Health Insurance Sign up time again

RoadTime

Veteran Expediter
Owner/Operator
Pick a plan, any plan...

Time once again to make a health insurance choice for next year.
I'm going back and forth between two plans. Decided to upgrade from my high deductible insurance from the last two years, which basically cost my nothing to have. But I also didn't use it or need it. So that worked out.

Knowing I'm going to need to utilize some healthcare next year that may get a little pricey, is why I really want to upgrade my insurance. A preemptive protection strike, plus peace of mind for if some unexpected mishap should occur that could leave me in a lot of debt.

Both plans are about the same in general.
Plan A- Would be the best overall choice cost wise, but I want Plan B for other reasons.

Plan B- Gets me the doctor I want, and is only 1 mile from my home. I would be more inclined to use it. There are other personal reasons I'd rather not go to the Plan A facility unless I had to, that I don't want to get into.

The Plan B premium is $200 more a year, so not a huge sticking point. But the kink is on the out of pocket co-pays/co-insurance being twice as much.

Sometimes it helps me to just write stuff out like this (kind of thinking out loud) and something will click ;)

After going over the plans for longer then I would like, while writing this, I did come up with the one main question that will help the decision.

What exactly happens when I reach my out of pocket limit for the plans? They both say, "The out-of-pocket limit is the most you could pay in a year for covered services". But what does that really mean?

Both plans are pretty close on the limit.
Plan A $700 Max
Plan B $775 Max

Does co-pay/co-insurance stop when the max limit is reached?
If so, it would not really matter and I would just go with Plan B.
But if they continue at twice the amount of Plan A, then I would have to give that more thought.

Well, I at least have a main question now.
But will have to wait till tomorrow for the answer as they are closed :rolleyes:

Have you already signed up, changed, or declined coverage for next year?

P.S.- According to my current high deductible plan the monthly premium on it is going up by $56 :eek:
 

RoadTime

Veteran Expediter
Owner/Operator
After talking with the insurance rep about the details for plan B, I was very pleased with the answers.
So I picked Plan B.

It will be nice to have good usable health insurance again. If anything, a nice peace of mind knowing that future expenses will be capped with out breaking the bank :rolleyes:

I've obtained my insurance through the Marketplace since it's inception. This was the first time I've used the insurance rep to complete the process. I must say using the rep directly was much easier and faster, then doing everything through the exchange.

Pretty happy with the decision and process :)

Now, I just have to stay healthy until January 1st ;)
 
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robin280

Seasoned Expediter
Out-of-pocket means just that. I have "Obamacare insurance" also. Last May, I ended up in the ER in Raleigh, NC. I live in Illinois. You also need to make sure you have out-of-network coverage on your health insurance. My bill ended up being about $5400, and insurance paid all but $1530 of it. My out-of-network and my in-network deductible and out-of-pocket were both $1750. After that happened, all of my medical expenses were absolutely free including prescriptions. I just filled out paperwork for financial assistance with the $1530 to try to get that amount reduced. My premium for 2018 insurance was about $130/month.
 
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RoadTime

Veteran Expediter
Owner/Operator
With the dead line a few days away, I begain to question my new healthcare plain choice.

Glad I did.

After reading how some of the exchanges and insurance company's information may not be current or updated, big surprise :rolleyes:
I called the doctors office to verify coverage.
Turns out my chosen B Plan insurance is not accepted by them. And the accepting new patients part is extremely limited as far as who they will take. After reading reviews about several people being turned away after showing up for the first appointment, I didn't like how this was looking. Not to mention it takes about 6 weeks to even get a appointment. Not exactly the easy access to my doctor I was use to ;)

So I switched to plan A, keeping my current doctor (who I have no problems with, just had other reasons for wanting to switch), save a little more money, and will just have to deal with the reasons I wanted to switch. Didn't really want to start from scratch with a new doctor anyways :rolleyes:

So just a word of caution if changing plans or doctors.
Verify any information given before committing. In my case, even the actual insurance company I was changing to, didn't have all the facts o_O
 

RoadTime

Veteran Expediter
Owner/Operator
Ahhh, tis the season again for open enrollment :rolleyes:

I already received my letter that my rate and deductibles were both going up (again), no surprise there.
Time to pick another plan to bring the rate back down.

What was a surprise is for the first time, I don't qualify for good old Obama care o_O

I sure didn't make too much money :confused2:

Apparently, my income is so low (poverty range) that I'm being referred over to Medicaid :oops:
There is no question, financially, the last year has been horrible for me. I was just a couple of weeks away from going under earlier this year. But somehow survived.

Funny thing is, I don't feel like I'm in poverty, despite what my business reports scream at me each month.
Maybe I've just gotten so use to being a minimalist/have not, that I don't notice it much.

All I know is that the thought of qualifying for Medicaid was a huge gut punch/ego blow, and I didn't want anything to do with it.

24hrs. after the news. I chilled a little, and will just see what happens with the State, and explore other options.

But really, it's just another confirmation that I need to get the hell out of this business,
before it's too late :dash2:
 
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