HELP! I don’t understand my work insurance! Is this a good plan?
Hi all – I’m coming up on open enrollment at my job and have no idea what any of it means!
Some backstory: I’ve had state Medicaid for some time now so I’m not used to dealing with this aspect of my insurance. I’m planning to have a baby this year (a HUGE factor in what plan I’m considering) but otherwise I’m a healthy 28 year old female.
There are two provider plans being offered:
Kaiser HMO
Ind Deductible: $1,000
Family Deductible: $3,000
Ind OOP Maximum: $4,000
Family OOP Maximum: $12,000
Coinsurance: 20%
Inpatient Hospital: Deductible + Coinsurance
Emergency Room: Deductible + Coinsurance
Urgent Care: $45
PCP Office Visit: $25
Specialist Office Visit: $35
Outpatient Hospital: Deductible + Coinsurance
Lab/X-ray: $0 copay
Major Diagnostics: $100/visit
Prescription Drugs: Retail Tier I $15
Retail Tier 2 $30
Retail Tier 3 $50
Mail Order (90-day): 2.5x retail copay
The other plan is through Cigna – there are three tiers being offered. I won’t list details because it’s pretty similar in terms of what’s covered and has a higher deductible/premium so I’m not really considering it. Is there any reason I should??
The biggest contributing factor here is my plan to have a baby this year. I’m trying to figure out how much that will cost, but can’t seem to wrap my head around it. Would that be considered inpatient hospital for delivery? So that would mean I’m paying deductible ($1000) plus coinsurance (20% of what???) for delivery?
For context, my salary is $45,000/year (hopefully getting promoted in March and getting a raise) and the monthly premium for this plan is about $120. I live in Portland, OR.
How much will I pay to have a baby?! How much will I pay to go to the doctor?!
submitted by /u/Fragrant-Ad-235
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