Health Insurance Thoughts

blondie42107 · January 2016

My new employer offers three plans however H and I have it narrowed down to two. (The third plan has no deductible and a family Out of Pocket Max of $1200. Employee's monthly cost is $219 for family coverage.)

Plan 1: $24.78/month (employee cost)
Copay - $20 office visits, $50 ER
Deductible - $100/member, $200/family
Coinsurance - 10%
Out of Pocket Max - $500/member, $1000/family
Rx - $15 generic, $30 brand

Plan 2: $0/month (employee cost)
Deductible - $1300/member, $2600/family
No copay/coinsurance after deductible is met.
Rx - $5 generic, $25 brand, $50 formulary
Employer funds HSA $2600 annually.

Thoughts?

hoffse · January 2016

#2 easily. They fund your HSA up to the family deductible. It's basically free.

hoffse · January 2016

Also, then you have an HSA, which is a MM win, especially if you don't drain it each year. The funds are yours to take with you.

JoanE2012 · January 2016

hoffse said:

#2 easily. They fund your HSA up to the family deductible. It's basically free.

Ditto. Unless there's more to to the plans, #1 should not even be a consideration. Am I missing something?

blondie42107 · January 2016

Yes the HSA is a major bonus. One employee (that I know outside of the office) has over $7000 in her HSA. She likes the plan a lot. H and I have never used one so this is new to us but we were also leaning towards that plan since the deductible is employer funded.

Vision and dental are separate but the employer pays 100% of the premium, even for family plans.

blondie42107 · January 2016

JoanE2012 said:

hoffse said:

#2 easily. They fund your HSA up to the family deductible. It's basically free.

Ditto. Unless there's more to to the plans, #1 should not even be a consideration. Am I missing something?

I've looked over that plan several times and I can't make any sense to it. I can't justify paying $2628 a year in premiums. I don't think H and I are missing anything...Are we???

Plan 3: $219/month

Deductible - $0

Office visits - $20

ER - $50

** pretty much all other services are covered 100%

ambulance, hospital, prenatal & postnatal care, chemo, surgery, PT, OT, speech, etc

** mental health and substance abuse is only covered 50% but that's the only thing not 100% other than office visits and the ER.

Out of Pocket Max - $600/member, $1200/family

Rx - $10 generic, $20 brand

dragonstarjk · January 2016

hoffse said:

#2 easily. They fund your HSA up to the family deductible. It's basically free.I

*SITB* Ditto this.

blondie42107 · January 2016

The total cost for:

plan 1 (premium and OOPM) is $1297.36

plan 2 (premium and OOPM) is technically $0

plan 3 (premium and OOPM) is $3828

hoffse · January 2016

blondie42107 said: Yes the HSA is a major bonus. One employee (that I know outside of the office) has over $7000 in her HSA. She likes the plan a lot. H and I have never used one so this is new to us but we were also leaning towards that plan since the deductible is employer funded.
Vision and dental are separate but the employer pays 100% of the premium, even for family plans.

Literally the only risk I can think of that would maybe make option 1 better is if your employer funds the HSA throughout the year, instead of in a single lump sum at the beginning of the year. In that case, you obviously run the risk of needing the money in it before it's fully funded.

That said, if you guys don't consume much health care - or if you could afford the deductible without the HSA - then option 2 would still win for me, even with that caveat.

If I were you, I would also fund the difference to fully max it out each year. HSA's are great savings vehicles, and it's one of the VERY few places where the IRS lets you double-dip - you get a deduction in your contribution year AND funds grow tax-free as long as they are used for medical expenses at some point. It's an amazing deal, and health care is only going to get more expensive as we all age.

FWIW I'm going into my third year of having an HSA, and I max it out each year. I'm on a single plan, so I can only contribute half of what those who have family plans can contribute. My HSA has over $6,000 in it right now because I've never had to use the funds in it. I could get reimbursed for my BC prescription and my annual dermatologist visit, but I budget for those items, so I've never seen a reason to drain my HSA funds. I view the money in my HSA as part of our emergency plan in case one of us is in an accident. With any luck, we won't have any medical emergencies in the near future, and we can roll it into our retirement plan.

hoffse · January 2016

blondie42107 said:

JoanE2012 said:

hoffse said:

#2 easily. They fund your HSA up to the family deductible. It's basically free.

Ditto. Unless there's more to to the plans, #1 should not even be a consideration. Am I missing something?

I've looked over that plan several times and I can't make any sense to it. I can't justify paying $2628 a year in premiums. I don't think H and I are missing anything...Are we???

Plan 3: $219/month
Deductible - $0
Office visits - $20
ER - $50
** pretty much all other services are covered 100%
ambulance, hospital, prenatal & postnatal care, chemo, surgery, PT, OT, speech, etc
** mental health and substance abuse is only covered 50% but that's the only thing not 100% other than office visits and the ER.
Out of Pocket Max - $600/member, $1200/family
Rx - $10 generic, $20 brand

These are the oddest three plans put together that I've ever seen! Not that I'm an expert, but I don't get it at all.

Maybe option 3 covers some specialty things not covered in 1 or 2? So if you knew you needed those services it would make sense? But for a family that's generally healthy outside of routine stuff, I don't see a reason at all to go with #3.

blondie42107 · January 2016

hoffse said:

blondie42107 said:

JoanE2012 said:

hoffse said:

#2 easily. They fund your HSA up to the family deductible. It's basically free.

Ditto. Unless there's more to to the plans, #1 should not even be a consideration. Am I missing something?

I've looked over that plan several times and I can't make any sense to it. I can't justify paying $2628 a year in premiums. I don't think H and I are missing anything...Are we???

Plan 3: $219/month
Deductible - $0
Office visits - $20
ER - $50
** pretty much all other services are covered 100%
ambulance, hospital, prenatal & postnatal care, chemo, surgery, PT, OT, speech, etc
** mental health and substance abuse is only covered 50% but that's the only thing not 100% other than office visits and the ER.
Out of Pocket Max - $600/member, $1200/family
Rx - $10 generic, $20 brand

These are the oddest three plans put together that I've ever seen! Not that I'm an expert, but I don't get it at all.

Maybe option 3 covers some specialty things not covered in 1 or 2? So if you knew you needed those services it would make sense? But for a family that's generally healthy outside of routine stuff, I don't see a reason at all to go with #3.

All three plans are through the same insurance company. They provide a side by side compare of all three plans and I can't find anything that it covers, that the other two don't.

We are a family of 4 that paid for two urgent care visits last year and a few Rx. Otherwise everything was covered as routine wellness or preventative care. We aren't big users. I'm a huge planner - no pregnancy planned although this technically could happen - highly unlikely.

But if something big did happen, the high deductible HSA plan would cover it if we couldn't cover the cost.

I work with the older population r/t their health so I'm VERY aware of the costs! It's scary.

hoffse · January 2016

@blondie, then I don't get it at all - I mean I guess it's good they offer the other plans, but it's still kind of crazy!

If you make your own contributions on top of your employer's (and max it out), you ought to have the entire family deductible in place by April/May. If you guys can hold out that long without an emergency, then it's just money in your pocket going forward!

IMO if you guys aren't heavy users then the HSA is the way to go. It's a very good opportunity to save for future costs.

blondie42107 · January 2016

Oh sorry @hoffse ---

The HSA is funded in a lump sum at the beginning of the year. For those that opt out of health insurance, they get the same amount for not taking it. Both plan 1 and 2 are better than our current plan through H (premium wise and OOPM), so we wouldn't do the payout.

hoffse · January 2016

blondie42107 said:

Oh sorry @hoffse ---
The HSA is funded in a lump sum at the beginning of the year. For those that opt out of health insurance, they get the same amount for not taking it. Both plan 1 and 2 are better than our current plan through H (premium wise and OOPM), so we wouldn't do the payout.

Well then this would be a no-brainer for me. If you get a lump sum, then it really is free!

lbonga1 · January 2016

I think the plan with the HSA would be the best choice too. I actually used to have a plan that was very similar to your most expensive option, but it while I was pregnant with my girls. I wanted to be prepared for anything that might've happened, and I ended up going into preterm labor with both pregnancies and dealing with constant contractions until I gave birth, so I was glad I chose that plan! Otherwise I'm pretty healthy, so I'd choose the HSA plan for any other time.

jtmh2012 · January 2016

hoffse said:
FWIW I'm going into my third year of having an HSA, and I max it out each year. I'm on a single plan, so I can only contribute half of what those who have family plans can contribute. My HSA has over $6,000 in it right now because I've never had to use the funds in it. I could get reimbursed for my BC prescription and my annual dermatologist visit, but I budget for those items, so I've never seen a reason to drain my HSA funds. I view the money in my HSA as part of our emergency plan in case one of us is in an accident. With any luck, we won't have any medical emergencies in the near future, and we can roll it into our retirement plan.

We've got an HSA too. We reimbursed for childbirth expenses, but beyond that, we haven't as of it. We've had little bills here and then for the various follow up visits, but didn't see the need to pull out the HSA funds. Currently, I have all the bills in a pile as I know you can reimburse on these later as long as you keep the documentation.

But the question I have, how does one normally keep this? A spreadsheet with the date/biller/amount? Copies of the bill? Scan in the bills?

Seems like a lot to keep up with if say you wanted to pull the money out in 10, 20, or 30 years....

hoffse · January 2016

jtmh2012 said:

hoffse said:
FWIW I'm going into my third year of having an HSA, and I max it out each year. I'm on a single plan, so I can only contribute half of what those who have family plans can contribute. My HSA has over $6,000 in it right now because I've never had to use the funds in it. I could get reimbursed for my BC prescription and my annual dermatologist visit, but I budget for those items, so I've never seen a reason to drain my HSA funds. I view the money in my HSA as part of our emergency plan in case one of us is in an accident. With any luck, we won't have any medical emergencies in the near future, and we can roll it into our retirement plan.

We've got an HSA too. We reimbursed for childbirth expenses, but beyond that, we haven't as of it. We've had little bills here and then for the various follow up visits, but didn't see the need to pull out the HSA funds. Currently, I have all the bills in a pile as I know you can reimburse on these later as long as you keep the documentation.
But the question I have, how does one normally keep this? A spreadsheet with the date/biller/amount? Copies of the bill? Scan in the bills?
Seems like a lot to keep up with if say you wanted to pull the money out in 10, 20, or 30 years....

My HSA company has a "vault" where you can scan in bills and get them approved, but you don't have to request reimbursement. If yours doesn't have something like that, I would probably just keep them on the cloud with other scans of important docs.

Frankly, I'm guessing our medical expenses will outstrip whatever we have managed to save in our HSA anyway, as we age. Obviously there are no guarantees about that, but I doubt we'll have enough in that account to really need to go back 20 years to take it all out!

jtmh2012 · January 2016

hoffse said:

Frankly, I'm guessing our medical expenses will outstrip whatever we have managed to save in our HSA anyway, as we age. Obviously there are no guarantees about that, but I doubt we'll have enough in that account to really need to go back 20 years to take it all out!

Agreed. I just like making sure I can claim a benefit in the event I should be able to do so. Especially when you're involving the IRS.

jtmh2012 · January 2016

hoffse said:

My HSA company has a "vault" where you can scan in bills and get them approved, but you don't have to request reimbursement. If yours doesn't have something like that, I would probably just keep them on the cloud with other scans of important docs.

Looks like mine has something similar. So I guess I can use that and maybe still keep everything in a folder by year or something.

hoffse · January 2016

jtmh2012 said:

hoffse said:

My HSA company has a "vault" where you can scan in bills and get them approved, but you don't have to request reimbursement. If yours doesn't have something like that, I would probably just keep them on the cloud with other scans of important docs.
Looks like mine has something similar. So I guess I can use that and maybe still keep everything in a folder by year or something.

Yep, that's what I do! It's better documentation than what most people have!

jtmh2012 · January 2016

hoffse said:

jtmh2012 said:

hoffse said:

My HSA company has a "vault" where you can scan in bills and get them approved, but you don't have to request reimbursement. If yours doesn't have something like that, I would probably just keep them on the cloud with other scans of important docs.
Looks like mine has something similar. So I guess I can use that and maybe still keep everything in a folder by year or something.

Yep, that's what I do! It's better documentation than what most people have!

True.

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