If you have a high deductible health plan, please come ine

DH's job is giving us two options - switch to a high deductible health plan or to keep our current health plan and pay a higher premium.

After running all of the numbers, the high deductible plan will end up costing us more for the year IF we meet the full deductible. We have 3 kids, so I think the chances of meeting it are pretty good. We also can't change back to the original plan if we switch to the high deductible since it isn't offered anymore - they are just grandfathering in anyone who already has it.

I don't know anyone personally who is on a high deductible plan so I was hoping to get the good, the bad and the ugly from anyone on here who might have one.

Re: If you have a high deductible health plan, please come ine

what is the coinsurance once the deductible has been met?

Re: If you have a high deductible health plan, please come ine

I'm on one, but I have a number of medical issues so I met the deductible really quickly and I have 0 coinsurance after meeting it....so for half the year everything is covered which is AWESOME for me. IF I didn't go to so many doctors so often nad have as many prescriptions as I do, it probably would not be worth it. My job also contributed 50% of the deductible amount into our HSA so that helped a lot! I only had to pay 50% of my deductible and I met it quickly. For me personally it is very worth it but I have coworkers who hate it with a passion and may leave because of the change!

Re: If you have a high deductible health plan, please come ine

I can't say what you should do, but I used to have a high deductible plan ($5,000+). I never even came close to meeting it. The only year I met it was the year I gave birth.

I know you said you have kids, but remember all well visits will cost you nothing. For the plan we had, even when we had to have testing, or see a specialist, we only had to pay what the insurance company negotiated, which was always a fraction of the original cost.

Lastly, we were able to put pre-tax money into our health savings account so even the year we paid the full deductible it really only cost us like 65-70% of it.

Re: If you have a high deductible health plan, please come ine

not worth having a high deduct!

I had it for a while and never ever met it.

If you have a high deductible health plan, please come ine

We did some math here and we didn't meet the high deductible even with the amount of times DW sees a dr.

Also keep in mind, the high deductible has different coverage effects once the deductible has been meet. I line up both quotes side by side and compared. While 95% was the same, you should watch for the differences.

Re: If you have a high deductible health plan, please come ine

We're a family of four and have a $5k deductible. We've only met the deductible 2x since having this insurance. The year I had my 2nd DD and the year both my husband and daughter had surgery. Very expensive years. All well visits are covered and sick visits are just the copays.

Re: If you have a high deductible health plan, please come ine

It depends on how many people are in your family and what the deductible is and what the max out of pocket for the year is.

For example our family plan choice was:

$500/month for a $2500 deductible with company contributing $1000 in a health savings account. Maximum annual out of pocket is $5k and the "bridge" between meeting deductible of $2500 and the max out of pocket of $5000 is 90%/10% (we pay 10% co-insurance).

So.. that plan annually costs:
$8,500 with the $2500 deductible included which we usually meet. if we made the max out of pocket at $5000 then the plan would be $11,000 a year MAX...

The other option is to pay $1400 a month our cost for a plan with traditional $20 co-pays. That is $16,800 a year NOT including co-pays.

So- for US cheaper to do the high deductible

Re: If you have a high deductible health plan, please come ine

We have a high deductible/coinsurance plan with a total OOP cost of $7500. This is the only year we met both coinsurance and deductible because I gave birth to our son. In other regular years, we come nowhere near meeting the deductible. Never even get to coinsurance. I personally HATE these high deductible plans so if it were me I wouldn't opt for it if you have a better alternative already in place.

If you have a high deductible health plan, please come ine

i had high ded... we met it when i had the baby. this year dd wasnt eating went to ER...$1,500 later....no labs though

usually annual exam covered

usually our sick visit no labs $60 and $30 on meds

i heard coworker had colonioscopy was $1500

Re: If you have a high deductible health plan, please come ine

Don't do it! I have had 2 one with a 5k deduct and the we have now with a 10k deduct. No coinsurance after for in network. We met ours this year bc my DD had been sick a lot and then needed surery. Annuals and annual gyn were covered, but labs etc were not. I felland severe sprained my ankle and that was like a 2k hit. 2 sick kids and you get a $300-500 bill. It is okay when everyone is healthy but if something doesn't go smoothly it can be a big hit bc you have to pay it all at once. It can add up quickly. I hate to go to the doctor bc I knew I would get a big bill so we put things off we normally would do routine. If you have kids it could really add up. At least when you have a copay you know it is $25 or $50 or what. Hard to know what you will be hit with when you have those other plans. Btw other years we came no where near the lower deduct so you honestly never know.

Re: If you have a high deductible health plan, please come ine

My DH is able to carry over money from one year to the next from our HSA if we don't meet the deductible.

If you have a high deductible health plan, please come ine

I have a high deductible plan
I also have an FSA and Health saving account (funded by my employer $1500)
Generally speaking, I never hit my deductible. Which if you knew me is pretty darned amazing!

This year alone just to date we have had:
CT Scan, Chest Xray, two visits to dermatologist, two unscheduled visits to the pediatrician with vaccinations outside the schedule (therefore not free), Two ENT visits, 2 follow-up visits for me at the ENT, Tele-doc session for me for severe vertigo, blood work done for the hubby, medications have included Vitamin D, Anti motion sickness, water-pills and several refills. We have a scheduled visit with a plastic surgeon for AJ next month, plus I need physical therapy sessions.

I have NOT met my deductible to date. Chances of me getting there are meh to possible.

However, I have my HSA pay first (that $1500) then past that my FSA picks up the tab and I currently have that pretty high at $2500 (I normally only keep $1500) because I am planning a major dental surgery that I quoted out last year and its nearly $1300. We also have two eye appts, two pair of glasses including frames (outside our vision program) at least 4 periodontal visits and 4 upgraded dental visits are scheduled for the hubby this year, the periodontal is out of pocket around $65 and the dental another $40.

But normally I put aside Tax deferred FSA (when I didn’t have HSA) to equal to half the deductible in my plan which is $4500. With HSA, I generally still keep whatever I can in my FSA to make up the difference to my deductible.

I put FSA money aside that I think my medical could be at worst. Including glasses, dental, medications. Then use insurance like a coupon for everything. Since I’m insured, all prices are negotiated. What I pay is less. But I put that amount aside in a tax deferred account. I only put aside enough that I KNOW I will use.

Re: If you have a high deductible health plan, please come ine

Re: If you have a high deductible health plan, please come ine

Re: If you have a high deductible health plan, please come ine

If you have a high deductible health plan, please come ine

I won't speak to the financials, but I will say that it is a HUGE PITA to keep track of the FSA and payments to the drs. Take that into account as well.
If it were me, I would stick with the traditional plan, and switch over when they make you (and by that time, you can save up money to be ready for emergencies)

Re: If you have a high deductible health plan, please come ine

Re: If you have a high deductible health plan, please come ine

Posted by Xelindrya

Posted by cutie

Posted by Xelindrya
But normally I put aside Tax deferred FSA (when I didn’t have HSA) to equal to half the deductible in my plan which is $4500. With HSA, I generally still keep whatever I can in my FSA to make up the difference to my deductible.

I put FSA money aside that I think my medical could be at worst. Including glasses, dental, medications. Then use insurance like a coupon for everything. Since I’m insured, all prices are negotiated. What I pay is less. But I put that amount aside in a tax deferred account. I only put aside enough that I KNOW I will use.

I'm confused by your response - my understanding (and I have very little knowledge about all of this) is that you can't have both and FSA and a HSA (or HRA) at the same time - unless you only use the FSA for dental and vision and the HSA for medical.

That was one of our other issues - we re-enrolled for the FSA (which we can only put $1000 into) before we were told about the switch to the high deductible plan.

You can not have an HRA and an FSA

But you CAN have an HSA and an FSA
We have two different high deductible plans I choose the one that allows me to use both. Espeically as my HSA rolls over year after year and is funded by my employer. But yes, you absolutely CAN have both.

HSA is for medical only, that is correct. FSA however is a federal deal so they can't limit the use of that money as it is set by the government as to what is an acceptable expense which obviously includes Medical. I use my HSA first for all medical expenses then if that is exhausted, it will start to erode my FSA. In the meantime, we have an FSA card which we use like a credit card for dental and vision expenses and it comes out of my FSA.

I may not be a pro of Employee Benefits insurance (or Life and Health as we call it) but since I am a licensed broker in both NY & TX, I at least have friends who are useful! LOL Ive learned a lot from them.

Thing is my company is 'self insured' and using Aetna as an administrator. So we never deal with our own company, we deal directly with Aetna who is paid by my company and made whole. The company also pay a good sum into our benefits (which is why I currently can't afford to leave this place).

But to clarify .. yes you CAN have an HSA and an FSA. You can NOT have an HRA with an FSA.

sorry if that's more confusing!

Re: If you have a high deductible health plan, please come ine

High deductible plans are really for healthy people who dont get sick. We have one through DH's job. He contributes xxamount per paycheck to the HSA fund; his job contributes 40% of the deductible to the HSA in quarterly deposits.

our family ded. is $3000; then we pay 10% until we reach the out of pocket max of $6000; after that everything is covered.
Well visit with the GYN is covered; well visit for DS is covered.

DH injured his eye on xmas morning. The ER bill was almost $1000; (however i was able to show financial hardship and that was negotiated down); all the eye dr visits and procedures and we've now met our deductible.

Really its not that terrible b/c you pay the negotiated amount from the insurance company. SO for ex, my annual pap left me a lab bill of $300; however the billed total was over $800 and they applied $500 of what was allowed from Aetna. and since we contribute to the HSA fund, the bill gets paid from those funds.

I'd like to have baby # 2 so that is probably the only other time I would meet a 3k deductible fairly quickly.

Good luck!

Message edited 4/27/2013 12:43:35 PM.

Re: If you have a high deductible health plan, please come ine