$400 health insurance deductible

Discussion in 'Community Discussion' started by rpaloalto, Nov 3, 2008.

  1. macrumors 6502a


    Sep 19, 2005
    Palo Alto CA.
    My Wife and our 2 Children used to have duel coverage. Her insurance was the primary and my insurance was the secondary or co insurance. So my wife decided to leave work to be at home more, for the kids. We did not think that my insurance alone was going to be so much different.

    I just got home from the Dr. I had to actually turn down some testing he wanted to do. Turns out I have a $400 deductible and the MRI he wants would be really expensive. If I have to pay $400 I don't want to pay so close to the end of the year. I think my insurance renews each year in February.

    So now I'm scared, Thats a lot of money. all in one shot.
    When we had duel coverage we had virtually no big bills unless it was some big hospital emergency, or my daughters birth.

    My wife keeps pointing out that unlike here insurance which was costing her $180 a month for all 4 of us. Which was deducted from her paycheck.
    My union pays for all of us. All I pay is my $35 monthly union dues.

    What do you think
    $25 for a normal office visit . If any tests need to be done or special treatment like therapies. I have to pay the first $400 then the insurance will begin to kick in and pay for 75%

    $75 emergency room visit no deductible and they pay for I think 80%

    vision we get $200 a year per person
    Dental is $25 office visit with think 60% coverage up to $1500

    The reason I ask is because next year I will have the option of switching from ppo to a all in one kaiser family plan that will pay for almost everything. I have heard some bad things about Kaiser hospitals. My wife likes the ppo option of seeing any Dr. she wants
    Any one with experience with kaiser?
  2. macrumors G4

    Rodimus Prime

    Oct 9, 2006
    400 dollar deductible sounds almost cheap.

    check into what is the max you have to pay in a year. It could be like $1500 per person and $3000 per family. After that point it is a 100% as long as you are in network.
    It might be a lot better than you think.
  3. macrumors 68040


    Dec 19, 2004
    Wow a $400 deductible is really good. If the max out of pocket is also good I would keep it.

    As for Kaiser vs PPO look at both the annual max out of pocket and the deductibles when making your choice. Also remember Kaiser can mean many more hassles than a PPO.

    With Kaiser you have to get your general physician to recommend you see a specialists before you can go to a specialist. It can take many visits and losses of your valuable time before getting to see the specialist if the general physician decides to run tests and try treating you first. While with most PPO's you chose which doctor you see. For instance if your foot hurts you can go straight to a Podiatrist.

    Basically with Kaiser you have to get approval for everything. With a PPO you have more power over the doctor and specialist you see as long as they are within your network, usually PPO's will still pay a percentage for out of network doctors.

    The only time I would recommend Kaiser is if budget necessetated it or it is simply far cheaper. Mainly this is if you are paying for your own family/individual plan Kaiser is hands down the cheapest for what you get or if that is all an employer offers.
  4. macrumors 6502

    Jul 10, 2006
    A $400 deductible is definitely on the low end. When I was looking for individual insurance plans, the deductibles were around $1000 AND the cost per month was around $300. I would keep this.

    Also, I can definitely relate to money being tight (I'm a grad student!) but if your doc thinks you need an MRI, it might be wise to go ahead with it. If the reason for the MRI isn't really serious, maybe you can discuss the option of getting it once the new insurance year starts over.
  5. Moderator emeritus


    Mar 25, 2002
    London, England
    I don't understand it...here we have the NHS, which is of course completely free. Since you don't have that I realise it's not really relevant.

    I also have private care through my companies AXA policy. I think it's ~£50 a month for my wife and me, if we need to see anyone, or get anything done, it doesn't cost a penny.
  6. Guest


    May 26, 2004
    Randy's House
    $400 a month is definitely reasonable.

    Mine is $250, but it is with a $450 a month premium that my company pays half of.
  7. macrumors 68040


    Dec 19, 2004
    Well not exactly free. The national health care system is payed for through taxes. While we don't have those taxes to deal with we instead have to pay for our own insurance. So the question is what percentage of your income goes into taxes to pay for your healthcare? Or is it a flat rate.

    If it is a percentage of income, it seems unfair that someone making a high income should be forced to pay for the medical expenses of someone else.

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