Money Matters
formerlyGDaisy09
member
Dear Community,
Our tech team has launched updates to The Nest today. As a result of these updates, members of the Nest Community will need to change their password in order to continue participating in the community. In addition, The Nest community member's avatars will be replaced with generic default avatars. If you wish to revert to your original avatar, you will need to re-upload it via The Nest.
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Note: This only affects The Nest's community members and will not affect members on The Bump or The Knot.
Our tech team has launched updates to The Nest today. As a result of these updates, members of the Nest Community will need to change their password in order to continue participating in the community. In addition, The Nest community member's avatars will be replaced with generic default avatars. If you wish to revert to your original avatar, you will need to re-upload it via The Nest.
If you have questions about this, please email help@theknot.com.
Thank you.
Note: This only affects The Nest's community members and will not affect members on The Bump or The Knot.
It's open enrollment time...anyone making changes?
Just got an e-mail about open enrollment, I'm thinking of making big changes, anyone else?
I've been on a PPO plan (Prefered Provider Organization) for the last 6 years. But I'm thinking that switching to my employer's High Deductible Health Plan might be the way to go. here's my math:
PPO plan (me+baby)
Premium-$272.43/month ($3270 annually)
Deductible-$250-then 10% coinsurance
$20 pirmary care co-pay
$30 Specialty care co-pay
Max OOP individual-$2,250
Max OOP $4,500
Employer contribution to Flex spending account (use it of loose it) $250
Potential Annual cost: $7,770 (-250 FSA)=$7,520
HDHP (me+Baby)
Premium-$79.83/month ($958 annually)
Deductible-$2,600/per person-10% coinsurance
Individual Max OOP-$4,000
OOP Max-$8,000
Employer contribution to Health Savings Account (rolls over year-to-year)-$1000
Potential Annual Cost: $8958(-$1000 HSA)=$7,958
I'm considering the HDHP, realistically there is little chance that both I and Baby will need $16,600 worth of care ($2,600 deductable+remaining $1,400/.10) Well-child care visits are covered at 100%. At most I'm risking $438, but I'll more likely be saving several hundred dollars in premiums. I am not a heavy healthcare user. to date this year I'm $1,300 towards my OOP max-which includeds some $500 in labs and $300-400 in ultrasound charges, in the past I've never even hit my deductible on the PPO plans. so realistically I probably stand to save a few thousand dollars.
This is all assuming all care is "In-Network" but in the last 6 years I've never had a problem staying in network.
Me: 28 H: 30
Married 07/14/2012
TTC #1 January 2015
BFP! 3/27/15 Baby Girl!! EDD:12/7/2015
Re: It's open enrollment time...anyone making changes?
We don't have options on our plan, so open enrollment is pretty unimportant around here.
Our open enrollment ended in May, at which time I changed to a low deductible policy since we're TTC. Normally, I just go with the cheapest option but this year it made better sense, as I would have been able to get pregnancy and delivery care without paying anything but the premiums. But unfortunately I'm not coming out on the winning side of that gamble!
I don't have the new info for next year yet, but it is probably pretty similar to this years and I will keep it basically the same. A couple things I might look at are adding vision care and buy more life insurance under their plan. Though I seem to think that is not an option or I would have already done it, lol.
My company has two medical plan options, one of them is a High Deductible. I don't remember exact numbers, but these will be pretty close.
My employer contributes $500 individual/$1000 family to the HSA.
Assuming H remains unemployed he will stay on my HSA. He never goes to the Dr. and doesn't have any Rx so it is a no brainer for him.
@hoffse what does it look like with your HDHP as an individual? Is it possible that when you (in theory) will go on your H's plan to have a family that you would you actually make $ doing 2 health plans and staying at your work as an HDHP individual? It doesn't sound like it since your benefit is not tied to the HDHP. In my case my individual HDHP annual cost is less than the $500 they put in my HSA so in a way it pays to be on this plan even if it isn't used.
********** stuck in the box*********
My out of pocket max was $2300.00 (15% copay after $200 deductible) when I was pregnant. With my first I had one day of hospital observation, then four days admission for my planned vaginal turned c-section delivery. My entire pregnancy was all in the same calendar year and I still didn't meet my out of pocket max.
My second pregnancy was a three day stay for a failed VBAC c-section. Never reached my out of pocket max.
********* SITB********
My OB does the same. They contacted my insurance company to determine benefits and gave me a print out of my expected vaginal delivery and pre & post natal care. They also gave me the additional cost if I required a c-section. So by my 12 week appt, I knew exactly how much I was going to owe my OB.
Until this year the cost difference between the PPO and the HDHP was the same as the deductible difference. Meaning that if we had little or no health care issues, we made out on the HDHP. If we ended up using our insurance, we were no worse off with the HDHP than we would have been choosing the PPO option. Yes, I'm ignoring the pre-tax benefit of having the premiums taken out of my check. However, most years we rarely if ever use our health benefits other than wellness visits that would be covered at 100% anyway. Plus we have the HSA contributions with the HDHP that we wouldn't have with the PPO. Although, most small things we just pay instead of pulling from the HSA.
This year they raised the deductibles, so the math doesn't quite work out anymore, but again, we rarely see a doctor so I'm not really looking at what happens if I max out my OOP. The HSA is there if I need it and there's an investment option, so it grows on its own as well.
The only downside we had so far was that our OB put us on a payment plan to cover the expected deductible over the course of the pregnancy, but they didn't bill until the baby was born. Unfortunately, the hospital beat them to the insurance company. So we had to pay the hospital (we called and got a nice discount), and then call the OB and get them to refund the difference (they would have done it anyway, but by calling we got it done sooner). We also had enough money to float all this, so it was an annoyance more than anything else.
Just a thought to the poster who said they were using an FSA for contacts. If you have an HSA available, you can use it for contacts as well and you don't have the use/lose risk at the end of the year. Not sure what your other expenses are, but just a thought.