Originally Posted by
NERD
Cohiba,
I live in DFW, so lots of in network(all my doc's). I'm just covering myself and a child. They look like the same coverage(preventive 100%, co-insurance in-network 80/20, out of 60/140 and prescrips the same) The only difference I see is the deductibles of 1150/2300 vs 2150/4300. Unless I'm missing something(highly likely) in a worst case max deductible situation I'm out an extra $550 family and $350 individual with the silver. If my usage is like last year which was standard(annual checkup for my son and I, and usually one or two visits each for a cold or other minor issue((knock on wood it continues this way)) So for me it looks like if I have another status quo year I save $700 dollars per year with the silver. I do agree if you go out of network it is a no-brainer. What am I missing?
Nerd,
You are correct. We had a pilot a couple years ago in SLC whose teenage sons ski race and race snowmobiles. One of the boys crashes the snowmobile and needs to see the best neurosurgeon in the area. $22000 later he's calling for help. The neurosurgeon is out of network. The bottom line is this:
You're balancing cash flow on a month to month basis and that's your Premium cost. Pretty easy to figure. You're balancing the risk/reward issue on your deductibles and a normal year is easy. It's that pit of the stomach and how well you sleep factor that makes it hard.
Personally I use the HSA but this year the 80/20 makes the Gold HRA a better deal. I'll still use the HSA because I can save $6000 in my HSA account and we're heavy users of meds. But...the Silver is the basic no-frills plan and can bite you big if something should happen. It just depends how you roll the dice and sleep.