Thursday, July 23, 2009

My biggest health care mistake: Choosing the wrong plan

The costs of health care are top of mind lately, and like everyone else, we've felt the effects. I remember the days 10 to 15 years ago of $5 copays for doctor's visits . As a full-time elementary school teacher before we were married, M's doctor visits were completely covered by her paycheck deductions.

Now copays under my current employer's plan are $20 to $25 (though routine physicals and annual checkups are "free"). Meanwhile deductions from my paycheck have increased as well, relative to just a few years back. I don't know if the federal government has the right answer, but at least President Obama is asking some tough questions.

A sweet choice
Rising costs, in fact, led me to make one of my biggest personal finance mistakes: choosing the wrong health care plan. Two years ago, my employer revamped its insurance benefits to reduce its own escalating costs. I opted for the "middle-of-the-road" plan, one with medium-sized paycheck deductions but with higher deductibles and potential out-of-pocket costs. To sweeten the deal, my employer made a $1,000 contribution to a savings account that could help defray any costs we might have to pay on our own.

I'd considered the plan with the highest paycheck deduction and the most coverage, but no $1,000 contribution. I decided against it because we're a pretty healthy family, M and I are through having babies, and our kids aren't in day care and thus prone to bringing home the "virus of the week." I figured the middle plan's $1,000 contribution could get us through half of the year at least.

Best laid plans go awry
Then in February--just a few weeks into having the new plan--my stepdaughter had to make an emergency room visit in the middle of the night. A slew of tests and doctors confirmed that she was, thankfully, okay (and, ironically, that her symptoms weren't an emergency at all, but could have waited for a visit to the doctor in the morning). But that $1,000 which was supposed to help us pay for out-of-pocket costs for several months? Effectively wiped out in one fell swoop.

This year, I bit the bullet and chose the plan with the highest coverage. Naturally, we've had no trips to the emergency room and relatively few visits to the doctor. If that remains true through December, we'll have effectively overpaid for insurance coverage this year after underpaying last year.

Needless to say, that's frustrating. A colleague of mine with several kids who also chose the middle-of-the-road plan last year and the highest coverage plan this year has had a similar experience. We both shared a laugh at life's little ironies.

High coverage a better choice
But I still think the high coverage plan is the right one for us, and what we'll choose again for 2010. Our insurance covers two adults, plus four children ages 2 to 21. Based on that information, the chances that we'll have some significant health care costs throughout the year are probably fairly high. I may end up paying more out of my paycheck compared with a lower coverage plan, but I'll be more certain that no matter what, I'll pay a minimal amount out-of-pocket (and can redirect money I would have saved to pay for deductibles to other goals).

My mistake was trying to be cheap and pay the least amount out-of-pocket possible, and picking a plan based on a prediction of our typical health care costs (which turned out to be wrong, both times). Insurance is about replacing the uncertainty of risk with the certainty of fixed costs. The high coverage plan may mean a little less in my paycheck each month, but it also means a lot more peace of mind.

1 comment:


Healthcare inflation is now out of hand and getting worse all the time.