June 15, 2012

Insurance headaches


This week, I've been looking into our upcoming insurance conundrum. Here's how things stand at this very moment: DH is on a single BCBS plan through his employer; I am on a single high-deductible individual plan through Medica. We have separate plans because for DH to go to a family plan at work, it would basically take about 3 quarters of one paycheck a month away. Just for the 2 of us. We cannot afford that, and likely can't even consider it unless we have more than 4 children. So the question arises of whose plan the baby goes on when it arrives?

1. Although BCBS does offer single + dependent plans, DH's employer hasn't included that option to their employees. So that's out, unless DH wants to drop his work plan and do it privately through BCBS (I'll explain later why he would have to be the one doing it).

2. The baby can go on mine, automatically making it a family plan, which will increase both the deductible and the premiums (to be expected), but will also be the least headache-inducing option since all you have to do is let Medica know within 30 days and they'll adjust stuff without having to re-apply. DH would stay on his current plan. And I did call them and ask about the deductible, since my $2,000 limit has already been met. It would transfer over to the family plan deductible of $4,050, so that was a huge weight lifted off. I'd feared that we'd have to start all over again on it, which would completely BLOW.

3. Likewise, DH can come onto my plan as well with only the premiums rising. The only thing about that is that he'll have to apply to be included. And while I have no fear that he'll be denied, it is kind of a hassle. The good thing is that his employer would reimburse him a few hundred dollars a month to be on mine. They currently pay $400 a month for him on their plan, and should he decide to drop their coverage, they'll still pay... not $400, but I think about half that. So that would cover most, if not all, the rise in the premiums should he be included on mine.

4. We could also shop around for a completely new plan for all of us, though it's very unlikely that that will happen. The biggest hurdle is the fact that I still want maternity coverage, and not many insurance companies in the state of North Dakota offer that in individual plans. Just BCBS, Medica and Sanford Elite1. BCBS has already denied me coverage due to my infertility problems (when I worked, BCBS was my insurance, so they know my history), so I doubt that'd change, even with the addition of a baby. Sanford's is a plan I'll look into more, but from my quick glance at it, it'd be more expensive all-around.

So without knowing all the numbers and such, #3 is probably what we'll go with since DH still has to pay towards insurance each paycheck, even with the $400 his employer kicks in... and whenever he goes in to the doctor, we still get bills for it. The nice thing about my plan, is that even though the deductible is high, once that's met, the plan pays 100%, and there's no co-pay at any point unless you go to the ER. And even then it's only $50. Right now, since my deductible has been met, we pay for nothing save the monthly premium. I go to the chiropractor: no charge. I get my Metformin refill: no charge. I go to my bi-weekly soon to become weekly doctor visits: no charge. Any testing I get done: no charge. Anything else that comes up, like a potential ultrasound to check baby's position: no charge. So it's nice not to have to worry about that until the baby is born.

All this makes me wanna move to Canada though.

No comments:

Post a Comment