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Titillating conversation - health insurance
So, I think I know what I am going to do, but I just wanted to get other opinions.
I have always had PPO coverage. It is now open enrollment at my firm. The cost of the PPO is going up, plus I am adding my husband to my coverage (and of course, continuing with Andy). The cost for family coverage is making me sweat.
My firm seems to be pushing hard for people to go with the other option, high deductible health. They will contribute monthly to a health savings account for anybody that takes it. The deductible for a family, in-network, is $3,500. That, too, makes me want to cry.
I know that I just need to stick with the PPO, but I just wanted to see if anybody out there would recommend the high deductible. I assume it is stupid to do that with a kid. I just have no clue how much annual check-ups are (not to mention the fact that my kid has my coordination, therefore a trip to the emergency room is never out of the question).
Being a grown up sucks yo.
Re: Titillating conversation - health insurance
Eh, we have private insurance with a $5,000 deductible PER PERSON, so it wouldn't make me bat an eye.
An annual checkup probably isn't as expensive as you think.
This is a topic that enrages me.
How much more per month is the premium for the PPO vs the high deductible?
How does the max out-of-pocket compare for the two plans?
Insurance makes me want to hulk-smash things.
Baby Boxer is coming! 5.23.12
www.focushunting.com
Buddha, do you mind telling me how much you pay monthly?
I guess I just have no frame of reference since I have been here so long. The insurance was one of those things that really made this place stand out. I'm sure it is just a sign of the times, and their coverage is still good. It just stings when they have done it one way for so long, and now they have to change what they provide.
How much of a cost difference is it to go with the high deductible vs the PPO? Also, how much will the company contribute to the HSA and does that money keep rolling over assuming you don't spend it during the year?
We have a $2,000 family deductible for our coverage, but annual exams and well baby visits are covered at 100%, no deductible. Does the high deductible plan at your employer include something similar?
Does the cost of the employer contribution to the HSA offset the deductible?
Are your chosen doctors on the HDP?
Is there an increase in co-pays, costs to visit ER, prescription costs with one plan vs. the other?
I would definitely look into the high deductible plan a bit more. How do the premiums compare to PPO? What happens after you meet your deductible? Is everything 100% covered?
Our family deductible is $6,150. The firm kicks in $1,000 of that to the HSA. It's nice that you can roll your remaining balance over year after year, but it does suck to have to shell out thousands at a time if you need surgery or CT-scan or some other expensive procedure.
I made a spreadsheet to compare the two plans and assumed I would be paying out my full deductible. It ended up that the plans were basically the same cost-wise. One just has you paying out the cost over time, while the other was large chunks of money at a time.
The PPO is $215 more per month than the HDP ($490 for PPO, $275 for HDP). Plus my firm will contribute $100 per month to the health savings account for HDP. The health savings account will roll over to the next year. My firm will provide a short term loan if you need major medical and your health savings isn't built up.
All in-network, it is:
Deductible - PPO none; $3,500 HDP
Max out of pocket - PPO $6,000; $3,500 HDP
Preventitive care - both are 100% covered
PCP/specialist office visits - PPO $50 copay; deductible then 0% HDP
Urgent care - PPO $30 copay ; deductible then 0% HDP
ER - PPO $75 copay; deductible then 0%
Tell me what to do, oh smart ones. You're my only hope.
I would go with the high deductible plan.
You'll be paying your deductible, plus your premiums, which adds up to $6800, minus the $1000 your firm contributes. So $5800.
Your premiums for the PPO alone are $5880, plus any copays.
This is all assuming that your savings is in a place where a $3500 bill all at once wouldn't hurt you guys.
we all fall down sometimes
brass and ballet flats
Am I reading that right that your deductible is the max out of pocket you'd pay for the HDP?
Do co-pays, et al count toward the deductible?
It's almost reading as though the HDP would be the better option (provided your desired doctors are in-network) cost-wise, depending on the % for the loans from the firm if necessary.
I think it's close to $500 for all three of us, but that's with added maternity coverage. Once we drop that, it will be around $300.
Mississippi sucks ass for private insurance. ASS ASS ASS.
This is what I am thinking L.
The HDP doesn't have copays, so the visits would just be the total amount. I'm curious what the 100% covered for preventitive care means. Do I not have to pay anything at a well child visit? If not, that might make all the difference right there, seeing as how Andy went to the doctor one time last year...well, minus his trip to the urgent care for stitches. That is where I still worry about the HDP.
My firm is having a meeting about coverage tomorrow. Before this thread, I was just planning on doing PPO and walking away. But now, I am going to go to the meeting and figure this all out. Why is this $hit so hard?!
Thanks all!
I think HDP is, cost wise, the best option. If you figure you're saving $215/month in premiums and add that to the $100 per month the company is putting in your HSA, you have your deductible covered right there.
First of all, I hate you all. I pay over $800 per month, and my hourly rate was lowered by a $1.50 to get my current health care. And have a $1,000 deductible per person. And that's just for me an my H. If I had a family it would be over 1K per month. Thankfully I'll be able to switch to a more reasonable plan once I don't need maternity anymore.
The max out-of-pocket usually doesn't start until after the deductible has been met, so you could wind up paying up to $7,000 in medical expenses with the high deductible plan. It still seems to me like the HDP is your better option though, especially considering that well-care is 100% covered.
Baby Boxer is coming! 5.23.12
www.focushunting.com
2/20/2011
Oh really? Shots are included under preventitive care? Okay. I may now be sold.
I think the HDP, in the worst case scenario, just about breaks even with the PPO cost-wise. And that's worst case. You very well could save money most years.
I think especially with the safety net of the employer loan, I'd go with the HDP for sure.
The poster formerly known as PDXPhotoGrl
"That chick wins at Penises, for sure." -- Fenton
No opinion on which you should choose but as an FYI - we got a bill for a well baby visit (they didn't have our new insurance numbers yet) and it was $250 for the visit and another $50 for vaccines and ANOTHER $50 to administer those vaccines...
For $350 I would gladly weigh my kid and give him the shots myself.