How much insurance to buy?

[lucky-girl]

We're currently reviewing our options for health insurance. I'm covered through work, but my husband and son (4) will both need coverage. We used to have a high deductible plan that's now been phased out, so this is our first time searching for ACA coverage.

The choice is basically between the bronze HSA plan (about $370 per month with a $5000 deductible per person, and a $6450 out-of-pocket), and the gold plan ($542 per month with a $650 deductible, and $4000 out-of-pocket). We'd save $2000 per year on monthly payments going with the bronze plan, and could put up to $3200 per person in an HSA (my current understanding). We've got a decent sized 'stach, and so could cover unexpected costs if required (my husband seems to be accident prone, and my son is extremely active).

But I was actually surprised that the price difference seemed relatively small between the two plans. I'm starting to wonder if the gold plan might just be a better option for us. IF something happens, it could cost us far more than the 2000 saved. It is also too late for me to increase the amount being set aside in my FSA plan at work.

Any thoughts?

[jawisco]

I just was shopping plans myself. 

I don't understand your logic - it sounds like the gold will cost you $2000 extra in premiums and the bronze plan has approx $2450 in greater out-of-pocket possible liability.  How is $2450 far more than $2000?  And it is quite unlikely you will get to that limit, where the gold plan will definitely cost you an extra $2000/year. 

Plus - the ability to contribute to HSA will save you a lot in taxes.  Plus, if you are in 25% tax bracket and you put 6400 in HSA for hubby and son, you are saving yourself $1600 in taxes right there and you are finding more tax-deferred investment space for an expenses (health) you will surely have plenty of as time goes on.

I think the bronze (or silver with the sliding deductible if you qualify for subsidies) is the way to go.  If something comes up where you are looking at re-occurring health expenses, you can always switch to silver or platinum the next year.

[lucky-girl]

I think I agree with you, but just to clarify, the deductible and OOP above were per person, but the payments were for two people (so a little apples to apples, and I probably just made it confusing). So the total OOP for bronze would be $12900, and for gold would be $8000, a difference of $4900.

[jawisco]

Oh - I get it now and I can see the dilemma with those numbers. 

I still think over time, unless someone has re-occurring health issues, the bronze will win some/lose some, but overall be a win.

This is my first year signing up for obamacare and I am using the national exchange - it is frustrating how hard it is to compare plans,the fact that I can't sort the plans effectively drives me bonkers (can't sort by HSA enabled plan), and it is difficult to get a good idea of the provider networks.

I am self employed, so I am still grateful it is available, and grateful that if I did get sick, I can continue to get coverage. 

[gaspony]

I think the rule of thumb is to self insure as much as possible and if you could stomach the additional $4900 in a year when you have great health expenses then can't you always upgrade to the gold plan later if that made more sense? I thought that was one of the benefits of the ACA plans, no preexisting condition clauses.  So the worse is you have a higher out of pocket expense for one year, of course make sure I'm not mistaken on my assumptions. 

[lucky-girl]

Thanks for the advice! I think that is the plan!