I’m exceptionally lucky that I currently have the option of several good health insurance plans (public servant life)… but need help picking which one. Obviously, there are so many details, but I tried to condense it.
Husband (25M) has a $6k deductible/12k out of pocket max family plan that is free for the whole family. I do not believe husband can opt out (union thing). Co-pays are $30/each for regular appointments.
I have access to three different plans each with $750 deductible/$4500 out of pocket max per family, all with slightly different benefits. Cost of each plan ranges from $50 to $95 per month for us both. If I opt out, I would receive $233/month (unknown if this is pre or post-tax). Co-pays for regular appointments are $10-15 each.
We are each healthy individuals, but participate in med/high risk sports. Ie if something were to go wrong, it would go very wrong ($$). Husband relies on daily oral medications to stay alive, cost of these out of pocket are about $300/month retail, insurance brings this down to a fraction of it.
We have combined finances.
Would it be better for me to go on his plan (and receive the opt-out $$ to build a health fund?), or him on mine? Or stay on our own? Anything else to consider?
If you rarely go to the doctor I would just stay on husband’s plan and pocket the $233
If your husband can’t opt out and you’ll get $$ for opting out, then I suggest staying on your husband’s plan. The deductible/out of pocket is higher, but every few years you’ll be covering the deductible with what you’re being reimbursed + your lack of premium for not carrying health insurance through your employer. Depending on how long you plan on staying with this employer, you can create an emergency savings account that covers the deductible/out of pocket on your husband’s plan, then start aggressively investing the money you’re getting beyond that.
The only possible exception is A) if your husband’s monthly medication cost is actually relatively high post-insurance and would be covered completely or close to completely by your insurance and/or B) if one of the plans through your employer offers an HSA with a good match, which you can treat as basically another retirement account that’s triple-taxed advantaged.
This becomes a discussion about your tolerance for risk, and your financial situation.
Option 1) Use your husbands plan. Collect $2330 + $460 from your employer, which we will round to $3k for easier math. This effectively makes your husband’s plan a $3k deductible, $9k max out of pocket assuming maximum use. If you don’t use the plan, you get to roll over $3k to the next year and it becomes a $0 deductible and $6k max out of pocket. I would recommend in this case contributing to a HSA (this sounds like a high deductible plan so probably eligible). You do not mention cost sharing which would help us assess what the max out of pocket means (50% is much different then 80).
Option 2) Use your plan which costs you $600-$1200 per year up front. $750 deductible is easy to hit. No cost sharing mentioned again.
The difference in cash is +$3k vs -$1k (rounded) up front. You get no benefit for not using your (better) plan, while you get benefit for not using your husbands, in the fact the money “rolls over”. Both plans will cover preventative care regardless. Knowing your age, and going back to the original comment about risk, you need to guage can you afford the risk of injury to possible make money as opposed to spending money up front.
Hope this helps, if anything isn’t clear let me know and I’ll clarify.
Edit: I did forget to say, if I was in your situation I would not get your plan.
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