A couple years ago you guys helped me pick a plan – I need your help again
I chose the deductible plan in 2021 and have had that plan for the past two years. This year the deductible and copay plan options have changed. I can’t include a photo but below are the main comparisons. I live in FL.
Copay premium: $154/month or approx $1,850/annual
Deductible premium: $133/month or approx $1,595/annual
Copay PlanDeductible Plan$1,250 deductible (no contribution)$2,000 deductible w/ $500 contribution$4,250 OOP max$5,000 OOP max80% coinsurance for everything including imaging/lab90% coinsurance after deductible for everything$25 copay PCP/Physical therapy90% coinsurance after deductible$50 copay specialists90% coinsurance after deductibleInpatient hospital – 80% after $500 copay and deductible90% coinsurance after deductible$300 copay ER visit90% coinsurance after deductible$150 copay Urgent Care90% coinsurance after deductible
Due to health issues I have to plan for some sort of procedure every year and an average of 50 doctor’s visits/year with some specialists. I am also considering getting pregnant so a hospital stay is a concern (am I crazy or what, LOL). In 2021 I did hit my OOP max due to a surgery. In 2022 I have spent about $1,800 so far towards my deductible (this doesn’t include what I spent in premium) so nowhere close to the current $4,000 OOP max, which will increase to $5k in 2023.
I am leaning towards switching to the copay plan for 2023. To me it looks like the plans are virtually the same cost-wise but the copay plan reduces costs per visit leading to reduced annual costs. Copay plan also has a much lower deductible. Am I understanding this correctly? Do you agree OR do you still think the deductible plan will save me more?