Trying to decide between 3 plans in Illinois. The third option is an HSA plan which I can put aside $7750 for 2 people and of course invest that if needed. It's also a tax deduction on my S Corp.
Family of 4, 2 small children. All very healthy, no medical issues in 2023. I have no issues getting referrals for HMO, it's a big hospital - Northwestern. All plans are through the exchange.
Monthly premiums
Deductible $0 Individual total /$0 Family total Out of pocket maximum: $9,450 Individual total / $18,900 Family total
Primary care doctor visit In Network: $150 per visit from day 1
Specialist visit In Network: $160 per visit from day 1
X-rays and diagnostic imaging In Network: $250
Laboratory outpatient and professional services In Network: $250
Outpatient facility In Network: $750/50%
Outpatient professional services In Network: $400
Generic drugs In Network: $100
Preferred brand drugs In Network: $120
Urgent care centers or facilities In Network: $160 per visit from day 1
Emergency room care In Network: $2000/50% Inpatient doctor and surgical services In Network: No charge
Inpatient hospital services (like a hospital stay) In Network: $1500 Copayment per day/50%
Deductible $4500 Individual total /$9000 Family total Out of pocket maximum: $7500 Individual total / $15,000 Family total
Primary care doctor visit In Network: 40% coinsurance after deductible
Specialist visit In Network: 40% coinsurance after deductible
X-rays and diagnostic imaging In Network: 30% coinsurance after deductible
Laboratory outpatient and professional services
In Network: 30% coinsurance after deductible
Outpatient facility In Network: $600 Copayment with deductible/30% coinsurance after deductible
Outpatient professional services In Network: $200 Copayment with deductible/40% coinsurance after deductible
Generic drugs In Network: 20% coinsurance after deductible
Preferred brand drugs In Network: 30% coinsurance after deductible
Urgent care centers or facilities In Network: 40% coinsurance after deductible
Emergency room care In Network: $1000 Copayment with deductible/40% coinsurance after deductible
Inpatient doctor and surgical services In Network: 40% coinsurance after deductible
Inpatient hospital services (like a hospital stay) In Network: $850 Copayment per stay with deductible/40% coinsurance after deductible
Family of 4, 2 small children. All very healthy, no medical issues in 2023. I have no issues getting referrals for HMO, it's a big hospital - Northwestern. All plans are through the exchange.
Monthly premiums
Code:
PLAN A HMO: $1,326.25
Deductible $7,400 Individual total /$14,800 Family total
Out of pocket maximum: $9,450 Individual total / $18,900 Family total
Primary care doctor visit In Network: $65 per visit from day 1
Specialist visit In Network: $105 per visit from day 1
X-rays and diagnostic imaging In Network: $150
Laboratory outpatient and professional services In Network: $100
Outpatient facility In Network: $300 Copayment with deductible/50% coinsurance after deductible
Outpatient professional services In Network: $150
Generic drugs In Network: 10% coinsurance after deductible
Preferred brand drugs In Network: 20% coinsurance after deductible
Urgent care centers or facilities In Network: $105 per visit from day 1
Emergency room care In Network: $1000 Copayment with deductible/50% coinsurance after deductible
Inpatient doctor and surgical services In Network: No charge
Inpatient hospital services (like a hospital stay) In Network: $850 Copayment per day
Code:
PLAN B HMO: $1,303
Deductible $0 Individual total /$0 Family total Out of pocket maximum: $9,450 Individual total / $18,900 Family total
Primary care doctor visit In Network: $150 per visit from day 1
Specialist visit In Network: $160 per visit from day 1
X-rays and diagnostic imaging In Network: $250
Laboratory outpatient and professional services In Network: $250
Outpatient facility In Network: $750/50%
Outpatient professional services In Network: $400
Generic drugs In Network: $100
Preferred brand drugs In Network: $120
Urgent care centers or facilities In Network: $160 per visit from day 1
Emergency room care In Network: $2000/50% Inpatient doctor and surgical services In Network: No charge
Inpatient hospital services (like a hospital stay) In Network: $1500 Copayment per day/50%
Code:
PLAN C HSA PPO: $1,839
Deductible $4500 Individual total /$9000 Family total Out of pocket maximum: $7500 Individual total / $15,000 Family total
Primary care doctor visit In Network: 40% coinsurance after deductible
Specialist visit In Network: 40% coinsurance after deductible
X-rays and diagnostic imaging In Network: 30% coinsurance after deductible
Laboratory outpatient and professional services
In Network: 30% coinsurance after deductible
Outpatient facility In Network: $600 Copayment with deductible/30% coinsurance after deductible
Outpatient professional services In Network: $200 Copayment with deductible/40% coinsurance after deductible
Generic drugs In Network: 20% coinsurance after deductible
Preferred brand drugs In Network: 30% coinsurance after deductible
Urgent care centers or facilities In Network: 40% coinsurance after deductible
Emergency room care In Network: $1000 Copayment with deductible/40% coinsurance after deductible
Inpatient doctor and surgical services In Network: 40% coinsurance after deductible
Inpatient hospital services (like a hospital stay) In Network: $850 Copayment per stay with deductible/40% coinsurance after deductible