Posts tagged Work

Question: health insurance question: i work for a small company. we switched to a cheaper health insurance plan within?
oxford because i added my wife and 2 kids on after my wife left her job. my current plan would have cost 1,900 a month for family coverage. we switched to one through oxford as well with 1,300 a month coverage. the in network coverage seems to be identical except the copays are 20 for primary care and 30 for specialist instead of 10 and 10 on the old plan. in network hospitalization is 500 dollar co-pay for in-patient and $ 250 co-pay for out-patient.

on the out of network this is the deal: 2,000 deductible per person and 6,000 per family total deductible. co-insurance is listed as 70% of 10,000. out of pocket is listed as 3,000 per person and 9,000 per family excluding deductible. out of network hospitalization is deductible and co-insurance. out of network E.R. visits are 75 dollars each.

my general question is this decent health insurance? would this be considered high deductible insurance? would i be completely screwed if a family member had to stay out of network at a hospital?
for example, if we are on vacation and someone needed major hospitalization and there was no oxford network hospital. we could take a hit.

heres the deal if we take the 1,300 a month insurance my work covers the whole thing. if we took the 1,900 a month insurance i would have to pay the 600 dollar difference myself (difference between 1,900 and 1,300). did i do the right thing by picking the 1,300 dollar one so i dont have to pay anything out monthly and it is completely covered by work?
cheaper health insurance

Best answer:

Answer by Insurance Biz CT
This plan does not qualify as a High Deductible Health Plan.

It looks to me that you made a good move on this one. There are some minor increases in copays, but the monthly savings far outways these increases.

As far as out-of-network hospitals, this would not apply if you were traveling and someone had to be hospitalized. You will be covered. If it is a bona-fide emergency, seek medical attention at the nearest emergency room. You will have to contact Oxford within 24 hours to report the visit. If it is an urgent matter, that cannot wait until you return home, contact Oxford at the number on the back of the card and ask them to refer you to a local doctor or urgent care center. This will typically be treated as an in-network visit. One advantage to being an Oxford client is that, as they are now owned by United HealthCare, you have access to the United network of doctors and hospitals outside of your home state. Their network extends through many areas of the United States.

Basically, the key to care outside of your home state is communication.