4 answers

Which Plan for Pregnancy - PPO or CDHP? What Was Your Experience?

It's annual enrollment time at my employer and I'm trying to make a decision between a the traditional PPO plan (with a premium of $100 per pay check for me and my spouse) or the CDHP or Consumer Driven Health Plan (with a premium of $75 per pay check). I've been very pleased with the CDHP plans I've had the last couple of years, but my husband and I may want to start a family in 2009 and I'm just not sure if the CDHP plan gives good enough coverage for something like pregnancy (I'm also concerned that any complications might end up costing more with the CDHP than the PPO). Other than possible pregnancy, we're both young and healthy and rarely visit the doctor for anything other than annual check-ups. I'd love to hear any of your experiences with either plan.

UPDATE - thanks to those who have responded so far. Some additional info - the out of pocket max for both plans is the same and neither plan requires referrals for specialists.

What can I do next?

More Answers

I agree with HP to look closely at what you're going to pay in addition to the monthly premiums. There are lots of dr. visits with pregnancy and the baby's first year. Look at what they both cover with the hospital stay, and any complications (c sections are much more expensive). Sometimes a little higher premium is worth it, sometimes it's not.

1 mom found this helpful

I am not familiar with the CDHP, but just had a baby with UHC's PPO plan. While the per paycheck costs are more, the out of pocket expenses for the pregnancy was very minimal (less than $200).

If you have to get a referal to see a specialist (i.e., you have to choose a POC) for the CDHP, I would recommend against it for pregnancies. When you are in the hospital, lots of doctors will come in to visit and then charge you that doctor visit. I question a few of the visits, wondering if they were necessary or not. But becuase my insurance paid them, I didn't really worry about it. With a POC type of insurance, you have to police this yourself. That's the last thing you want to do while you are in the hospital. Also, for pregnancies, don't forget about the pediatricians as well. The doctor on call may not be covered under your insurance.
Insurance is such a pain to deal with, but it's still way better than none at all, regardless of the plan you choose. :)

1 mom found this helpful

S.,
I would look at what it will cost you in co pays and otherwise. I am currently on a PPO with Blue Cross/Blue Shield and I am due in February with my second child, we have to pay 80/20 for everything. This means I have to pay the ob almost 450 just to deliver the baby. Not to mention what the hospital will charge. I don't know anything about the CDHP plans, as our only other option is an EPO, which I am switching to so that after my co-pays they will cover at 100%. This is just my experience, every insurance is different, but I would take a close look at what you will spend out of pocket (not only the premium every payday)

Good Luck
N

1 mom found this helpful

I think that no matter how healthy you are complications can alway arise and you need to be covered. I was on BCBS for both my pregancies and love it. You will only have to pay up to you total out of pocket max which is nice to know. Also remember that you will have charges for the baby as well so that is another deductible and out of pocket max (which you will probably not meet that for his/her expenses). I was very healthy when I got pregnant, but had lots of little complications with both my pregnancies the cost add up quickly.

1 mom found this helpful

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