It’s open enrollment season for both mine and my wife’s employers. Here’s how I would break it down:
We’ve been using an in-network-only plan for years, with an HSA where my employer matches my contribution up to a certain amount. It has been convenient in that if/when we have a bill or an unexpected walk-in visit, we just whip out the HSA debit card and no harm no foul. This plan relies heavily on not needing medication, frequent urgent care, or any specialists. You need a referral to see any specialist — if you can find one in your network that is.
In 2015, I had to go the ER... the doctor they stuck in the room was not in my network, so I had to foot the entire bill, AND it did not count towards my deductible OR out-of-pocket maximum. This should be incredibly illegal but oh well. (Apparently there will be a new law in 2020 to dissuade these kinds of “you’re fucked” emergency scenarios, but I won’t hold my breath).
S in summation: the plan is good for dental visits and going to a walk in clinic once a year if your genitals are unexpectedly itchy.
How much would it be to pay up to an actual network that would give me reasonable coverage? 48% more!
Now onto my wife’s plans: even their *worst* plan has out-of-network deductible and maximums OOPs, although those figures are a little high. The two big hangups? 1) Families are not subsidized by her employer. Adding me to her potential plan does not have the employer contribute even one cent more. As a result, the difference between just insuring her on that base plan, versus the two of us, is *800%.* No, I did NOT mean to type “eighty.” Clearly, they have zero interest in adding more people to insure... But the dental plan is a little better.
In terms of monthly burden, it would be cheaper if we each were on our own plan (duh). Problem? She doesn’t have access to my HSA if she leaves the current plan, unless we BOTH leave the plan and move over to hers, which hell no that ain’t happening. So, by splitting us up, we’d be on two separate, crappy plans, with no access to each other’s perks.
Also, how many more years can I roll the dice with this in-network-only plan that covers nothing whatsoever? I’m only getting older...
Did I also mention my employer is ceasing IRA contributions? What a fucking year.
Thank you for your time.