Choosing a health insurance plan.

Silas and Camila Sims have two children, with ages of 6 years and 5 months. Their younger child, Julian, was born with a congenital heart defect that will require several major surgeries in the next few years to correct fully. Silas is employed as a salesperson for a major pharmaceutical firm, and Camila does not work outside the home. Silas employer offers employees a choice between two health benefit plans:

A plan that allows the Sims family to choose health services from a wide range of doctors and hospitals. The plan pays 80 percent of all medical costs, and the Sims family is responsible for the other 20 percent. Theres a deductible of $500 per person. Silas employer will pay 100 percent of the cost of this plan for Silas, but the Sims family will be responsible for paying $380 a month to cover Camila and the children under this plan.

A group HMO. If the Sims family choose this plan, the company still pays 100 percent of the plans cost for Silas, but insurance for Camila and the children will cost $295 a month. Theyll also have to make a $20 co-payment for any doctors office visits and prescription drugs. They will be restricted to using the HMOs doctors and hospital for medical services.

Which plan would you recommend the Sims family choose? Why? What other health coverage options should the Sims family consider?