What to look for while choosing healthcare plan, especially if planning for a baby?

New bQJU74
Jun 8 14 Comments

I am a woman in my early 30s, planning to have a baby soon. I have an opportunity to choose the healthcare plan at my employer. Any special tips, things to look out for?

For example:
I recently found out that sometimes you can be slapped with unexpected medical bills even when you go to the in-network hospital as some services/doctors there might still be out-of-network and you might not even be informed about it beforehand. So, just minimizing the in-network cost is not sufficient. Need to take care that out of network numbers are not outrageous either.

Is this true ^
Also, any other tips/gotchas/things to look out for?

comments

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TOP 14 Comments
  • New / Eng QTdN03
    PPO’s are the best medical plans. They mostly disappeared after Obamacare, but Microsoft still offers one.
    Jun 8 4
    • New bQJU74
      OP
      Thanks. Good to know!
      Jun 8
    • New / Eng QTdN03
      It’s also good to consider how much your plan pays out to doctors (more expensive plans often pay out more), because they are ultimately running a business. I kid you not, when my wife gave birth to our youngest, there was one doctor and one midwife on call (small town). The woman next door went into labor and the doctor was there, then my wife went into labor. The doctor left the other room with the midwife during labor to make sure she was present to deliver our baby. (I had really good insurance at the time).
      Jun 8
    • New bQJU74
      OP
      Thanks! By more expensive, do you mean high deductibles?
      Jun 9
    • New / Eng QTdN03
      Not necessarily. By more expensive, I mean the actual amount the plan costs (your contribution + employer contribution). Health plans that take in more revenue tend to spend less time fighting to reduce every single line item. Because they can pay.
      Jun 9
  • Intel LvOT55
    If you are able to go for a high deductible health plan I'd choose that and contribute to an HSA. My wife and I just had a baby and there was no cost to prenetal care and our childbirth only cost about 2k which will be covered by HSA
    Jun 9 2
    • New bQJU74
      OP
      My employer does not seem to have the option of HSA, even for high deductible plan :( We have FSA though. Will it be advisable to use FSA instead? My main concern is - we need to decide the contribution amount upfront and the balance does not get carry forwarded.
      Jun 9
    • Lockheed Martin Iusahjbbvc
      You can open a personal health savings account. It's not ideal, how committed are you to your company?
      Jun 13
  • F5 Networks bhai-log
    Max out of pocket expense and the limit to which they pay.

    Also choose the hospital you want to have delivery. Once done that, check if the hospital takes the insurance.
    Jun 8 1
    • New bQJU74
      OP
      Thank you. Do you mean to choose the plan with minimum "Max out of pocket expense"?
      Jun 9
  • PayPal Dgof20
    Lowest deductible plans, $0 if offered by your company. PPO is better.
    Jun 8 2
    • New / Eng QTdN03
      For everyone saying “lowest deductible”, I would caution that this only helps on one metric—upfront out of pocket expenses. And even that isn’t necessarily true. A high deductible HSA PPO could be a net benefit due to tax-free HSA contributions.
      Jun 8
    • New bQJU74
      OP
      I was going to ask this. Wouldn't low deductible mean a possible higher percentage of co-pays/coinsurances? At least that's what I have seen far in the plan options. Maybe other employers have better plans to choose from.
      Jun 9
  • This comment was deleted by original commenter.

    • New bQJU74
      OP
      Yeah, I agree about due diligence. So, wherever possible, we will always try to avoid surprises. But when it comes to medical/health and you have some critical decisions to be taken, it may not be always possible to get the entire picture but I do understand your point.
      About HSA tax benefits - My employer does not seem to have the option of HSA, even for high deductible plan :( We have FSA though. Will it be advisable to use FSA instead? My main concern is - we need to decide the contribution amount upfront and the balance does not get carry forwarded.
      Jun 9