Help picking a plan in NYC
Hi all, I'm looking at health plans for next year, and I'm really not sure which plan is right for me. I'm in NYC and these are my plans I've been going back and forth on for a while:
Fidelis Care Silver 1
My premium: $125.73
My deductible: $5,300
Total OOP Max: $9,100
Specialist Visit: $60.00
X-rays and Diagnostic Imaging: 40.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs): 40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services: $35.00
Fidelis Care Silver
My premium: $182.05
My deductible: $2,100
Total OOP Max: $9,450
Specialist Visit: $65.00 Copay after deductible
X-rays and Diagnostic Imaging: $75.00 Copay after deductible
Imaging (CT/PET Scans, MRIs): $175.00 Copay after deductible
Laboratory Outpatient and Professional Services: $50.00 Copay after deductible
Anthem Gatekeeper X, Bronze
My premium: $59.06
My deductible: $4,600
Total OOP Max: $9,450
Specialist Visit: $75.00
X-rays and Diagnostic Imaging: $75.00 Copay after deductible
Imaging (CT/PET Scans, MRIs): $175.00 Copay after deductible
Laboratory Outpatient and Professional Services: $50.00 Copay after deductible
(I'm also considering a Healthfirst plan that is similar to Fidelis Care Silver)
I have an ongoing heart issue (mitral valve prolapse) that requires specialist visits at least once or twice and year, and at least one echocardiogram a year. I also need to start seeing a hematologist soon for a platelet issue, but not as pressing a need as seeing my cardiologist. The flat fees for specialists with the Silver 1 and Bronze plans seems very attractive, but because of my needs, I worry a bronze plan might not be enough. However, unless I'm missing something, this Anthem plan seems to be the exact same as the Fidelis Care Silver except the deductible is about double, but its premium is half. My fear is I won't hit my deductible with the Bronze. Basically I'm torn between the premium of Anthem Bronze, Specialist cost of Fidelis Silver 1, and the Deductible of Fidelis Silver.
Realistically I can't afford any other plans, so these are my only options. Any advice anyone has would be greatly appreciated. I genuinely don't know which way to go. Also, I don't mind about Anthem needing referrals – my Medicaid I have now requires them so I'm used to it. (RIP to my Medicaid coverage I'm really gonna miss it)
submitted by /u/lonka-donk
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