lins77

All this talk of healthcare recently has got me looking at health insurance again.

Neither me or my husband are covered at the moment (stupid, I know).

My husband has recently become self employed and I'm self employed too so we get no coverage from work.

The trouble is all the different kinds of cover available - its not just a straight comparison between one company and another.

From what I can gether there are 3 kinds:

1) Traditional - you pay a set % of any treatment

2) PPO - you pay copays etc and have a deductable up to which you pay for any treatment. After that you pay a % up to a certain max out of pocket amount.

3) HMO - you pay a copay and if you need anything the doctor has to refer you to someone and that's free or with a copay too. If you go outside of the HMO network you pay all or a % depending on policy.


Does anyone have any idea what the best policies really are? We're a healthy couple, no kids etc but I want the reassurance of the insurance in case something bad happens. I'm just at a total loss as to what kind we should go for. My husband has never had to get insurance himself before so he has no clue either - and we'd never get covered if I left it to him anyway!

I thought HMO's were bad but from what I've read they sound better, but they cost more too.

I also have no idea what a reasonable amount to pay is, either.

Thanks
Lindsey

NC Penguin

The way my spouse and I chose our health plan (we are both eligible through our employment but we are both covered through my husband's employer's health coverage) was to estimate how much we'd use health services (medical, dental)

You should estimate how often you'd be going to the doctor. It's a hard question to answer but you say you're healthy. This means you'd probably not visit a doctor/specialist that often.

Both myself and my husband consider ourselves healthy too. Since we'd probably not anticipate on visiting a doctor or specialist many times in a year, we decided to choose a PPO. The PPO has a lower monthly premium but a higher deductible (if I'm not mistaken). During the course of the year, if we don't use the services much/at all, we only pay for the monthly premiums and any copay and deductibles (I can't remember all the terms used) for services.

If a member of your family has a medical condition that requires continuous medication or you plan on getting pregnant during the year, any plan with a lower premium is probably not appropriate 'cos you'll end up paying more than a plan with a higher premium (HMOs?).

Don't take my word as gospel though. The US medical system is a jungle and it's taking me a while to get a grip on the complexity of it.

Despite considering myself healthy, there's no way I'd consider not having any kind of medical coverage in the US.




NC Penguin