High Deductible Plan for Family

The cost of the HDP is substantially lower than the plan we currently have. For those that have it, how is the claims submission process handled? Are the claims handled by the insurance company and then they send you a bill for the amount you need to pay? Or, do you find that you are doing a lot of work getting bills paid? I have a family of 5 and I really don't want to do any extra work.

High Deductible Plan for Family

We have one and I really don't love it. I'm sure they are all different but my doctor's offices bill my insurance and then I receive a bill. Every time I go to the doctor I swear it costs me between $150.00 - $400.00. It's ridiculous.
If you have young kids that means every time they need a doctor visit, other than a well visit you are going to be paying $$$.

High Deductible Plan for Family

We have it for a few years now and we have an HRA through our employer. For me, it is a lot of work because of the HRA.
It would simply be a matter of the dr's office submitting the claim and then mailing you a bill after processing for payment. Some will demand payment at time of service, though I was once told that is a violation of their agreement with the insurance company because who knows what it will be, if deductible was met, etc.

High Deductible Plan for Family

My DH handles it all, but he doesn't complain. He has a little spreadsheet to keep track of all the bills and all the HSA stuff. The Dr submits a claim to the insurance company. Then, we get the explanation of benefits from the insurance company and a bill from the Dr office. For a lot of bills, there is a way for DH to pay by credit card.
Sometimes I'll be asked to pay at my next Dr appt which is annoying because they don't always know if they've mailed the bill already and my DH pays the bills immediately. So, I have to call him and make sure we're not paying the same bill twice.

Re: High Deductible Plan for Family

It definitely works out better financially but I do find it requires more organization and work. In network, the doctor submits the claim and I get billed the remainder, which isn't so bad but out of network, I submit it and it is a PITA.

Re: High Deductible Plan for Family

Generally, you pay nothing at the point of service, get an explanation of benefits from the insurance company several weeks later and a bill from the provider after that. I manage the claims online just to make sure the amount being charged towards the deductible is accurate. Years ago, I had a different insurance company completely screw up the deductible amount and it took a little while to sort out.

I don't find it hard to manage. It's always good to be organized and to shop around for certain services. With my current employer, it's completely cost prohibitive to choose anything other than the HDHP. I accept the fact that we will likely blow through the deductible every year, but I'm still paying less out of pocket than I would with a PPO plan.

Re: High Deductible Plan for Family

I have one. Basically you have to pay the contracted discounted rate to any participating provider (so you don't pay what someone with NO insurance would pay), up until you reach the deductible. Let's say our deductible is 3,000 for our family. We literally have to pay out $3,000 before we start getting our plan to pay out, which after that they will pay 80% and then we pay %20. There are no copays.

Re: High Deductible Plan for Family

What happens is we go to the doctor, they take our card. We don't pay anything. Then about a month after the visit the doctors office will bill me to pay whatever the contracted rate is with our plan (so let's say it's $250 for someone without insurance, being that we have insurance the contracted rate may be $140). So I have to pay the bill to the doctor for $140. That gets added up until I reach my deductible.

The plan costs less than other plans that use copays (PPOs). But not enough to justify having such a high deductible.

Re: High Deductible Plan for Family

NM

Message edited 11/15/2016 10:32:09 PM.