Are you getting ripped off by paying too much for your health insurance? The same type of plan can vary by hundreds of dollars per MONTH depending on which company you choose with very similar benefits! Below we compare four similar and popular plans (noting any major differences) with their monthly costs. Which one is right for you? We can help and will work to get you the biggest bang for your buck.
The plans quoted are top of the line comprehensive coverage with Prescription, Maternity, and Naturopathy, and have a $1,000 per person deductible per year. Rates are based on an average non-smoking family of three, with a 45 year old husband and wife and one child using in-network providers. Other higher deductible plans will have similar rate differences from carrier to carrier. There may be small differences from plan to plan but we note the major differences or advantages of each that we feel are important. Information below is not a full summary of benefits, but the highlights.
Lifewise (Premera) Insurance:
Plan Name: Wise Choices-20% Coinsurance
Copay: $30
Prescriptions: Generic $10, Formulary $45, Non-Formulary 50%
X-Ray and Lab: Deductible required, then 20% Coinsurance
Preventative Check Up: Covered at 100% with $30 copay if in Network
(Note: Especially good immunization coverage for kids will save family about $100/year on average.
COST: $1086 NOTE: Rates increase January 1st for all Lifewise Plans
Group Health Insurance:
Plan Name: Balance 1000 20%-Coinsurance (This is their ANY doctor plan)
Copay: $30
Prescriptions: Generic $10, Formulary 30%, Non-Formulary 50%
X-Ray and Lab: 100% coverage (AMAZING BENEFIT HERE)
Preventative Check Up: Covered at 100% with $30 copay if in Network
(Note: This plan allows you to see the largest network(s) of doctors in Washington. Rich Lab and X-Ray benefit may save family about $300-$600 year in out of pocket costs. A few less visits for Chiropractic, Massage, Naturopathy than other plans.)
COST: $696
Regence Blue Shield:
Plan Name: Breakthru 70-30% Coinsurance
Copay: $30
Prescriptions: Generic $10, Formulary 30%, Non-Formulary 50%
X-Ray and Lab: Deductible required, then 30% Coinsurance
Preventative Check Up: Covered at 100% with $30 copay (limited to $200/year)
(Note: Regence is by far the most dominant insurance company in Washington.)
COST: $954KPS Health Plans:
Plan Name: Sound Harbor Elite 1000-30% Coinsurance
Copay: No copays, must pay ENTIRE cost of doctor visits until deductible reached.
Prescriptions: Generic $10, Formulary 50%, Non-Formulary 50%
X-Ray and Lab: 30% coinsurance
Preventative Check Up: Covered at 100% with $30 copay (limited to $250/year)
(Note: Lifetime Maximum benefit is very low at only $1,000,000. No doctor visits included with Copay, instead you pay the entire doctors visit cost until reaching deductible! Minimum charge of $40 for Formulary and Non-Formulary Prescriptions.)
(We DO NOT recommend this plan as it is not as good as the others!)
COST: $659 (Watch out for plan limitations!)
Summary:
My opinion is that right now the hottest plans in terms of rates and benefits are the Group Health “Any Doctor” plans. Will that be the case in a few years? Perhaps not and at that point you may want to compare and change plans again. My Health Insurance of Washington is here to assist you in finding (or changing!) plans to fit your needs and budget. Give us a call to see if we can help prevent you from paying too much!
