What Should we do? Health Insurance Question

amother

Wed, Feb 08 2023, 3:08 am

What makes more sense financially?

If DC will be 26, and taken off my insurance, here are the options.

An Obamacare plan that cost approximately 500+ monthly. 4700 deductible, and higher co pays after.

An Obamacare plan that costs 700+ a month, 1700 deductible, and lower co pays after.

A private plan, approximately 500 + a month, no deductible, co pays only, but here's the catch. If chas vshalom hospital is needed, depending on the plan, it only covers 5-10 days in hospital max, between 10-16 visits per year to any PCP or specialist, and generic meds only.

Bli ayin hara, DC is healthy, but chas vshalom, anything can happen. What makes the most financial and logical sense to do?

amother

Wed, Feb 08 2023, 4:10 am

imasinger wrote:

He's unmarried and learning FT?

Depends on your and his risk tolerance, but his opinion should be part of that decision making.

I'm not sure where you got the idea that DC is a male, and learning FT...I said nothing of that sort.

Either way, That wasn't my question.

I'm trying to find out what makes financial sense for my child to do.

Ty

amother

Saddlebrown

Wed, Feb 08 2023, 4:54 am

With your first option, you will for sure need to pay $6,000+ for the insurance. If any medical care is needed, there's up to $4700 deductible, and an unknown amount of copays. So $10,700 + ???

With your second option you will for sure need to pay $8,400+ for the insurance. If any medical care is needed, there's up to $1,700 deductible, and again unknown copays. So $10,100 + ???

With your third option, you need to pay $6,000 plus an unknown amount of copays for what you consider substandard care.

Another option which you did not consider is Refuah Health Share which is not insurance but is a way to handle medical expenses. That would be about $200 a month + up to $1500. But they do not cover pharmacy or a number of other costs, and have a maximum cap of $1 million per covered event. So $2,700 + ??? in not covered costs.

Basically, there are too many unknowns to be able to say definitively which is the best option financially. At the end of the year, you can look back and see.

I know which one I would choose, but my risk tolerance may not be the same as yours.

amother

Bellflower

Wed, Feb 08 2023, 4:59 am

Are there no more catastrophic plans on Obama care? DH was on one for a few years and it worked great. If he needed a dr 1 or 2 times a year he paid out of pocket but we still came out way ahead.

amother

Turquoise

Wed, Feb 08 2023, 5:16 am

amother OP wrote:

Which insurance company is selling the "private plan"? It doesn't sound kosher to me. Is it some kind of supplemental plan designed to be combined with a "real"plan.

I'm not an expert in obomacare, but I work in an adjacent field.. as far as I know there are rules for all "real" medical insurance since real " plan, and they can't limit necessary medical care the way you're describing.

NotInNJMommy

Wed, Feb 08 2023, 5:45 am

amother Gladiolus wrote:

Wow I am shocked at how much it costs to insure ONE young person!!

That's why many people strive to get jobs with health insurance as benefit....because then the employer substantially subsidizes. It's still not cheap, but it's not like this.

amother

Wed, Feb 08 2023, 6:21 am

NotInNJMommy wrote:

That's why many people strive to get jobs with health insurance as benefit....because then the employer substantially subsidizes. It's still not cheap, but it's not like this.

Insurance offered at job is worse. Tremendous deductible, Tremendous premium per paycheck, horrible co-pays, and horrible medical insurance...meaning, no doctor takes it.

amother

Wed, Feb 08 2023, 6:22 am

amother Turquoise wrote:

It is a kosher plan, spoke to an insurance broker. It's a plan for those who probably have nerves of steel and minimal anxiety and worry!

amother

Aubergine

Wed, Feb 08 2023, 6:23 am

NotInNJMommy wrote:

That's why many people strive to get jobs with health insurance as benefit....because then the employer substantially subsidizes. It's still not cheap, but it's not like this.

It really depends on your job
I have amazing job health insurance but not every plan is so great or worthwhile

NotInNJMommy

Wed, Feb 08 2023, 6:24 am

amother Aubergine wrote:

It really depends on your job
I have amazing job health insurance but not every plan is so great or worthwhile

Yup. But again, that's why people go into certain careers/employers---for the bennies...many people do this.

I wouldn't work for an employer with bad bennies cvs.

But yes, not everyone plans for that, for various reasons.

NotInNJMommy

Wed, Feb 08 2023, 6:28 am

amother OP wrote:

Insurance offered at job is worse. Tremendous deductible, Tremendous premium per paycheck, horrible co-pays, and horrible medical insurance...meaning, no doctor takes it.

Yes, I guess I wasn't clear that people plan to get employment with employers who offer competitive rather than sub par benefits. Can DC get a job?

amother

Turquoise

Wed, Feb 08 2023, 6:29 am

amother OP wrote:

It is a kosher plan, spoke to an insurance broker. It's a plan for those who probably have nerves of steel and minimal anxiety and worry!

Which insurance company?
After Obamacare even "private" plans ESPECIALLY individual ones can't limit hospital stays, etc

NotInNJMommy

Wed, Feb 08 2023, 6:32 am

amother OP wrote:

Are you sure it's only 5-10 days in hospital max per year or the copays max out after 5-10 days?

When I was on an HMO, the daily copay for hospital max'd out after a week or so, but th ehealth insurance kept paying.

Similarly, my mother in law now on a medicare HMO was recently in the hospital for over two weeks and her copays max'd out as far as what she had to pay---but the health insurance didn't stop paying.

keym

Wed, Feb 08 2023, 6:38 am

No personal comment because like a previous poster said, my risk-level may be higher or lower than yours.
But you don't say if it's a male or female and whether they are married or not.
But it would make a difference if it's a female who possibly may become pregnant over the year.

amother

Caramel

Wed, Feb 08 2023, 6:40 am

If the employer if offering a group plan and your DC is choosing not to take it, he/she can ask the employer if they are willing to reimburse the amount they would have paid if he were on the plan, to be used to help offset the premium for the better policy. If they are agreeable (doesn't cost them any more out of pocket than if DC was on their plan) it can really help with your final costs.

amother

Wed, Feb 08 2023, 6:40 am

NotInNJMommy wrote:

Yes, I guess I wasn't clear that people plan to get employment with employers who offer competitive rather than sub par benefits. Can DC get a job?

DC has a job. Insurance is awful, that is offered. As are most places offering similar jobs