is going to tuition :-/

Also how do you calculate how much you need to save up for all those hospital procedures when the insurance is vague about how much they pay (20 percent of an unknown amount Bec you don't know what emergency medical procedures you might need such as during labor and delivery) and doctors don't have visibility of costs.... unless you call each one individually!

How do I get a realistic estimate of costs when picking out a health insurance?

nursemomma

Thu, Nov 16 2017, 12:33 am

All plans should have a maximum out of pocket amount, and that is the max you will pay.
For ex, a plan has $3,000 ded, 20% co insurance and $5,000 moop. That means once you hit 3, you’ll only pay 20% of all bills until you spend 5. From them on, you should not have to pay anything other than copays.
That is, until January, when the cycle starts again Sad

lavenderchimes

Thu, Nov 16 2017, 7:27 am

You can't really know, because you don't know what medical things you will need. That is how insurance works -- both sodes gamble on how much medical stuff you will need, and the insurance company makes money no matter what.

I know this must be scary, but try not to worry about this -- it's not good for the baby! Make sure tou have enough to pay the deductible and expected copays. When it comes to the big hospital bills, explain to the hospital that you are poor, and have them out you on a pyament plan.

Amarante

Thu, Nov 16 2017, 10:11 am

You make an educated guess based on your anticipated medical needs - you could be wrong but if you buy the plan with the high deductible and co-payments, the most you will ever pay in a year will be the yearly out of pocket expenses - IF - you stay within network of the plan. The out of pocket cap works differently.

If you plan to get pregnant and deliver next year, then it's pretty easy to determine - multiply premiums by 12 to get annual cost and then add the total out of pocket - that would be your total annual medical costs approximately.

Where it is tricky is if you don't anticipate anything other than normal health costs and then something unexpected major happens and you are hit with more expenses -but remember that you are capped at whatever the total out of pocket expenses are.

The New York Times has run a series of good articles on selecting medical plans and they said for most people, purchasing the higher premium/lower co-payment/low deductible actually costs them ore because they over-estimate their medical expenses - this article gives an excellent simple explanation of how to determine.

https://www.nytimes.com/2015/1.....ticle

amother

Aubergine

Thu, Nov 16 2017, 11:01 am

I have insurance like that it works we have a 10,000 deductible but one person can't spend more the 7 I think and when you hit 12,000 everything is covered even Dr co pays and meds. when we figure out how much out plan will cost for the year we add in 12000 and yes we have hit that amount . shock

note some offices and medication will help with deductible or have assist program out. There make sure to ask