Choosing Plan for Family, Explain Please

[florida2001]

hi when choosing health insurance plan on healthcare.gov is it better to get one insurance plan for 3 family members or get for each person different plan.

the out of pocket for my plan is 5500 vs for whole family $17000
how does it work it real world? if lets say I get in the hospital and have critical illness will I need to pay then $17K ? wuldn't it then be smarter to get for each family member own plan?

 

[somarco]

Questions?

Call 1-800-318-2596

 

[LostDollar]

hi when choosing health insurance plan on healthcare.gov is it better to get one insurance plan for 3 family members or get for each person different plan.

the out of pocket for my plan is 5500 vs for whole family $17000
how does it work it real world? if lets say I get in the hospital and have critical illness will I need to pay then $17K ? wuldn't it then be smarter to get for each family member own plan?

Caveat not an agent.

I think there should be some information about a plan on healthcare.gov. You should be able to go to a specific carrier's website and get more information on a plan. If you do that, you may find that a family deductible is limited both per person and for the entire family. You have to read the plan documents for the plan you are interested in.

 

[Truce]

The individual maximum is fixed (you said $5500....2022 max is $8700) and does not increase when you add more members to the plan. So to answer your question, NO you cannot get a higher bill just because you've added more people to the plan. The family max is the individual max x 2, regardless of whether there are 2 people or 6 people on the plan.

That's why using three separate plans adds more exposure to the family, since you have the risk of reaching three separate annual maximums. Having everyone on the same plan would reduce the maximum risk to 2x the annual individual maximum.

Some slightly different rules for HSA plan, and there are sometimes still legit reasons to carve one member out of a family's plan, but in general once you get above 2 people you'd want everyone together to reduce risk.