Need help with insurance

**Hound05** · 11-14-2018, 03:52 AM

Hey guys any help or feedback on this would be great.

I get insurance through my job. All of them are great but Iâve been on âself plus 1â with me and my wife for dental.

Now that my kid is older I need to add him and change it to âself and familyâ.

My question is, there are several options and companyâs out there I can choose from. The one I have right now is great, even the dental people say theyâve not seen many like it. But when I add him itâs going to go up significantly! But there is another option out there for me that Iâve looked into and thereâs not to much of a difference in what they pay and what your copay would be for services. The only difference I canât figure out is the one I currently have is a PPO, and the one Iâm looking at is an EPO. I know what they stand for, but what is the difference? Pros and cons of each? Any insight would be GREATLY APPRECIATED!

***Westside*** · 11-15-2018, 01:58 PM

I never really read the insurance booklets. I always just asked everybody else what they were taking. I do know mine was usually a PPO although I have no idea what that stood for. I hope that helps. :biggrin:

**Hound05** · 11-15-2018, 07:57 PM

Haha Westie anything helps at this point bud haha. I wouldnât even be worried about it if it wasnât so much cheaper. But there is always a catch. Insurance is a joke to me anyways. Doesnât matter if you pay for it or itâs a Medicare Medicaid type plan. I just never heard of an EPO. and the interweb doesnât really clarify it

**RunItUpTheGut** · 11-17-2018, 10:06 PM

Hound05 Wrote:Hey guys any help or feedback on this would be great.

I get insurance through my job. All of them are great but I’ve been on “self plus 1” with me and my wife for dental.

Now that my kid is older I need to add him and change it to “self and family”.

My question is, there are several options and company’s out there I can choose from. The one I have right now is great, even the dental people say they’ve not seen many like it. But when I add him it’s going to go up significantly! But there is another option out there for me that I’ve looked into and there’s not to much of a difference in what they pay and what your copay would be for services. The only difference I can’t figure out is the one I currently have is a PPO, and the one I’m looking at is an EPO. I know what they stand for, but what is the difference? Pros and cons of each? Any insight would be GREATLY APPRECIATED!

I've been on a high deductible HSA plan for almost a decade. Almost all employers will eventually go to it. Every year the deductible goes up as well. I pay almost 7000 a year out of pocket for healthcare cost for my family. Its ridiculous. Not to mention the 120 a week I pay in just to have shitty anthem.

As for your question, I know with an EPO that you have to go to an in network doctor or your coverage will pay absolutely nothing. In a PPO plan, you can go to an out of network doctor or have something done without a referral and the insurance will pay but not as much coverage as if you went to an in network.

In my opinion, depending on your provider and assuming how many local doctors they have in network I would just pick the cheaper one if the coverage and deductibles and copays are the same.

**Hound05** · 11-19-2018, 07:43 PM

RunItUpTheGut Wrote:I've been on a high deductible HSA plan for almost a decade. Almost all employers will eventually go to it. Every year the deductible goes up as well. I pay almost 7000 a year out of pocket for healthcare cost for my family. Its ridiculous. Not to mention the 120 a week I pay in just to have shitty anthem.

As for your question, I know with an EPO that you have to go to an in network doctor or your coverage will pay absolutely nothing. In a PPO plan, you can go to an out of network doctor or have something done without a referral and the insurance will pay but not as much coverage as if you went to an in network.

In my opinion, depending on your provider and assuming how many local doctors they have in network I would just pick the cheaper one if the coverage and deductibles and copays are the same.

Ok thank you so much. With my insurance I donât have a deductible for anything. And I usually go to in network providers anyways. But EPO plan is cheaper by about half from what I carry right now. So before I switched I wanted to make sure there wasnât any major âcatchesâ to it. Because it pays the same as the one I have right now. Thanks Gut. I think you just helped me make my decision. Worst case. If I donât like it. Iâll just switch in a year.

**RunItUpTheGut** · 11-19-2018, 09:35 PM

Hound05 Wrote:Ok thank you so much. With my insurance I donât have a deductible for anything. And I usually go to in network providers anyways. But EPO plan is cheaper by about half from what I carry right now. So before I switched I wanted to make sure there wasnât any major âcatchesâ to it. Because it pays the same as the one I have right now. Thanks Gut. I think you just helped me make my decision. Worst case. If I donât like it. Iâll just switch in a year.

No problem buddy.
You should have a plan administrator threw your work that should be able to any questions you have assuming you work for a bigger company. It's usually going to be your HR person or whoever is setting up the open enrollment paper work.

**Spirit100** · 11-25-2018, 07:04 PM

Being self employed the wife and I just saw our Obamacare increase by 40%. That's what we get for having a SOLID financial year...

Suppose we could only work 50% this year and see our rate decrease! :eyeroll:

What the experts predicted has become the reality. GO FIGURE. Someone has to pay for those who don't work or aren't legal

**RunItUpTheGut** · 11-28-2018, 06:28 AM

I couldn't imagine shopping for insurance.
Until this absurd socialized health insurance is completely scrapped we will never get back to normal.

Mayfieldsportsfan · 11-28-2018, 07:59 PM

I made $40.00 more last year than the year before. My insurance deductible went from $200 dollars to $2500.00. My out of pocket went from $700.00 to $6500.00. It sucks.

**Spirit100** · 12-16-2018, 10:09 PM

So as with any "shocker" when it comes to the government and its redtape we chose to adapt and overcome.

We shopped "wisely" on the health.gov marketplace and was able to find a family plan to meet our needs which wasn't nearly as bad. Mind you we don't go to the doctor that often so we can sweat a high deductible option with a lower premium.

So keep the faith and be diligent before you choose. It was an Anthem plan that we ended up selecting and we were able to add dental as well.

:Thumbs: