Thanks in advance for any assistance that can be provided.

Clearly I’m cutting the deadline close here but I have been struggling trying to decide between which plans as this is the first time I’m enrolling in insurance so it’s all fairly foreign to me, and is seriously becoming overwhelming.

I think I’ve narrowed it down to 2 policies:

Plan 1) deductible $17,600. Out of pocket max $18,200. Emergency visit 50% coinsurance after deductible. Drugs: $25 copay after deductible. Primary Doctor $40 copay. Specialist $80 copay.

Plan 2) deductible $12,000. Out of pocket max $14,200. Emergency visit 50% coinsurance after deductible. Drugs: $25 copay after deductible. Primary Doctor 50% coinsurance after deductible. Specialist 50% coinsurance after deductible.

Monthly premium difference to pay between the policies is only $8 more/less.

So what I’m gathering from reading things online/plan brochures: for plan 1 (copays) most visits will not apply to deductible if it’s the copay option. I understand from plan 2 (coinsurances) I’ll pay 100% of the costs until the deductible is met. So in theory will plan 2 be about the same as being a self-pay patient until the deductible is met?

With all of that said here’s my biggest struggle: which one makes the most sense? Pay more out of pocket to have the less deductible (plan 2), or have the copay options with the higher deductible (plan 1)? Is ~$6k difference in the deductibles significant when it comes to insurance? On average should I expect to reach the $12k deductible (plan 2) where the insurance would then start to cover visits/care?

See also  Facility Component Charge

A few things I’m trying to consider in my decision: I rarely go to the doctor to begin with, and I’m rather healthy so I don’t foresee starting to go to the doctor any more often than my annual checkups I’ve been doing and paying out of pocket for. I did have a baby this year, so most visits will be for his checkups etc. If I am able we will be trying (possibly) to have another child 2023/2024. With that said does the lower deductible make the most sense if by chance I were to give birth next year?

I think that covers everything. Thanks if you’ve made it this far in my long post.