Is my employer health insurance too expensive/bad?

[john919]

20s M, healthy, Zip 19103, 70k salary, started new job. My new employer has cafeteria options, but they all seem really expensive to me. I've seen other options for HDHP and they can be half if not less the cost. I'm not sure if I am missing something here as to why these plans seem much more expensive. My previous employer only had 2 plans and paid premiums either way, so I never gave it much thought. Would it be worthwhile to look for outside coverage? For context as well, I am getting married in a year and the premiums more than double for each of these to add a spouse on to the plan, so ongoing costs are a concern. More long term planning for pregnancy and none of these really seem to have excellent coverage for delivery. Lowest minimum cost is around 3k out of pocket.

Medical Coverage Options - Per Month Premium

UnitedHealthcare Choice Plus 1000 - $581.45

Deductible - $1,000

out of pocket maximum - $4,500

co-insurance rates - 20%

co-payments - variable, e.g $250 for emergency room, 20% hospitalization

UnitedHealthcare Choice Plus 1500 - $532.69

Deductible - $1,500

out of pocket maximum - $6,350

co-insurance rates - 20%

co-payments - variable, e.g $250 for emergency room, 20% hospitalization

UnitedHealthcare Choice Plus HDHP 320 - $470.89

Deductible - $3,200

out of pocket maximum - $6,650

co-insurance rates - 10%

co-payments - 10%

UnitedHealthcare Choice Plus HDHP 1600 - $560.16

Deductible - $1,600

out of pocket maximum - $4,000

co-insurance rates - 10%

co-payments - 10%

UnitedHealthcare Choice Plus 500 (80) -$591.06

Deductible - $500

out of pocket maximum - $5,000

co-insurance rates - 20%

co-payments - variable, e.g $250 for emergency room, 20% hospitalization

UnitedHealthcare Choice Plus 2500 -$496.98

Deductible - $2,500

out of pocket maximum - $6,850

co-insurance rates - 30%

co-payments - variable, e.g $250 for emergency room, 30% hospitalization

UnitedHealthcare Choice Plus HDHP 5000 - $419.39

Deductible - $5,000

out of pocket maximum - $6,650

co-insurance rates - 20%

co-payments - 20%

UnitedHealthcare Choice Plus 6000 - $461.96

Deductible - $6,000

out of pocket maximum - $7,000

co-insurance rates - 0%

co-payments - variable, e.g $500 for emergency room, 0% hospitalization

UnitedHealthcare Primary Advantage 2000 - $468.83

Deductible - $2,000

out of pocket maximum - $6,500

co-insurance rates - 20%

co-payments - variable, e.g $250 for emergency room+20%, 20% hospitalization

UnitedHealthcare Primary Advantage 5000 - $423.51

Deductible - $5,000

out of pocket maximum - $6,500

co-insurance rates - 20%

co-payments - variable, e.g $250 for emergency room+20%, 20% hospitalization

edit- added more info

 

[chelseamc]

@john919 You can change plans when you get married. If you’re healthy, you can choose the lowest-cost plan. Does your employer contribute to an HSA?

 

[john919]

@chelseamc They do not, but I think that's probably the best option still.

 

[demetrius01]

@john919 Just make sure that if you have an accident/injury/major illness that you can afford to cover whatever deductible you choose. It does not take much to run up a $5,000+ medical bill. I know a lot of people don't have that kind of cash lying around.

 

[christeveanity]

@john919 Staying in-network, the following are in order from least expensive to more expensive--just did the top 3:

1st: UHC Plus 1000

Annual Premium: $6,977.40 + $4,500 OOP max = $11,477.40 total possible annual cost ($1,000 deductible)

2nd: UHC Primary Adv. 5000

Annual Premium: $5,082.12 + $6,500 OOP max = $11,582.12 total possible annual cost ($5,000 deductible)

3rd: UHC Choice Plus HDHP 5000

Annual Premium $5,032.68 + $6,650 OOP max = $11,682.68 total possible annual cost ($5,5000 deductible)

If you are pretty healthy and want to pay less in premiums, then you might want to choose Option 3, the UHC Choice Plus HDHP 5000---that will save you over $1,900 in premiums per year. Even if something goes wrong medically and you meet your OOP max, there would only be a few hundred dollars between the 3rd and 1st option above. Does the HDHP have an HSA which your employer contributes to?

Since you are offered affordable health insurance through your workplace, you really don't have another option for outside coverage, besides you want an ACA-compliant health insurance plan.

If you look at all of the plans in total, none will cost you over $13,000 for premium and OOP max in case something major were to happen.

 

[kgr13]

@john919 Actually these premiums seem pretty reasonable to me and you would pay far more if you purchased private insurance.

The way to determine which plan makes the most sense is to create a spreadsheet in which you add up the total costs for the year based on your best sense of how you access medical care.

If the worst happens and you have major medical expenses, your out of pocket annual costs are capped so you wouldn't face an economic catastrophe.

Every year you would have the ability to change your plan based on your estimate of what your medical usage would be for the coming year.

 

[lovejesusandlive]

@john919 If you want cheaper health coverage a lot of times you need to go to a larger employer.