Does my PPO option suck?
I really struggle to understand insurance plans. The benefits offered at my work seems so similar that I'm having an extra hard time deciding. This is my options: https://ibb.co/PMJdnFn
I'm in my 30s. Physically active, but I have chronic back pack caused by early onset arthritis. I see a DO and acupuncturists at least once a month each. I'll need to see a PT too regularly. I also have a psychologist who monitors my mental health issues that I'll see every 1-2 months and am prescribed meds. I don't currently, but want to start seeing a talk therapist as well, but this is more of a luxury. All of this would just be co-pay though. I always go in-network so I've never reached my deductible or out of pocket max ever even during my worst year.
I'm trying to figure out if I should opt for the lower PPO or the higher one. Considering my back issues and thinking about possibly what I might need, x-rays and MRIs come to mine. The higher one does cover labs/xray fully, MRI is $150. The lower premium one covers 10% of x-rays/labs after deductible, 30% after deductible for advantaged imaging (MRI). But I'm wondering if opting for cash payment (not going through insurance) for those, which maybe would run me $1000, and maxing our my FSA is better than paying the premium of the higher plan which if I math'd correctly, comes out to $2,610.48.
Can anyone see a reason for choosing the higher premium PPO? I know when worst comes to worst, it'll be good to have the higher PPO. But it just seems like money down the drain opting for the higher PPO for "just in case."
The gamble with a higher premium thinking something might happen vs paying a low premium and hoping that you don't incur any major injuries/need surgeries always makes me anxious. I want to choose the better option, but I think the house always wins? Are there stats that show percentage of folks who actually come out on top opting for higher premium (without preplanning the year)? HR benefits people and insurance advocators haven't really been able to provide much help outside of their canned responses so seeing if anyone could offer insight from experience they have. Thanks
submitted by /u/Snoo_8616
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