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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.
Who knows health insurance!!
I'm comparing Ameri healths IHC Preferred Plan which is $522 a month to Horizons Individual Direct Access plan C 100/70 which is $370 a month. Ameri healths Plan is an HMO and Horizons Plan is a POS. Can someone explain to me one from the other b/c they both look the same to me and it's a big price difference. I don't go to the Dr's very often but I want something with good maternity care for the future.
I think I may have asked about health insurance before but I've come to this two and I'm stuck
TIA
Re: Who knows health insurance!!
I don't know a terrible amount about health insurance, but I just chose my benefits with my company.
If I were you I would stay away from HMOs. They are really expensive and they make you go to certain doctors in their network. If you do want to stay with it and you have set doctors right now then I would make sure that they are covered under the HMO.
I chose a United Healthcare plan that is similar to the POS. It offered everything I needed and since I have doctors that I love, I am allowed to see them with this plan.
I guess it really comes down to personal preference, but since you don't go to the doctors much (just like me) and there is such a huge price difference, I personally would go with the Horizons Plan POS. Just my $.2
Is there any way you can e-mail me the plan summaries for these plans? I do employee benefits for a living, so I look at plan summaries quite often and I might be able to point out some differences for you.
In my opinion, an HMO isn't that bad. An HMO does not have a deductible as well, which in your case, can be a huge plus. A POS plan can carry a deductible, especially if you go out of the network and you go to a specialist without a referral and that deductible can be quite a bit of money. If you don't go to the doctor that often, then an HMO might not be as inconvenient as people make it out to be. It's not like the old days where you would have to go and pick up your referral. Most places do them electronically now.
If you want to e-mail me the summaries, my e-mail is abuszka83@ gmail dot com.
I just emailed you.....
and both plans don't have a deductible....I was gonna go with a plan with one b/c they are cheaper but I think on the line of maternity converage I would end up putting out the $2500 deductible and a 20% co insurance for delivery so it would cost me over $3000 where I could just pay the extra $100 a month in insurance coverage and not have to pay anything.
Is the POS less money monthly because you will have a deductible to meet? The HMO should have no deductible to meet. Look at the plans carefully. If you have a deductible to meet then you have to weigh the consideration that you might not meet it and may end up paying for your care out of pocket essentially.
Growing up, my dad had a deductible to meet. There were five kids in our family so he probably didn't have a problem meeting the deductible. However, he had to pay for our care out of pocket until the deductible was met. If I am not mistaken he had to then pay out of pocket when the deductible was met and bill the insurance company who then reimbursed him the coverage amount or something. I don't think POS is so drastic but it is something to consider if you have to meet a deductible. You will have to have the cash flow available to see the doctor, etc.
What about emergency room deductibles? That's what I always look out for, because thats the most likely way for me to fastly rack up a high medical bill. I really liked that with my HMO all emergency room visits were $xx dollars, no matter if I had a bee sting or was hobling in on one leg. If I knew that I had to spend $7,500 oop before submitting things to insurance company I'd be would likely sew my own fingers back on at home.
In my personal case I've always gone with an HMO and never had any problem. Right now I'm on a PPO b/c thats the only option my company has besides some lame flexible spending account.
I have the same insurance as Jaci...United Healthcare. No deductibles and I don't pay anything out of pocket for in-network docs as long as my $1800 pot of money isn't depleted. After that, I pay a 10% up to a certain deductible amount.
H has Blue Cross Blue Shield and he seems to like it. I don't know the specifics, but he broke his leg, got a bill for $75k and only had to pay a few hundred dollars.