Copay vs No Copay plan through employer, need some toughts.
I am currently working at a multi-million dollar manufacturing company as a full-time office worker. Like most Americans, my employer offers benefits such as free healthcare, vision, and dental insurance. The renewal period starts in September, and once we choose our plans, we're locked in for a full year. We can’t change or drop our plans unless we leave the job and are rehired.
When I first got the position, I was enrolled in a copay plan, where I paid around $53 in premiums every two weeks, automatically deducted from my paycheck. However, I haven't really used it.
During the last full cycle, I opted for a no-copay plan, which requires me to meet a $1500 deductible before the insurance kicks in. After that, I pay 20-40% copay until I reach the out-of-pocket maximum of $2500. This wasn't an issue for me this year because I had an auto accident. The at-fault party covered all the costs, and I reached my limits without worrying about extra out-of-pocket expenses.
However, I have been dealing with psoriasis for several months. It’s typically managed well through telehealth with a dermatologist, which costs $10 per visit under our insurance, and an ointment. Recently, my condition worsened, and I had to visit urgent care for immediate treatment. Now, I have an appointment with a local dermatologist next month for an initial visit, which will likely require long-term care.
The new insurance period starts on 09/01, meaning my deductible and out-of-pocket maximum will reset to zero. Given that I haven’t had many health issues or hospital visits, except for this recent flare-up, I'm uncertain about which plan to choose.
Should I opt for the copay plan, paying around $110 per month? This plan includes $25 for regular PCP visits, $50 for specialist visits, $50 for urgent care, and 30% coinsurance for hospitalization, surgery, or high-cost medical activities after meeting a $1000 deductible, with a $2000 out-of-pocket maximum. whereas, free plan is simply i pay 100% until $1500 deductible, then 20-30% coinsurance until $2500 out-of-pocket maximum.
I know it might seem trivial, especially considering the worse health insurance situations others face, but I need some advice to make the best decision. Can you provide some insights and recommendations?
submitted by /u/Life_Ad_5287
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