Anyone have experience with a "high deductible" health insurance plan?
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Anonymous
| Ugh, my work just gave notice that they will cease offering our current health insurance plan (a co-pay plan with 10% co-insurance) and move to a "high deductible plan" due to soaring costs. I'm really scared about this, as I have 2 young children and live paycheck to paycheck and am already struggling so I don't have money to pay increased medical $. From what I've read, a high deductible plan is pretty crappy. Anyone have more info on them and how they work? |
Anonymous
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You pay out of pocket for most things until you hit your deductible or max annual out of pocket limit. Some things have a copay or are free, like annual checkups. But, rx and other doctor visits are paid OOP. If the plan has a high deductible, you should open an HSA and put money in there. The money you put in is tax deductible. You pay for all medical and over the counter meds using the money in the HSA.
If you are single income, you might qualify for help from ACA. I would check that out right now as it is open enrollment. |
Anonymous
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They actually can save you $. I suggest first put the max in the HSA. Hopefully your employer is giving a contribution. And you will have to be very good at record keeping. So when you go the DRs you don't pay anything then later you get a bill. You can pay the bill out of the HSA. Once you reach your deductible you are then completely covered. The good thing is if you don't use all the HSA $ this year it will transfer to next year. good luck.
I switched 4 years ago it is an adjustment but it does work... |
Anonymous
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We're moving to one next year. You generally have to pay 100 percent of the charges (for in-network providers, this is a previously negotiated rate) until you reach your deductible, and then a portion of those charges until you reach your out-of-pocket maximum. You may have separate "embedded" deductibles for individuals on your plan.
You should plan to bank as much $ as you can in an HSA. That will enable you to pay your medical bills with pre-tax money. It also is not "use it or lose it" so you can use it later if you don't have many medical expenses this year. Depending on the cost of your premiums vs. your old premiums, you may wind up saving money if you and your kids are healthy. But it does require you to be more aware about the costs of doctor visits/tests/procedures and maybe think twice about whether you need them. Your company should provide you with extensive info. |
Anonymous
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I've had one for several years. The positive is that the premiums are generally lower although mine went up 35% this year. My first plan had a $5200 deductible, the current one is $3200. As a family of 4 we actually do hit the $3,200 limit fairly quickly. The biggest adjustment is prescriptions - we have a couple of regular prescriptions that can be $200-300 each until we've met the deductible.
I think well child care is covered outside the deductible so that shouldn't be an issue for you, but definitely look at the plan options you have. |
Anonymous
| Good information here. There are also several previous threads in this forum you can search. The comment to look at the ACA market is also spot on. Depending on your income you may find a more affordable plan. |
Anonymous
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We have a high deductible plan. Until a few years ago we could choose a plan but the premium increases [even when paid by an individual]made retaining anything other than the group plan with a high deductible unrealistic.
Our premium went up about 35% with less benefits. The amount you can contribute to an HSA annually is calendar year not plan year and is less than the deductible. The difference is about $6000. Can you price the obamacare plans? |
Anonymous
| OMG, OP here. I don't see how I can afford to put so much money in an account, I'm barely scraping by as it is and I don't have any leftover money in my budget to put away. I don't know how I'm going to afford my thyroid medication. I can't believe this. |
Anonymous
You need to look on the ACA exchange. Depending on your income, your kids may qualify for SCHIP. Now may also be a good time to dust off your resume and look for other jobs. |
Anonymous
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My dh's company forced everyone into a high deductible plan with an HSA and we have somehow come out ahead with this.
The idea is that you pay a lower premium and with each paycheck you also put money into a health savings account (HSA). This money is pulled out pre-tax so you are not paying taxes on the premium or the HSA contribution. In our case, the lower premium plus the HSA contribution was about the same as the old high premium so we didn't lose any money on this. Then, when it comes time to pay a medical bill we pay it out of the HSA account. We no longer pay a co-pay for doctor visits and regular checkups (kids or adults) are 100% covered so the cost does not even come out of the HSA. The only time we met the deductible is when I needed surgery. Every other year, we've never even met the deductible. The HSA is not like a flex-spending account in that there is no "use or lose". The money will roll over and accrue interest year after year. It is your money, after all. |
Anonymous
I have one. Assuming everyone is healthy, it's actually a pretty good deal. My traditional health plan would cost me about $6,500 in premiums a year. The high-deductible plan costs me about $2,200. I put the difference -- $4,300 -- into a health savings account and add another $2,450 or to max it out. use it to pay whatever doctor's bills I incur. Since well visits now are free, we don't see the doctor that much. I started this about three years ago. There's now more than $12,000 in my account since I don't spend much out of it. It makes paying for things like orthodontia and eyeglasses easier. Granted, we've also not had any hospitalizations or broken limbs or anything, but those are extremely rare events in life; I'm 44 and have never broken a bone, for example. |
Anonymous
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Most thyroid medicines are available in genetics and are not that expensive, at least in comparison to some brand name drugs. Both Synthroid and more recently Cyomel (t3) are available in generic forms. What is the med?
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Anonymous
Usually, the employer will give you an initial boost into the account (maybe $1000) at the beginning of the year. Setup the account so that the premiums plus the account contributions are about the same as your previous (higher) premiums. That way you will not feel the difference in your paycheck. Your account will grow with the contributions. |
Anonymous
If you are scraping by then the HSA may not make as much sense. The point of that is a tax deduction but that may not be relevant to you if you are below certain income threshholds. Remember that the point of a high deducible plan is that the premiums are lower so in theory the monthly premium savings balances out the out of pocket expenses. That is the case for us - the total of the monthly premiums plus the deductible is still less than a similar low deductible plan. It's worth calculating - I think on the ACA site there are calculators that will show this. |
Anonymous
Do you understand that the high-deductible plan will be much lower in terms of premiums? You bank the difference in the HSA -- that's how people "'afford to put so much money in an account."" Before, you paid premiums. Odds are you paid more in premiums than you used in health care. Now you pay less in premiums and pay-as-you-consume-medicine out of the HSA. Say your old plan cost you $6,000 a year. The high-deductible plan costs $2,000. You bank the other $4,000 and have no out-of-pocket difference. Under most circumstances, you spend down say half of your HSA, so you have $2,000 left on Dec. 31. Then next year you do the same thing and at the end of the year you have $4,000 net saved. |