Choosing new plan, am I oversimplifying with baby on the way?
Need to renew my coverage for the coming year and the plans my employer offers has changed. My medical costs are minimal (preventative yearly checkup) but my wife is 6 months pregnant with our first child. She is seeing a specialist on top of her normal OB for the pregnancy due to her age. She will be delivering 2 months into the new insurance term.
I'm breaking down the middle and high tiers which annually cost $3000 vs $6600 in premiums respectively. I'm trying to decide if the extra $3600 would be worth it when the individual out of pocket maximums only differ by $1250 (I'm assuming she will hit this max with her scheduled appts and delivery).
Yearly Cost: $3000 vs $6600
Individual Deductible: 2500 vs 1200
Family Deductible: 5000 vs 2400
Out of pocket individual 5250 vs 4000
Out of pocket max family 11200 vs 8000
Specialist visit 20% vs 40 copay
ER services 20% vs $200 copay
Urgent Care 20% vs 60 copay
Everything else presented in the plan comparisons is either the same or very close/similar.
Maybe I'm not giving the UC and ER coverage enough credit but in the past 10 years we've only used each one once. The way I'm interpreting the situation my wife will likely hit her out of pocket max of 5250 if we go with the lower plan, at which point she's covered, and we can save $2350 in premiums.
Any insights someone could share? I unfortunately don't have a way to see how this plays out once I add the newborn to the plan :\ I imagine the copays would be nice for the baby if ER/UC are needed but yearly premium comparison for the 3 of us would be $6100 vs $10.15k and I'm a little clueless what to expect with a newborn.
submitted by /u/whopsidoodle
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