Originally Posted by EricJ320

For all intent and purposes, this is only true if the worst case scenario involves mental healthcare, as it's the only care not covered at 100% after the deductible is met. Of course that assumes in-network. I've yet to find anything that was out-of-network, and never once had an issue with coverage. With the type of care my daughter needs, we need the occasional letter of medical necessity, but that is common for this type of care. It truly has been amazing coverage, and I know not just from past experience, but hospitals and physician's staff tell me regularly.

I put $750 in the FSA to cover the family deductible, except the copays, everything else is covered by the B plan entirely. Office visit and prescription copays count towards the $1000/$3000 max out of pocket. If it got real bad and you reach that $1000 for one person, the copays would even stop and be covered, but I've yet to hit that for her, though I've been close.

The premiums, plus $750 deductible, plus $10(Rx)and $11(office) copays is all you should plan to ever pay on that plan, should you choose that route.

One last note, on the A and B plan, there is a provision in our policy that if there is no generic drug available we only get charged the generic copay. So essentially every prescription is only $10, no matter the cost. My daughter had a $7000 prescription in August, $10 copay. There is a drug she may eventually be on that costs $280,000 annually, I've already inquired, $10 copay.