Can you all help me compare some health insurance options? I'm ignorant.

It's always better to get the lowest deductible and it offers more peace of mind if something were to go wrong and you needed the insurance.

Both of your plans suck though. 80% coverage in network and 70% in network are sucky plans. You have to worry about an out of pocket cost for every single need.

This oversimplifies things, but what was your healh care expense this year? Anything planned next year?

How much would you struggle if you eneded up paying the 5k out of pocket?

If I ended up paying the $5,000 out of pocket, it would be a very big blow. I'm already carrying several thousand dollars of debt, have almost no savings, and this would worsen things a lot.

Talk to your HR department and they should be able to get you the network details.

You need to look at hospitals and full coverage plans. What would happen if you got in a car accident, needed surgery, PT, and follow-up? Plan A may have a lower deductible, but you could well end up paying 50-300K of medical expenses on your own. AKA going BK.

The problem with the network stuff is even if you go to a network hospital, many of the doctors won't be in that network. Sometimes even the ER docs aren't. The radiologists, etc.

A lot of people aren't really insured at all.

Also, if you travel a lot, plans with very limited out-of-network coverage are suicide - you are essentially totally uninsured when traveling.

Insurance is supposed to cover a significant illness, and it looks to me that Plan A is not real insurance. I'd go for Plan B and start saving. Plan A is a "say a prayer".

What's breaking a lot of people now on medical costs are the network provisions - they find out that they are really uninsured when they have to use their coverage.

except the unexpected. That should continue into your late 30s, early 40s.

I'm not sure why your out-of-network copays are lower. The idea is usually to set prices so as to keep you in network.

In order to get doctors to accept lower payment the insurance company promises to funnel them more patients via networks. It's a horrible cost control mechanism but that's another thread.

I would go for the lower premium unless your profession and/or lifestyle and/or general health carry significant risk of prolonged care. For routine care and the occasional sniffles I'd go to a cash clinic.

Try not to be unconscious if someone takes you to a hospital, otherwise you'll be ruined because there is no limit, according to either plan, to what you can be charged and there will be no one to argue on your behalf to bring down your obligation.

I think I meant coinsurance, not copay - the insurance IS paying more for me in-network.

is to discourage you from using an out of network provider.

But to make an appropriate recommendation about which plan you should go for, you would also need to know if there are any benefit coverage differences.

In my case, I know I have a major surgery at the end of this year and then next year I'm going to have a million PT visits early in the year and several sets of x-rays/MRI scans over the course of the year. So I looked at what the plans offered in terms of PT visits and covered in the scans I'm going to need.

Also do either of your plans come with a rollover HSA that you could contribute to? That can also influence your choice. I have a friend who is in the position that she can afford to contribute the $3,300 max to that each year and for the years when she has a major health expense, she can pay out of that money which is also reducing her taxable income.

I listened to a discussion on a radio program about signing up for health insurance and, by and large, people are nearly as confused as they are doing income taxes. Health insurance should be as easy as my Medicare coverage. The card came in the mail. I signed it. I'm covered.

The other 20% is your responsbility unless you have additional insurance.

With relatively simple surgeries (gall bladder removal) and 3-4 days inpatient, you are looking at $50,000 and up for the total bill and $10,000 is your responsbility.

My point is I have automatic coverage without having to spend days filling out forms and dragging out old records. (As for the 80%, a $10,000 co-pay is chump change compared to what the insurance companies were charging for an older person with a pre-existing condition. My husband had a brief hospitalization this year and the co-pay was less than a month of the old insurance policy that had a gigantic deductible.)

For about $40 more out of your monthly pay, you get better benefits of something unexpected happens.

If you end up in the hospital for a couple of days, Plan A will save you $2500

With Plan B the out of pocket payment would be $2000 higher but then there are $400 in premium savings.

It would be $2100: $2000 out of pocket + $500 deductible - $400 extra in premiums= $2100.

Hmm, that begs the question is the deductible part of the out of pocket, although it usually is.

Anyway, it saves anywhere from $1600 to $2100 depending on how the actual language in the plan reads

go for plan A. I would also find out what hospitals near you are in network. Going to an in network hospital alone could save you thousands of dollars on healthcare.

My healthy son had an appendectomy almost 10 years ago. It cost way over $10,000.
My healthy spouse broke a rib about 4 years ago. The trip to the ER was $3,000.
A different healthy son fell and hit his head real bad, knocked him out. That trip to the ER was $5,000.

and as long as your medical bills are less than $2000 for the year, Plan B will save you money.

If your medical bills are between zero and $1500, Plan B will save you $400 (the premium difference).
If your medical bills are $1800, Plan B will save you $160.
If your medical bills are $2000, it's a wash.
If your medical bills are $2500, Plan A will save you $50.
If your medical bills are $5000, Plan A will save you $300.
If your medical bills are $10,000, Plan A will save you $1000.
If your medical bills are $12,000 or more, Plan A will save you $1600.

(all this assumes that you stay in network).

So it's pretty likely that Plan B is best for you, since you are reasonably healthy and it's probably fairly unlikely that your bills will total over $2000.

..if, you don't end up using it, put it towards retirement.

That's the approach I take with my family's insurance.

Contributions are fully tax-deductible, never forfeited, and are tax-free when withdrawn to pay medical expenses (such as deductibles and copays). You need to have what the IRS classes as a "high deductible health plan" in order to be allowed to have an HSA, but both Plan A and Plan B should qualify.

That's the math help I needed.