Could use advice from people who understand health insurance: I have a family member who was recently diagnosed with cancer and is trying to select the right health insurance plan during open enrollment. They work for the federal govt so have ~30 options. My inclination is to select the plan that has the lowest total cost of premiums + out of pocket max since they will have $150k+ costs this year. Is there anything else I should consider? Their doctor / hospital is in network for all plans

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Yes, that is the way, also factor any HSA or HRA contribution. Other things to consider. BCBS is significantly easier to deal with in my opinion than United Healthcare (UHC) from a claims perspective and tend to have better specialist networks. Also, select a plan that does not require referrals (most PPOs). If it is HSA eligible (high deductible), put aside enough to cover the OOP max if possible. Your family member can pay those medical bills with a credit card to get points then reimburse themselves from the tax free HSA dollars. Sorry your family member is going through this.

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Thanks so much! Very helpful. Definitely picking a PPO and planning to avoid UHC. Low paperwork is definitely a big benefit so they can focus on getting well.

One more question, if you know: there are a bunch of “high” and “standard” options for the various plans. High is always more expensive (eg higher premium and OOP max, and there is basically no break even point in care costs) so it’s unclear to me why anyone would pick the “high” option.

My research suggests “high” covers slightly more wraparound services such as physical or occupational therapy. Is that a typical setup and terminology? I don’t think they’ll need those wraparound services so should we just select standard in that case?

Sorry to hear about your family member. Yes thats how I would start off too. Maybe feed some prompts into AI to see if they come up with anything else to consider

Thank you for the recommendation. I did that and have an idea of what the best option is but always good to verify with a person who really knows this stuff. The govt doesn’t really have people who can help you select a plan that’s best for you so i wanted to turn to FB

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