It’s open enrollment again.   We were pretty sure we weren’t going to change our plan, but my husband brought home the explanation of benefits for me to take a look at.

There are 4 different plans, and we have the cheapest one.  Right now we pay $62 a paycheck (biweekly), which I don’t think is bad at all.  $124 a month for health insurance for 4 people is pretty good.   Our coverage is basically a $20 copay and 100% coverage for all the basic everyday stuff.  Like check ups, immunizations, urgent care visits, office visits, ect.  Then 60% of everything else.  Two things really caught my eye here.  A trip to the ER has a $50 copay and then only 60% coverage.  And for maternity care they only pay 60% of the delivery.  Prenatal and postnatal care is 100% covered, but the actual pushing the baby out is only covered 60%.  Which I’m pretty sure both those things have changed for this year.  They certainly paid for my delivery and ER trip when I was pregnant.  Anyways, it has a 2 million lifetime maximum and $5,500 max out of pocket per person.  The deductible is $1,000 per person/ $3,000 for the family.

There are 3 plans above this one, each one costing about $40 more a month than the previous one.  They are basically the same but the more you pay the higher percentage is covered.  We get 60% coverage, if we wanted to go up a step, we could get 70%.  Two steps up, would get us 80%.  Each step up also has a lower deductible and max out of pocket.

The best plan that is offered would cost us $179 a paycheck.  We would have a $20 copay when we went to the dr, but everything that they cover is covered 100%, basically.  It has a 2 million lifetime maximum benefit, $1,500 max out of pocket per person, and no deductible.  Nice, I wish we could afford that.

The only thing that would make me consider switching plans would be to get more coverage for prescriptions.  But all 4 options have the same coverage.  We pay $10 for a month’s supply of generic meds and 25% of brand name drugs.  Which for us we spend $30 a month on prescriptions.  So I would be willing to up our premium if we were going to save money at the pharmacy and get some additional coverage.  But since they don’t offer a better prescription plan, we won’t be switching.

So everyone… keep your fingers crossed that no one ends up in the ER.

I’m curious to know what everyone else is paying and the coverage you get.

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