Upstate NY Nesties
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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.
Help us choose health insurance!
We have a 90 day wait, but not sure how to choose which option is best for us!
Excellus Healthy Blue is offered, either the copay and deductible plan(#1) or the high deductible health plan(#2).
#1 is $1000(ind)/3000(family) deduct
#2 is $2600/5200 deduct
#2 is $52 cheaper per week than #1
#1 has copays($25/40), #2 does not (subject to deduct) Although both plans preventative care is covered 100%
#1 has 80% coverage for maternity, #2 is 100% (we do hope for more children)
The hospital coverage is the same as maternity above.
Any other info needed? Is a high deduct a bad thing for healthy people?
TIA for any help!
Re: Help us choose health insurance!
the husband and I are currently on a high deductible plan - we have an HSA, which pays for most of the stuff we need to spend: co-pays, precriptions, etc...but things get kind of expensive - I have to pay $30 a month for BCP (as opposed to $5 a month when I was on MY companies insurance)
but he said once we are ready to have kids (prob 2011-2012), we are switching to a lower deductible plan...
I know you said all preventative care is covered, but is that just the office visit? what about lab work, prescriptions, eyeglasses, dental (if its all lumped together), etc.
I think that you need to plan it out based on what you can immediately afford. If you had to go to the emergency room tomorrow - could you afford a $5200 bill all at once? That sounds extreme, but one emergency room visit can definitely cost that much
dental and vision are separate and a different insurer.....although this plan shows vision as well so IDK.
scripts are 5/35/70 and 0 for kids up to 19.....they are not counted towards the deductible as far as I can see.
diagnostic labs and path are covered 100%
plan max out of pocket is 3000/9000 for #1 and 5500/11000 for #2
Good point about paying the high deduct all at once if needed, although that is for family. So, if I went in it would be $1000 or $2600 (individual deduct) right?
On the high deductible plan, once you hit the deductible of 5,200 everything is covered 100% (and meanwhile maternity and preventive care is covered 100% along the way)?
Then I'd say go for that plan and save the $52/week. You can always change during open enrollment time, and reassess what your needs are then.
I opted for the Basic vs Enhanced coverage here at work because even though I have a higher deductible and copays, there's always the out of pocket maximum to protect me in case of a catastrophe. I'd rather have the extra $$ up front in my paycheck.
No - you would be under the family plan - individual is if an unmarried person joins the plan with no dependents.
I think if you go with the high deductible plan, then you should take the additional $52 a week and put that twoards a Health Savings account - I think the HSA is tax-free or tax deductible (i can never remember the difference), but then you have the money for health related expenses, should they arise.... If his work doesnt provide a HSA, you can get one through your bank, I think.
Hm, that is odd.....our current plan through dh's previous employer had it broken down as ind/family. We each had our own deduct and the family had a combined total.....I had reached my deduct by the time ds was born (we had very low deducts) and my hospital stay was covered at a certain % because of that. However ds's was a new addition and he had to meet his own deduct (the family deduct had not been met because dh never goes to the dr) before things were covered. His nursery stay and circ balance was due to having to meet his deduct. GWIM?
I guess dh needs to make a phone call!
Thank you for the info though, gives us some things to look at!
How bout prescription coverage? I really don't know what I'd do. As for maternity.. its 100% only after the deductible right?
Insurance is so confusing.. Ours the insurance pays the first $1000 (preventative services and everything counts against that) then we have a $1000 deductible for everything except EVE'S well visits (We still pay for our yearly visits).. and then we have a 20% copay after that. We have no prescription coverages except for generics which is pretty pointless since so many places have the $4 generics now.. That is a big problem for us.
m/c 1/2/08 and 3/12/08
Eve Amelia- Born 2/24/09. 6lb 9.9oz
Natalie Ruth - Born 6/13/11 7lb 6.6oz