Am I thinking about this right? Question about dual coverage, potentially waiving coverage and coinsurance.
So I currently have primary coverage through my spouse. It’s a good plan, no deductible – just a $20-30 copay for absolutely everything so it adds up but again, not terrible. Most expensive is a $50 copay for MRIs and CTs.
I just started a new job, and the company pays 100% of the premiums for employee medical. So I can opt for this new plan with no added coming out of my paycheck. It’s a benefit they say is worth like $6k to me 🤷🏼♀️
Here’s where I am not sure it’s worth it for me:
This employer plan has a $500 individual deductible, $2500 OOPmax. All office visits are $30 (vs the current $15/20 I pay on my spouses) and do not apply toward deductible. The issue is blood work / imaging is paid 80% coinsurance. So my understanding is I pay 100% of any blood test until I hit the $500, then I still pay 20% of any bill until I hit $2500.
This is calendar year so only runs till Dec 31 (let’s be honest I’m not hitting $2500 before Dec).
And here is why I’m concerned with blood tests and imaging. I’m pregnant so I have a lot of visits. Lots of specialists. Lots of blood and lots of ultrasounds.
Seems I’m better off waiving this coverage and sticking with my spouses plan if I’m looking at this accurately. Even if I pay $50 copay for a scan(which is my MRI copay) thats 50 ultrasounds to get to $2500 OOPmax.
I’ve never had a deductible/coinsurance plan so I guess I’m second guessing myself and if I’ve thought of this logically. Any opinions very much welcomed. 👏🏻👏🏻