Is this a bad plan from my employer? Should I do marketplace? (Newbie)
25F, will get off my parents insurance ($2k deductible) and I was originally going to do my new employers plan for 2023 bc they cover the whole premium. Can y’all help me decide how good/bad my employers plan they offered is? And if Ill get any benefit from choosing a Market Place plan over my employers plan?
$55,000 – salary on my offer letter before taxes/deductions $1,800 – paid twice a month on the 1st and 16th
What my employers plan is: ‘Medica with CHI NE 4000-50-100-50% Three for Free Silver’ (100% monthly premium covered by employer-idk what that is bc the papers don’t say I think)
Coverage for: individual Plan Type: PPO
Overall deductible: $4,000 per person in-network “Generally, you must pay all of the costs from providers up to the deductible amount before this plan begins to pay.
Services covered before I meet the deductible: Preventative care, preventative prescriptions, copayments, lab services and prescription drugs from in-network providers.
Out of pocket limit for this plan: $8,700
What is not included in the out-of-pocket limit? Premiums, balance-billing charges.
No referral needed to see a specialist.
If I visit a health care providers office or clinic: (In-network)
Primary Care: $50 copay. Deductible does not apply. Chiropractic: $50 copay. Deductible does not apply. Retail Health: $35 copay. Deductible does not apply. Virtual: no charge. Deductible does not apply.
Preventative Care/screening/immunization: no charge.
If I have a test: Diagnostic test: Lab-no charge. X-ray 50% coinsurance. Imaging (CT/PET scans, MRIs) 50% coinsursnce
Outpatient surgery: all 50% coinsurance
Emergency care, medical transportation- 50% coinsurance
Urgent Care: $50 copay
Mental health, behavioral health: outpatient-$50 copay inpatient-50% coinsurance
If I get pregnant: Office visits- no charge deductible does not apply Childbirth/delivery/facilities services- 50% coinsurance
No vision/dental
My teeth aren’t in the best condition so I’ll need to supplement dental care (also vision for contacts). Relatively healthy but I do see a MHNP for adhd/anxiety who will now be out-of-network.
