Health Insurance options?
I have just graduated college and I am about to start a job that offers health insurance. However, I am clueless about what type of coverage I need. My company has plans with United Health and Blue Cross Blue Shields, but I don't know which one to pick. I have a 2 year old son, so I need something that will cover routine visits to the doctor and I also go to the doctor myself for regular checkups (i.e. pap smears). I would like to have emergency room coverage in case I have to rush my baby to the hospital in the middle of the night if something happens. I don't want to spend a lot of money a month (under $200) but I would like to have the right coverage for me and my baby. I an annual deductible is $2500, do I have to pay that out of pocket first before the insurance kicks in? I'm so confused.
You won't find parent/child coverage for under $200 a month. I pay $400 a month for just myself.
What you need to do is find out exactly what both plans cover and compare them side by side. After age 2, children generally only need one physical exam a year, as does mom - therefore, if it costs you less to have a $500 annual cap on routine care, it's worth it. (If your son was under 2 years old, I'd say look for a larger covered amount of routine care.) Some plans only have deductibles for hospital visits - from ER visits to Xrays. Some have deductibles for procedures - urine testing, blood tests, Xrays, etc. Some plans, usually with the cheapest premiums, have the deductibles. You need to find out EXACTLY what the deductible pertains to. (BTW - NEVER pay for any services up front - your insurance needs to be billed first - they will then tell the provider how much to bill you for - the insurance calculates how much and what goes to your deductible.)
You want to cover you and your son for under $200 a month? You'd never do it on a private policy.
Yes, the $2500 is out of pocket, before the insurance pays ANYTHING.
What you need to do is lay out both of the plan coverage descriptions, to see what's going to do better by you. Emergency room coverage ALSO has a co-pay, these days it's likely to cost you $100 a pop for your deductible, AFTER you've paid the $2500.
Answers:
Generally a deductible is the OOP (Out Of Pocket) you have to spend until the insurance pays, usually at an 80/20, now with group certificates that are through an employer, you still will have your doctor visits covered, and obviously your prescriptions.
How to select a plan, well, are they PPO's or HMO's, General PPO's you have to work within a Network of doctors, and an HMO you have to get referrals to other providers, HMO's are more restrictive. Does your doctor belong to a either of those plans?
As I am a captured Agent for United Health Care, I know the Network is across the country, but my personal insurance is with Blue Cross / Blue Shield, and I haven't had a single problem with it.
If you want more assistance on what to pick or compare the coverage, drop me an email.
Blue Cross is well recognized. That's what I had with the State of Florida and now have as a supplement to Medicare. They are kind of expensive, but well worth it. It is a PPO (Preferred Privider) not an HMO (managed care) which I wouldn't have on a bet. I don't know anything about United Health.
Yes, if your deductible is $2,500. you have to pay that first out of pocket.
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That depends. Some plans have a deductible, but still have "first dollar benefits" under a co-pay before the deductible is met. For example, it may cost you $25 to go the the doctor, and the ins company pays the rest. The same with prescriptions.
I will tell you that in my state, United is richer in benefits than BCBS. And, the ER costs you $100 period. There is no deductible that applies.
Take some time to go over everything with the agent or the HR person at the job. They should be able to answer all your questions about their specific plans that are offered.
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Yes, the $2500 is out of pocket, before the insurance pays ANYTHING