Asked by Katherine  |  Submitted January 18, 2015

What type of health insurance plan is best for a 39 year old that is in decent health.

Looking for a plan where the deductible is reasonable and can get the best health care from professional pcp's?

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  Answers  |  2

January 21, 2015

Katherine, our insurance pros need more information from you in order to steer you in the right direction. Are you eligible for an insurance plan through a current job, or through a recent job via COBRA? Are you eligible for subsidies from the Affordable Care Act? While you're answering our questions, check out this article, PPO vs. HMO vs. POS vs. EPO

$commenter.renderDisplayableName() | 04.26.17 @ 04:18

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January 23, 2015

The MoneyTips staff are correct. A bit more detail, however, may help you. You are 39 and healthy. So, if you had a very rich health insurance plan such as a $250 deductible, 90% coinsurance PPO, and you did not object to the high price for this “top of the line Lexus” you would have very good coverage but you may find that you are over-insured. This Lexus comes with leather seats in the back that you will likely never sit on and goes 160 mph – you will pay for all that but when did you last sit in the back or drive that fast? At the same time, a $5000 deductible PPO with 70% coinsurance will cost less but you will have to pay the upfront part called the deductible if you use it. Why would you buy such a plan? Because you are healthy and this plan isn't for small stuff but will help with the really heavy lifting – like if you are really badly injured or a grave condition that is pernicious needs treatment. If you don’t use it, you will have a lower premium and still have the peace of mind that if something really bad happened, you have the unlimited benefit in your plan to pay for it. Put another way, it will keep the 2 million+ dollar bill from being all yours to pay after the coinsurance. See how personal it is when considering health insurance? If you have the 5K deductible sitting in a drawer and it is money you don’t need to spend, then the 5K deductible plan is not a problem, is it? What do I have? When I was 39 and healthy like you, I had a $3000 deductible plan with 80% coinsurance. Why? It cost less than richer plans and I saved money with that approach. In fact, I still have that same plan, I am still just as healthy, and it has proven to be a good choice. Were I over-insured, I would have paid more (see the Lexus example) but never received a benefit for the premium paid.

This is just one way to frame the thinking. There are others, but if you are weighing cost and coverage, you will find that the cost is higher with richer plans and lower with less rich plans. Healthy people don’t usually purchase richer plans. People with conditions that are expensive to treat and also pernicious tend to purchase richer plans because the higher premium is actually a plus; it is insulation against treatment costs that can show up later (and often) and can outpace the high premium. In such a case, the high premium can actually be the lesser of the two. Make sense?

$commenter.renderDisplayableName() | 04.26.17 @ 04:18

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