Question Regarding Choosing Marketplace Health Insurance
I am trying to understand why anyone would choose some of these very expensive insurance policies.
I am currently changing jobs and the new employer does not offer benefits. After searching for a plan for several weeks for my family, I’m fairly sure that the best policy for us is this one, which also happens to be the cheapest. Keep in mind that I have a wife and two kids, and lets just assume that there are plenty of doctors in my area (NJ) and we are not too picky on which ones we receive care from.
Amerihealth IHC Bronze EPO Silver HSA Advantage Premium – $380 per month (After tax credits) Deductible – $6k / $12k Maximum out of pocket – $8k / $16k
If I go with this policy, and I use doctors within the policy network, I have a total potential exposure of $20,560.00 (Premium + MOOP)
My question is, why would I (or anyone) choose one of these other Gold or Platinum policies with premiums that are $3,500 per month AFTER my tax credits?
For instance, this is another policy on the marketplace
Amerihealth Gold EPO Premium – $3,606.00 Annually (After tax credits) Deductible – $1700 / $3400 Maximum out of pocket – $7k / $14k
What is the advantage here? Why would someone pay $43,272.00 per year PLUS the potential for an additional $14,000.00 in out of pocket costs if they can choose a policy similar to the bronze? Is it JUST so they can see the doctors they prefer and not have to worry about referrals? I suppose if they have certain prescriptions too, but I still can’t wrap my head around this.
This same theory applies for all of the other policies in between as well. The one advantage I found is one or two policies in the $600-$750 per month range that offer doctors visits, specialists visits, and a wide variety of other services for a $25-$75 copay WITHOUT first hitting your deductible.
My wife and I Discussed paying a little extra in monthly premiums for this convenience of having cheap and easy doctors visits. We also thought we may be less reluctant to go to the doctor if we knew the visit would only be $50. However, after looking at this again and again, it simply wouldn’t be worth spending a guaranteed $350 a month in premiums just for that convenience.
Help me make sense of these “higher quality” plans. I just want to make sure that I am not missing something critical before making this decision because this seems crazy to me.
submitted by /u/AnalysisMinimum5762
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