Employer plans – HMO vs PPO, Kaiser vs Health Net – how do you balance cost for a quality plan?

I’m a former stay at home mom returning to the workforce after about 2 years out. Selecting health plans now and quite lost, hoping folks can chime in. I’m in SoCal, 41 with no health issues, but had a difficult IVF/pregnancy/birth so I’m very attuned to good doctors. I went through that whole process on a fantastic United Health PPO plan so I’ve been spoiled.

I have some free HMO options that don’t look bad, if absolutely nothing goes wrong. Kaiser and Health Net both have very low doc visits and therapy copay costs ($10-25!!).

Then I have a slate of Health Net PPO options. I’m not a fan of Health Net but it’s what I’m working with. Silver plan for $100/year that’s shit (deductible $2500, PCP/specialist $55/90, therapy $55), Gold plan for $1400/year that’s better (ded $350, PCP/specialist visit $25/50, therapy $25), Platinum is much better obviously but prohibitively expensive at $2400/year! ($0 ded! PCP/Specialist visits are $15/30, therapy is $15). So here’s where I am, it seems the cost of entry into the PPO world is high, I’m leaning on the Gold plan which is $1400/year – that seems like a lot for an employer sponsored plan. And the benefits of the Gold as you see for basic stuff is more expensive than either HMO plans.

All middle aged, and older folks, what’s your 2 cents? Help!

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