Open Enrollment Time – frustrated and confused with options
Hey folks!
I live and work in Maryland. My employer has dropped the healthcare provider we've been with for the last 8 years, which means I need to start over with a new provider for this year's open enrollment. The options we have this year are MUCH more limited than they've been previously and I'm frustrated with the limitations and confused on which one would best suite my family's needs. It feels like I've got a really raw deal this year for options and am hoping that this community can help me navigate which choices look the best for my scenario since I'm feeling kind of lost.
Family of 4. One person has Type 1 diabetes and overall we have 12+ maintenance medications across the family (some brand name without generic options). We probably have 30-40 total Doc office visits (primary and specialist / mental health) annually. We've had an FSA (maxed at $2850) to cover our youngest's diabetic equipment expenses to chew through that deductible each year when it resets. We've also hit our out of pocket maximum ($10,600) every year for the last 4 years in a row, after which the insurance covers 100% for in-network. Without that, our OOP expenses would probably hit 16-18k anually.
The Cigna plan we've had up to now has a 1000 individual / 2000 family deductible, with 5300 ind / 10600 family OOP Max with 70% coinsurance after deductible. This setup was at a cost of $415 per pay period to me ($325 plan + $90 FSA). My new options are CareFirst and United Healthcare 1000 Copay & HSA 2500 plans. The CareFirst copay plan has a 1000 ind / 2000 family deductible and a 4500 ind / 9000 family OOP Max with a $25 copay for office visits. This is $450 per pay period by itself. The HSA 2500 plans have a 5k family deductible, 5k ind / 10k family OOP Max, and 80% coverage for office visits after deductible is met, and the HSA option is $150 / pay period.
I am assuming that HSA plans are generally for healthier families and that they really aren't ideal for families that regularly have high medical expenses like mine. I believed that the main appeal to them is investing surplus HSA funds towards future use and/or retirement. I'd also be in a tight spot when deductible resets since the DME equipment carries a hefty cost which we normally offset with the FSA, which we couldn't use with an HSA. Is this wrong? Or is this generally correct and I'm just getting bent over the table this year with a huge price hike on the copay plans? I'm not sure which plan is best for my scenario.
Thanks in advance for any input ya'all might be able to share!
submitted by /u/Corran-RSI
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