Re: insurance (Jodie)

[Guest guest]

Hi Jodie,

In our case, I had all the doctors I needed on the HMO plan. Now a

few of them aren't on the PPO, and I have to go out of network. In

addition, I had no co-payment for DME equipment, enteral nutrition,

and the GH & Lupron, and now I will have to meet my deductible & pay

co-insurance. My husband did say something to his boss (not the

person who handles insurance), and his boss asked us to project what

the extra expense would be to us. With the HMO, there was a $1500 max

out of pocket for individuals and a $3000 max for family, but this

included all co-payments we would make - doctors, hospitals, tests,

pharmacy, etc. With the PPO, we have a $1000 deductible, a $3000 out

of pocket max for individuals (in network), a $3000 out of pocket max

for individuals (out of network), and $6000 in each category for the

family. In addition, pharmacy co-payments do not count towards the

out of pocket expenses and neither does the enteral nutrition. So,

we are going from paying $3000 for covered services on the HMO to my

estimate of $13000/year with the PPO, and this does not include the

higher premiums we will be paying in addition. See why I am freaked

out? We always deduct the medial expenses from our income taxes, but

you can only deduct anything above 7.5% of your AGI. Though we

always have more expenses than that, the deduction we get doesn't

compare to the amount we spend! My husbands boss mentioned something

about a possible supplemental policy just for . I decided not

to put on my insurance, as it would cost us an extra $410/

month, and I am not sure it would cover everything I need anyway.

Kim C.

> hey kim!!

> we have had a PPO in the past and for us even though it cost more it

> was better because not all of christopher's dr were on the HMO plan

> but

> with the PPO we could go out of network and it would still be covered

> (we had to pay a little more then had we stayed in network, but it was

> worth it knowing i didnt have to change all of his drs!!) and we

> didnt

> need referrals either!! you may want to add him on to your this way

> what ever your husbands doesnt cover your will pick up the rest, if

> you

> can swing the extra cost. remember you can also deduct the amount

> paid

> for your insurance off of your income tax when you file next year!!

> good luck!!

>

> jodie c

>