New job insurance tiers
Hi,
I just started a new job and chose the PPO option for my insurance. I want to make sure I am interpreting it correctly and would like to know if it provides good coverage (I am dumb about the health system/insurance).
It is a BCBS PPO with tiered benefits and I am single, so it’s just me. Tier 1 is the best and then is goes down from there for the next two tiers, the third tier is out of network. I want to make sure I understand the tiers. Plan details:
Premium: I pay $68 biweekly, my employer covers the rest ($1,768/annually for me)
Tier 1:
Deductible: $500
OOP Max: $2,500
PCP/Specialist Copays: $20/$40
Co-insurance: 90/10
Tier 2:
Deductible: $1,000
OOP Max: $3,000
PCP/Specialist Copays: $30/$60
Co-insurance: 70/30
Tier 3 (Out of network):
Deductible: $2,000
OOP Max: $9,000
PCP/Specialists: 40% co-insurance
Co-insurance: 60/40
So, the way I am interpreting it is, say I keep all of my care in the first tier by using tier 1 providers exclusively (there are actually a lot of providers in the tier 1), the maximum I would have to spend in a year with the cost of the premium out of my paycheck is $4,268. For tier 2, $4,768, and for tier 3, $10,768, is that correct? Would this be considered average/good coverage?
TIA