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opinions on new health insurance

January 20th, 2010 at 08:35 am

Hubby gets a new health plan starting Feb. 1st. We have two to decide from. The first one is an HMO and has no deductible or out-of-pocket-max. and costs $32/week, which is what we are paying now for his current health plan. The second is a HMO + PPO, where you can decide which to use, depending on what the doctor or hospital takes. The HMO side has no deductible or out-of-pocket-max. but the PPO side has a $2250 deductible and $18,000 out-of-pocket-max. It also cost $64/week, which is $32 more a week out of his paycheck, and that =$1664 more a year. Also, if we use the ppo side we still have to pay 20% of everything after we meet the deductible but the hmo covers everything. We have always had PPO and am not sure how hmo is. Does anyone have an hmo plan, and how do you like it? Would it be worth the extra money every week to get the option of having both? We are all very healthy and only plan to have routine check ups, but we do have two babies to think of.

7 Responses to “opinions on new health insurance”

  1. CB in the City Says:

    I enrolled in an HMO plan for the first time last year, and I am very pleased with it. The coverage has been great, the out-of-pocket expenses low.

  2. zetta Says:

    I would suggest calling your current doctors to see if they are in network with the HMO -- it may affect your decision if you have to look for a new pediatrician...

  3. miz pat Says:

    I'll tell you something. If you suddenly get something life threatening HMO's can be horrible.

    My ex got congestive heart failure and I was only allowed to go to 2 doctors. The HMO would allow us to have a heart transplant, but wouldn't allow him to get a better doctor. In this case, the doctor wouldn't prescribe new stuff (coreg) that actually heals heart tissue, and prescribed two medictions that the physicians desk reference said should never be taken at the same time. And they were foreigners who wouldn't talk to me because I'm a woman, and the husband was so defeated by them that he just wanted to die.

    I ended up using only our gen. practitioner for heart care until I could get a PPO. Because I insisted on him putting him on the coreg, his heart improved eventually to almost normal.

    Also, I got an eye problem and the HMO wouldn't allow me to go to an eye doctor. After fighting with them constantly, they allowed me to go to the eye doctor but I'm blind in that eye now.

    Now you guys are young, but just keep that in mind.

  4. lilmama Says:

    Hmmm, thanks for the advice. I'm hoping that since we're young enough nothing serious will happen. This insurance is only for 11 months, until the first of next year when we will vote in a new insurance. Plus I have the option of getting insurance at my job. As long as I start working 80 hrs./month again I get free insurance starting the month after if need be.

  5. Jerry Says:

    HMOs have their up and their down sides. It might be worth having both of the insurance options just to cover yourselves with two little ones. Unfortunately, being young doesn't necessarily mean that nothing can happen that leads you to need good coverage. If your coverage from your job is good, then that might make a difference.

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    Insurance is a very serious topic and before you make the final choice of your insurance option you need to weigh all the possible risks and expenses associated with it.

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