Cincinnati Nesties
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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.
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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.
Health Insurance
We are trying to figure out our health insurance for next year. We are currently still on our own policy through each of our employers.
How do you go about deciding on
a) if we should go together
b) who's employer we should go with
or c) continue to stay on seperate policy's through our own employer
I've always hated figuring this stuff out. Do we decide soley on the cost? I feel like I never understand what exactly it covers other than like office visits. Plus only God knows what's going to happen to us in the next year.
Any help, advice, tips??
Re: Health Insurance
We go on out of pocket costs. When my husband was employed and could get insurance through his work it would have cost him a few hundred a month. But if I added him to my plan it would only be and extra $25 per month. So that's what we went with. Of course it doesn't really matter now that he is out of work. But I don't have to pay the extra $25 since he doesn't have insurance through an employer.
Make sure you look at if or how much your respective companies would charge to add a spouse who could get insurance elsewhere. And if you do that, how much your company gives (if they do) for declining insurance.
Compared each plan, how much each would take out of our paychecks, plus coverage.
For ours it was easy, the coverage was pretty similar, but DH's took significantly less out of his paycheck than mine would have. So now we're all on DH's.
I would definately look at more than just out of pocket cost. For instance you will want to compare plans if they are High Deductible plans or if they are more "traditional" PPO plans. One may be significantly cheaper per month but may not have coverage until you meet a certain deductible which would mean that you would pay EVERYTHING out of pocket until that deductible is met which could benefit you if you don't go to the Dr, but if you use your insurance much it could wind up costing you a considerable amount of money!
Another thing to look at is if one of your companies charge additional for a spouse if they have access to other coverage. My company charges FULL premiums for the spouse if they are able to get coverage through their own employer but still choose to go on to our plan. I want to say its an additional $300-400/month if that is the case.
So far I don't see any wher on either of our insurances that it would charge and extra amount if adding a spouse that is declining insurance else where.
Also does anyone know anything about HMO's compared to PPO's. DH said he's always heard that HMO's are better but from what I've read online it seems only certain doctors will accept it and you have to get referrals for everything. I also read somewhere that HMO don't have deductibles but the HMO DH currently has does have a deductable.
We did the comparison by which doctors were covered since this was very important to me, then we looked at the monthly cost for each. Once we saw the difference and the increased coverage - even with a working spouse fee it was cheaper for us to go through dh's employer and me to decline mine.
Its a mess - but worth looking at.
We do C, we're each on our own employer's policy, b/c it's the cheapest option. This year they allowed us to purchase our eye & dental alone vs bundled with the health, so I put dh on my eye & dental-still cheaper than what he'd pay through his job.
I only have one choice of insurance through my job. DH has a choice of 3 or so policies. The one he chose has a really high deductable but it's cheap. He just about refuses to go to the doctor so a high cost, low deductable plan would be a waste for him. He has a strong family history of colon cancer so he needs to get a colonoscopy when he turns 40 (in 14 months). I'm going to figure out if he'd be better off with his curent plan or something with a lower deductable before he has the test-and I will make him do the test! I'm also going to re-evaluate our insurance when I get pg so we can choose the best plan (or even put me on both plans so I can have double insurance).
So anyway, my opinion is to decide on cost unless one of you has a medical condition (diabetic, etc) or you plan on a big life change like having a baby.
It all depends on usage, as many people have touched on. Whoever has the lower copay would be the best option of the monthly/ weekly costs are similar. Also, a lot of times (unless your employer is going to charge you 100% of the premium to add spouse who is eligible for coverage elsewhere) it may be cheaper to join the plan that seems more expensive because a higher upfront cost USUALLY means stronger coverage that helps you save in the longrun IF are going to actually go to the doctor routinely.
Another thing to look for is the term "embedded" when it comes to deductible, especially if you have a family. Typically deductibles are written as $5,000 individual, $10,000 family. (or whatever numbers they may be). Let's say the entire family was in an accident, have the "embedded" coverage means that MOST the family is on the line for is $10,000...not $5,000 x each family member. So, if one person's cost are 5,000, another is 4,000 and last 2,000...you aren't responsible for all because you've exceeded 10,000$. Seems high, but doctor's bills add up so quickly!
Lastly, you do NOT want to wait until you are pregnant to combine coverage. Most insurance companies will consider it a pre-existing condition and not cover all expenses off the bat. Some companies even have 6 month clauses written in where if you become pregnant in that beginning time they are not responsible for coverage.
I know a lot of it is confusing. I only know becuase I administer our insurance for work. If you would like to send me the details of your plan, I will give you my friendly, non professional opinion.
For us, we compared not only the out of pocket expenses (like our yearly deductible), but the premium taken out of DH's check. We recently changed our insurance due to an additional member next year. But, we chose to go with the insurance where DH had more taken out of his check, to lower our deductible. Since the premium would be taken out pre-tax from his paycheck.
Also, DH works for a major corporation, so they have better insurance options. My company has maybe 50 employees, so we figured his was the best bet.
One thing to add - some companies charge "working spouse fees" if you or you husband is still eligible for coverage at your companies. So, really it could be cheaper to just keep your own plans.
I hope my ramblings have helped some!
We went based on cost at this point. My husband and I each have our own seperate insurance due to cost. He is a PhD student at UC and his program offered to pay for his so obvious free insurance for him was something we wanted to take advantage of. Though at my company is it costs the same for a family of two as it does for a family of four so even if we had to pay for his through UC it is still cheaper.
However I will point out I work in healthcare and there are lots of things to try to look into because private insurance coverage is not all created equal. One thing that can stink about my coverage is that it doesn't cover preventative services such as an annual pap. Also many companies require preauthorization for various services (calling ahead with TONS of information). Another weird thing is not only do they just cover specific docs but they may only cover some of his/her offices. For instance if you have a procedure from a doctor that is covered but say he spends 3 days at Good Sam but then goes out to Mason the other 2 days. That Mason office may not be covered even though the doctor is.
I would say try to read the explaination of the coverage and talk to your HR department. I agree with the other girls about the pregnancy coverage. Traditional vaginal births cost a lot more than what you expect so private insurance try to avade paying for it, if possible.
We are each on our own plan. I have a high deductible and he has a more traditional plan. His is paid 100%. Mine is paid 90% plus I am giving 1000 toward my 2000 deductible. On top of that my yearly is free as are physicals and other preventative care. For him to go on my plan it would double the deductible and the company only covers 85%. With his we would have to pay for all of mine.
Plus, we both understand our own insurance already. Makes it a lot easier. If we were planning on kids we would probably look at it differently...If I would choose to go off my health insurance at work they would give me a raise. Something you might want to look into.