Does switching to a more expensive plan, in exchange for a 0 deductible, make sense in my situation?
I don’t get health insurance offered through my job so I’ve been using MAhealthconnector and I’ve had Tufts HMO bronze for years.
This year I was diagnosed with narcolepsy and started talk therapy as well. Thankfully, my EKG/sleep study used my deductible very fast and I’ve only been paying co pays most of the year. My current insurance is $330 a month with $2850 deductible
Now that the new year is here I need to look at insurance for 2024. I was looking at a $525 a month, 0$ deductible plan from Blue Cross bc I think having a higher monthly payment outweighs the deductible from tufts. I’m thinking this makes more sence and I was hoping for a second opinion here.
Here’s why I want to switch:
I am expecting to try a new medication for my narcolepsy in January. but it is brand-name there’s no generic and it’s new called Lumryz. it’s hella expensive out of pocket (like hundreds if not thousand or dollars.
I also go to talk therapy 2x a month. That’s $150 a session or $300 a month.
So let’s say I switch to Blue Cross. If they approve the new medication, id only pay the copay of $100 every refill, and $30 for therapy. If I stay on tufts, therapy alone would have me reaching the deductible in about 9.5 months, not including any medication copays.
I’m thinking in the long run it’ll save me more money with Blue cross. Does that seem to make sence?
Also dumb side question. Let’s say BC doesn’t approve the meds. The out of pocket max would be what I pay the most even if it’s not covered right? I don’t think I’ll have a hard time getting it approved but who knows.
Thank you all!
Edit to add. From Massachusetts, make about $60k yearly
submitted by /u/TryingNotToGoCrazy48
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