My wife and I just had our first baby! We both currently use our own employers insurance plans because it is cheaper than us coming under one plan (EE+Spouse is a biiitch). Both of us have the same insurance provider so the quality and options of "In-Network" providers is a non-issue here.

My insurance is obviously better, but at what cost? We are struggling to decide because if we go with mine and nothing major occurs, we are guaranteeing we are out around $2k per year. We are well off financially (neither of us are 30 yet and our household income is close to 200k with a very reasonable mortgage as our only debt). So with that to consider, even if a surgery or significant event occurred, would the difference in the two plans really matter all that much?

If my math is correct… If we go with my plan we definitely pay $2,100 more immediately in annual insurance out of paycheck expenses. Then if we hit the OOM of $3,000 we are now looking at a net of $5,100. However, with her plan we "save" $2,100 but may hit an OOM of $6,000 which nets to $3,900. So… Should something bad happen, it would actually be CHEAPER with her plan? Am I following that correctly? Again, this would be assuming something were to happen that caused us to hit our OOM (god forbid), and at which point money would be the last thing on our mind..

Breakdown to consider:

Cost difference: Having the baby under my insurance would cost us $2,179.20 more PER YEAR vs. under her plan (her annual cost would increase by ~3.1k, mine by ~5.3k) My Plan (In-Network) My Plan (In-Network) Her Plan (In-Network) Coinsurance 90% 75% Deductible $1,000/$2,000 $2,500/$5,000 OOM $3,000/$6,000 $6,000/$12,000 "Most" Standard Coverage $15 Copay (Or None), Plan Pays 100% Primary Care: $35, Specialist: $60 Urgent Care $15 Copay, Plan Pays 90% (Deductible Applies) $75 Copay ER Visit $250 Copay, Plan Pays 90% (Deductible Applies) $450 Copay Pharmacy Generic: $20, Preferred: $50, Non-Preferred: $100 $20/$40/$60 submitted by /u/YBHunted
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