The dilemma grows ...

First day as a real employee down!

The new employee orientation we had this morning was only a couple hours. Seeing as we'd already been there 6 months, she didn't need to go over a lot of things with us.

The health insurance ... This will be long and rambly ...

Of the plans to choose from, one is an HMO and the 2 others are through a self-insured POS plan.

HMO - nope. None. Nada. They'll cover the diagnosis and treatment of the underlying cause, but nothing beyond that.

POS - yes. A little. There's a lifetime maximum benefit of $5,000. It includes everything IVF related - drugs, office visits, etc ... And they have a recommended in-network drug company they'd rather you went through. Better pricing, yadda yadda. All things IVF related go towards that maximum. (Whereas IUI isn't included in that lifetime max because it has no max, it's just covered.)

$5,000 isn't a lot. Each of you know how quickly that money will run out. Even if the RE only charges the agreed upon amount, that lifetime maximum will be hit with just one try.

Pros and cons ...

Outside of that one benefit, the HMO has everything going for it. It's a major HMO in this area and you'd have a harder time finding a doc / hospital that won't take it than you would who do. The monthly premiums are almost 1/2 the cost (just over $100 for both of us).
There's only the office visit and RX co-pays. None of that 85/25 stuff.
There isn't a lifetime max - if we get cancer, everything is covered 100% until we either die or it goes away.
The downside - referrals. You need a referral from your declared pcp to see any type of specialist. Yuck.

The POS - well ... you can go out of network if you want and still get at least some coverage.
No referrals - if you want to see someone, you make an appointment.
It offers sometype of fertility treatment. Ok ... it offers IVF.
My RE - the one I love? She participates.
The downside - it costs twice as much per month ($240 per month for both of us), there's a lifetime max of 2,000,000, there's a deductible and then it's 85/25.

Really - I'd be stupid to not take the HMO. It's way more economical and cheaper. If one of us is diagnosed with a horrible disease, at least we wouldn't run out of coverage (of course, HMO's are notorius for refusing more expensive treatments).

But it doesn't cover anything fertility related.

Open enrollment is in November. If I go with the POS, take my one lifetime shot at IVF, I can always switch to the HMO for next year.

But ... always with the buts ... can I really afford to lose $249 a month in pay? Just to use a benefit once? A benefit that isn't promised to work and one I'll still have to push money towards?

Gah ...

And I did look - Ms. J asked about adoption benefits. Nope. None. Although they do have a fertility leave plan. Go figure.

What to do ... really ... what do I do?