Switching From Parents HMO to My Own

Turned 26 and now I have to figure out my health insurance. I've been on my mom's and didn't realize how good it was until I just started looking at what my company offers.

My mom had an HMO plan with 0 Deductible and a 3000 oop maximum, now I have no idea where to go with my own since all my plans deductibles range from 1200-2000 with oop ranging from 3k-5k. I have a THP and two HDHP offered.

I really only visit an allergist usually once a quarter and have monthly visits to get allergy shots. Aside from that I'll visit my pcp once a year.

So a few questions :

On my currently EOB I see I get a "plan discount" which brings my allergy Shot visits down to 10 dollars, my co-insurance kicks in and I pay 2 dollars. So now on my new plans do I still get the "plant discount" or will I have to pay the full 50 a shot that is billed?

Now copays/co-insurance do I need to hit my deductible to visit a specialist and get it covered? Last year I did do the allergy prick test which came out to 2000, my plan discount was 1200 and then I just paid my 20 dollar copay. Does this now mean with my deductible I'd have to pay 800 when I do it again next year (assuming the plan discount is the same)?

Last up is pharmacy. On the traditional plan I have a 100 dollar deductible and and then it kicks it. On the hdhp it says my deductible goes towards the health plans, but this does not include preventative drugs. So I have nasal spray, and an epi pen. Does this mean I now have to pay for those both out of pocket if I get the hdhp?

See also  Ambetter Peachstate Healthcare Georgia

submitted by /u/OldAmber
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