A few years ago, this twin mama had one kiddo sitting correctly in the designated seat with the lap belt clasped and another kiddo standing as the figurehead at the prow of the cart. We were inching along at the local nursery ever so slowly enjoying the season’s blooms. And BAM. The cart came to a sudden halt as the front wheels hit a water hose snaking across the aisle. And my figurehead child did a full flip over the outside of the cart and landed flat on her back on the concrete.
Praise God for our chiropractor telling me to take her to the ER immediately. Praise God for essential oils that helped calm me enough to remember my child’s name. And Praise God for a children’s ER close to us who offered excellent, respectful care. And Praise God our little girl was totally fine.
Part of that story also involves the security we felt by whipping out our handy dandy insurance card when arriving at the ER. We clung to that blue cross, that blue shield. Insurance served us well for so many things! It paid for my transabdominal cerclage so I could carry babies, paid for radiation on my small little brain tumor, paid for my emergency twin csection and lengthy nicu stays for both children. We definitely used our employer-provided insurance!
However, God moved us to a new place in our lives: my husband gained employment at a small company not offering a group plan and I was able to consider staying home with our children. But insurance was the main concern. My pay check went fully for child care and my own insurance policy. But with my husband and children now in need of coverage, suddenly my check was not enough to cover our family insurance needs. And neither was hubby’s – he was taking a pay cut to change jobs.
We knew as a family we needed to be prepared for medical events. But with costs so high, what could we do?
With the option of traditional insurance through our employers off the table, out went the more expensive COBRA option (extending employer healthcare coverage for up to 18 months post employment). We looked at private plans through the marketplace and our insurance agent, but the costs were well out of reach – high premiums ($1200+/month for our family of 4) and higher deductibles ($6500 – $12500) meant private plans were more expensive than what we already could not afford through my employer.
One might think well, the premium just becomes a cost for security of catastrophic coverage. But what if we needed a doctor’s visit in the meantime? We would incur the full cost – and not the cost of the doctor, but the cost negotiated between doctor and insurance. For example, the optic neurologist I saw had a negotiated rate of $350-450 per appt depending what tests he ran. I would have to pay that every single time I saw him until I hit that deductible of $6500. But I also found out his cash price for self-pay patients is $75 flat regardless of what tests he runs. This was true across the board with every practitioner we may see! Carrying the insurance policy would actually cost us more!
Still…what if? What if a car accident happened or somebody needed major surgery or a baby was born and needed a NICU stay? Suddenly that $6500-12,500 deductible and accompanying max out of pocket wasn’t too bad.
In this blog, I hope to offer a brief overview of various healthcare coverage options along with explanation and experience of our final choice.