November 2008 Weddings
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.
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.
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.
Anyone Good with Medical Ins?? WWYD
So, DH and I currently have the first section of the medical below. We have until the 31st to decide if we want to change to the upgraded second tier. The monthly difference will be $74 until baby is here, then will be $106 more per month (emp + spouse opposed to emp + family). The OB will be $1800 and the minimum amount the hospital will be is $3500 (C Section it goes up to $10,000 plus anesthesiologist etc). So, if I have the hippy midwife med free delivery that I want, we could stay with the ins we have, but in the event anything goes wrong, should we upgrade? Once we select the higher coverage, we cannot change it until next Dec, and it is a lot out of pocket each month. I am sure this is simple math for someone, I am however mathmatically challenged.
|
Annual Deductible (Single / Family) |
$500 / $1,500 |
$500 / $1,500 |
N/A |
$250 / $750 |
|
Coinsurance |
Carrier pays 80% / You pay 20% |
Carrier pays 60% / You pay 40% |
Carrier pays 90% / You pay 10% |
Carrier pays 70% / You pay 30% |
|
Annual Out-of-Pocket Limit (Single / Family)
(Deductible Excluded) |
$2,000 / $4,000 |
$4,000 / $8,000 |
$1,000 / $2,000 |
$2,000 / $4,000 |
|
PCP Office Visit |
$20 co-pay |
After deductible 40% |
$15 co-pay |
After deductible 30% |
|
Specialist Visit |
$30 co-pay |
After deductible 40% |
$25 co-pay |
After deductible 30% |
|
Lab & X-Ray |
After deductible 20% |
After deductible 40% |
10% |
After deductible 30% |
|
Specialized Scanning (MRI, PET, CAT) |
After deductible 20% |
After deductible 40% |
10% |
After deductible 30% |
|
Urgent Care |
$30 copay + 20% |
After deductible 40% |
$25 copay + 10% |
After deductible 30% |
|
Emergency Room (Waived if Admitted) |
$50 copay + 20% |
$50 copay + 20% |
$50 copay + 10% |
$50 copay + 30% |
|
Inpatient Hospitalization |
After deductible 20% |
After deductible 40% |
10% |
After deductible 30% |
|
Outpatient Hospitalization |
After deductible 20% |
After deductible 40% |
10% |
After deductible 30% |
|
Prescription Drugs (30-day supply)
Generic
Preferred Brand
Non-Preferred Brand |
$10 co-pay
$30 co-pay
$50 co-pay |
Not Covered |
$10 co-pay
$30 co-pay
$50 co-pay |
Not Covered |
|
Mail Order (90-day supply)
Generic
Preferred Brand
Non-Preferred Brand |
$20 co-pay
$60 co-pay
$100 co-pay |
Not Covered |
$20 co-pay
$60 co-pay
$100 co-pay |
Not Covered |
|
Bi-Weekly Rates
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family |
$14.54
$30.95
$27.62
$45.50 |
$31.49
$67.04
$59.80
$98.52 | ||
Re: Anyone Good with Medical Ins?? WWYD
We just went through all of this with our insurance and I got some great advice from my HR about which to choose. If I were you, and given the baby coming into the picture, I would up the plan. The no deductible, low out of pocket, lesser copay, and STILL at a fantastic price is a great deal.
Mine is 3 times that for a "family" plan and D's is almost 4 times that.
OMG, are you serious?? The team always says that they offer great ins, but since I didn't pay for mine before I guess I was jaded.
If it were me, I would. I also go to the doctor a lot, and so will Hunter. He's already had two extra trips to the pedi in addition to the normal ones and we've already seen the savings from upgrading our insurance.
Also, even with a natural vaginal birth, the hospital stay is expensive in itself. I paid $70 for a tube of hemmerhoid cream. They charge you for everything. Add the "unexpected" in to that - an extra visit from the ortho doc to look at my tailbone and we already had significant savings from upgrading.
The unexpected happens a lot, especially with babies. So even if you do have a great delivery, that barely costs anything, you'll probably be using your insurance A LOT with the baby coming.
I am a fan of more coverage, if you can afford it. In my profession I see more people that are sorry they don't have enough insurance. I've never seen somebody say they wished they had less.
I don't know your situation, but I would upgrade if you're going to have a big medical year (and you are since you're having a baby). J and I upgraded our plan last year because we knew I was probably going to need surgery and it was the best decision we made. Yes, our monthly payments went up but our copays went down and there were so many extra doctors visit that it was worth it. And things do go wrong. My hopsital bill was through the roof because of all the issues I had, but it ended up being covered under the upgaded plan.
Great, thank you so much girls, you helped me make up my mind. I am at a loss when it comes to these things. I have to admit though, I also made a spreadsheet and had my COO (degree in finance and econ) crunch the numbers for me.
Karrey, that is great ins! Reminds me of the good 'ole Kaiser days. You can say what you want about them, but I never paid for ANYTHING when I had that ins.
This is definitely not included in the babycenter.com baby cost calculator! Note to self to keep part of our "baby budget" for random expenses like that.
I agree with pp about upping your coverage.
DH has really good insurance, and it went up a bit this year, and our coverage went down somewhat, so I am a little disappointed in them, but its still pretty fabulous insurance. And what you have to remember is that employer provided health insurance comes out before taxes (and therefore reduces your taxable income). I made him up to higher insurance when we got married- b/c I knew we would need it when we had babies. My D&C was almost $8000. We didn't pay a dime of that- b/c we had the higher level of coverage.
I once had a job where my health insurance went from $28 every 2 weeks to $80 every 2 weeks when my company was bought out. There was a very insignificant change in my paycheck. And DH was surprised at how little change there was in his check when he added me and we went to the higher coverage option.