The Money Mustache Community
Learning, Sharing, and Teaching => Ask a Mustachian => Topic started by: WorkingToUnwind on March 21, 2018, 07:31:08 AM
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My husband and I are taking a year off work to travel, starting next week. Our combined income for 2018 is low enough to qualify for a honkin' subsidy on the ACA marketplace.
A silver plan will cost us $150/month and we'll each have a $2,250 individual deductible. The bronze plan is only $34/month, but has a $6,350 individual deductible.
The plans only work for providers and services rendered in our lovely home state of NH. Once we travel outside of NH, both plans with only cover us for emergency services rendered in life threatening situations. The silver plan has a 30% coinsurance on ER visits after the individual deductible is met. It has a $5,850 out of pocket max per person. The bronze plan has a 40% coinsurance on ER visits after the deductible is met. It has a $7,350 out of pocket max per person. So a $1,500 ER visit will cost the same under both plans. A $2,500 ER visit will be roughly the same price as well. It's in the $2,500 and up range that the plans start to differ in what they'll cover. A $5000 ER visit will cost me 5k with the bronze plan, and $3,075 with the silver plan. Granted, I'm paying $1,380 more per year toward the silver plan premium to get that cost savings.
Neither of us has been to the ER in ages. However, we will be skiing, mountain biking, and hiking quite a bit in the upcoming year so there is the potential for injury. Although, I think driving across the country probably poses the greatest statistical threat.
Should either of us develop a chronic health condition, we'd likely make our way home for care.
Which plan would you buy? The more I break down the costs, the more the bronze plan seems to make sense for our situation. Am I missing anything?
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I'd do the Bronze plan. You might get hurt and end up spending more than you would have with the other plan, but you also might not get hurt. And if nothing bad happens, then you still have your $1380.
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I presume that you're a young and healthy person with the talk about hiking and skiing.
So it seems that the most likely reason you'd need to go to the ER would be trauma - a broken bone or dislocated shoulder (or god-forbid a car accident). If that's the case, a CT scan and a visit with an orthopedic surgeon in the ER is going to burn through your max out of pocket pretty quickly. For planning's sake, I'd assume that any ER visit is going to cost you up to your max out of pocket.
The difference between the max bronze & silver is $7350-$5850 = $1500 per person difference between an ER trauma visit with the bronze plan vs the silver plan.
Would that extra $1500 be a disaster for you?
If the answer is yes, then get the Silver plan.
If the answer is no, then the Bronze plan would probably be OK.
Good luck
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Payed my first premium for the bronze plan today. Here's hoping for a healthy year ahead.