Health Plan Options: A Single Mother’s Choice

A single mother with three kids had a choice of health plan options through her employer of ten years. As a full-time sales associate for a retail chain, she loved her job and its benefits. She also drove for a ride-sharing company to “save money to buy a house and send my kids to college.” Like many moms, she had lots to juggle.

The driver shared her health insurance needs and health plan options; which plan did she choose?

• Preferred Provider Organization (PPO) with low deductible and out-of-pocket maximum but high employee contribution, as well as in- and out-of-network coverage.
• High Deductible Health Plan (HDHP) with high deductible and out-of-pocket maximum and low employee contribution, as well as in- and out-of-network coverage.
• Health Maintenance Organization (HMO) in some locations. The member was responsible for copays, as well as an employee contribution. There was no out-of-network coverage.

The driver enrolled in the HDHP because the low contribution “worked with my budget.” She also had $4,000 in a Health Savings Account to pay for unexpected costs on a pre-tax basis, which allowed her to manage her finances. Her employer may have contributed to the HSA to encourage HDHP enrollment.

The driver suffered from asthma and struggled to pay for her medication. We talked about Shark Tank, Mark Cuban, and his new drug company, Cost Plus Drugs. The company might sell her asthma medication at a much lower cost than her health plan cost. “I’ll Google it.”

The driver might have talked about her children’s coverage if we had more time. They may have been covered by the employee’s plan, their father’s plan, or—given an estimated salary of $35,000 (based on an average sales associate wage of $17/hour)—the state’s Children’s Health Insurance Program.

This single mother juggled three kids, two jobs, and one health plan on a tight budget. She had a clear understanding of her family’s financial and health needs and made informed choices about her health care coverage. In other words, she was Mastering Health Insurance.

Photo: Chicago’s South Pond after morning snowstorm. No juggling required.