[TruffleLabs]

There is no cut dried answer in USA. Parameters to review: * what is your (you/wife/family history) current health? * what is your current list of medications and will they even be covered by an insurance plan you like? * how much risk do you want to carry (less premium, higher deductible) vs the insurance plan (higher premium, lower deductible )? * where you live. Certain regions will have higher premiums. * family vs single. * how close can you predict your health expenses into the future year?

Options to consider * alumni associations, affinity groups, clubs etc. may offer health plans * talk with an insurance broker. Yes, a real live person, as they will be knowledgeable about the current market and any issues with specific carriers and plans. They usually are free to talk with and obtain quotes from.

If you can do it, get a high deductible insurance plan with an HSA for the years in which you are not having a baby. HSA contributions get some tax deduction status and those unspent HSA dollars can be carried in to the future. My CPA says HSA contusions are a good way to save for long term future medical expenses.

For the plan year you get pregnant, aim to understand the total costs and can an HSA / high deductible plan fit your finances. Will you be comfortable taking on the out of pocket expenses (the high deductible part) and continue making contributions to the HSA?

Will/can your wife work for a company that can offer health insurance?

Getting a plan in place is something that will take 2 to 6 weeks to get ini place so don't wait too long.

Now for the bigger question: do you have disability insurance and life insurance also in place?

Fyi, COBRA will most likely be more expensive than any plan you can get at the family level.

Hope this helps:)

[javahava]

thanks! i have talked to a broker, and he pointed out several different options - all somewhat pricey unfortunately. as i expected, he viewed HSA's as a generally inferior option, thought that was a bit unclear why (i recall perhaps something to do about ease of reimbursement/coverage). not sure if that's actually true.

> If you can do it, get a high deductible insurance plan with an HSA for the years in which you are not having a baby.

this seems like a good strategy. why not just use an HSA exclusively? is it due to risk of complications/cost during pregnancy? or do pregnancy costs likely come close or exceed premiums of a traditional plan anyhow?

> Fyi, COBRA will most likely be more expensive than any plan you can get at the family level.

why is that? my wife is looking to quit soon, and is coming from a fairly large organization. and it seems like the cobra, group-negotiated rates are slightly better than the family rates i'm trying to negotiate on my own. just my own experience.

[TruffleLabs]

COBRA payments for health care are what the company paid for your healthcare, not just your portion. I worked at a large Fortune 500, my monthly premium was (2006) about $150 a month. COBRA was $985 a month. Personally purchased Family insurance plan was $300 month (though hard to compare these plans for their benefits, just the dollars). Yes, if the large company did a great job in negotiating, super, it may be lower than individual plans.

Having a baby has some uncertainty; is the baby growing fine, is the mother doing well, how will the birth go, what about the first year, etc. That is why I suggest looking at the total costs, the mother's health, and what financially you are willing to take on up front with an HSA. Sorry I do not have a clear path for making a decision.

HSA: there are two parts to this. The high deductible healthcare plan and the HSA account admin. For a healthcare charges up to your high deductible you would pay for it with your HSA debit card or electronic check. The amount still gets sent in to the insurance company so they can record it.

Once your deductible is reached then healthcare costs would still be sent to the insurance company, and based on coverage, the insurance would pay its part and any remainder would be paid by you, with your HSA account.

Any reimbursements issues would be with the insurance plan, hopefully not with the HSA.