I’m having a difficult time deciding on a sensible health plan in my open enrollment package…
My company insurance pays over 90% of medical expenses on average. The insurer is Aetna.
My average income is about 25K per year. I am a full time college student, living alone. My medical needs are minimal… a couple of normal daily prescriptions and routine examinations. I have had a family doctor for 16 years who is very lenient with my retail health care costs, and is in the network of preferred providers.
Coverage (even low level) comes with visual and life insurance, and the dental options are just a couple bucks a month.
The PPO plan runs 113.00 per month. This leaves my provider options open, annual deductible of 200.00 and a 2,000 maximum “out of pocket” (not including copay, coinsurance, or deductible). This plan has a $250 copay for hospital inpatient, and pays 90%. ER is 100 copay then 90%. The remaining services have an affordable copay with 100% coverage.
The EPO (higher) is a pretty 102.00 per month, and models an HMO. No deductible, 1500 maximum out of pocket, 100% coverage on each benefit, and a cheaper hospital/ER copay of 75/100 dollars. To me, this somehow seems like a sweeter deal… (given my docs are in the network)…
The lowest option is 63.00 per month, no deductible, 2,000 max, and covers most benefits at 100%, except inpatient (250 copay, 80%)… The emergency copay doubles, the remaining copays just go up about 5 bucks.
It seems to me… the best “deal” is the EPO (higher) plan. I don’t understand how the PPO can be more expensive, offer less coverage, and be a better plan. Is this all related to “network” providers?
Even so, the higher EPO is pretty dang expensive. Its going to cut a big chunk from my regular pay (2x the smaller EPO). As a young woman with a (thus far) clean bill of health, would taking the smaller option be a better “bet” for me? I’ll save nearly 500/year on the smallest plan, but if a hospital visit pops up I could be left so broke I can’t pay attention.
In the opinion of you experienced insured workers out there.. what is best for a single student? Take a smaller plan and save precious dollars? or take the bigger plan “just in case”??
