Deleted
Joined: Apr 17, 2024 20:46:09 GMT -5
Posts: 0
|
Post by Deleted on Nov 5, 2019 14:08:59 GMT -5
It's open enrollment time again. Last year they started offering an HSA but I wasn't sure what it would do to us financial aid wise with the new tax laws so held off. Now I know we're good and was ready to jump on the bandwagon, but they offered a THIRD much cheaper option and it seems like a no-brainer to do this, but I want to make sure I'm not missing anything.
| PPO | HSA 1500
| HSA 5000
| Annual Premium
| $4400 | $3244 | $1320 | Wellness Credit
| $600 | $600 | $600
| Employer HSA Contribution
| $0
| $1000 | $1000 | Deductible | $750/$2250 | $3000 | $5000/$10,000 | Max OOP
| $4000/$8000 | $8000 | $6750/$13,500 | Scripts
| Copay ($15/$45/$65)
| 20% after ded
| 20% after ded
|
We typically only have a few appointments beyond preventative a year, my oldest son is double covered under his dad's PPO plan as well and the three scripts I have are cheap...as in, less than the copay amount going the PPO route. I don't remember ever meeting the PPO deductible with all the preventative stuff being free and they still would jump to a coinsurance amount on some things instead of applying it all to the deductible. (I don't get medical billing at all).
Here is my thought process. I currently have $274 per paycheck ($7132/year) withheld for all insurance and FSA contributions. Going with the HSA 5000 (and the new wellness credit) I would only have to increase that $91/check and I would have $7100 going into an HSA/year. I figured I could reduce the amount I was putting into the 401K by $2300 to cover that and still be up $4800 in savings. Barring something really bad happening I can't see how I'd be spending thousands. Carrot might need orthopedic surgery at some time (please no for so many reasons), but I think he is still on a 2 year schedule for checks and was just there in February of this year, so there wouldn't be anything in 2020.
|
|
|
Post by The Walk of the Penguin Mich on Nov 5, 2019 14:15:26 GMT -5
What is going on with Carrot's legs these days? I think that that might drive your decision. Honestly, knowing he might need surgery in the future, I would be reluctant to go with the HSA. I know that even after my hip replacements, I kept myself insured to the hilt because shit happens sooooo quickly.
|
|
raeoflyte
Senior Associate
Joined: Feb 3, 2011 15:43:53 GMT -5
Posts: 14,698
|
Post by raeoflyte on Nov 5, 2019 14:30:50 GMT -5
What is going on with Carrot's legs these days? I think that that might drive your decision. Honestly, knowing he might need surgery in the future, I would be reluctant to go with the HSA. I know that even after my hip replacements, I kept myself insured to the hilt because shit happens sooooo quickly. We always have big medical bills, but most of it is just standard care, check ups/rx etc. At least hitting our family deductible and its not unusual to hit our OOP max. With the HSA I know exactly how to budget. For the PPO I have to budget for higher premiums and still plan on hitting our OOP max. I don't understand how the PPO is a better option (when deductibles and oop are similar between both plans).
|
|
Deleted
Joined: Apr 17, 2024 20:46:09 GMT -5
Posts: 0
|
Post by Deleted on Nov 5, 2019 14:31:44 GMT -5
What is going on with Carrot's legs these days? I think that that might drive your decision. Honestly, knowing he might need surgery in the future, I would be reluctant to go with the HSA. I know that even after my hip replacements, I kept myself insured to the hilt because shit happens sooooo quickly. Femoral anterversion. He has too much range of motion in his knees and hips, it's like he's walking on spaghetti noodles and he's really clumsy and trips over himself a lot. They get a little more concerned every time he goes, but they're still saying "come back in 2 years" and we'll see how it looks then. He was there in February of this year, so I don't think he needs to go again until 2021 and I would assume if we do decide on surgery it won't be an emergency, needs to be done now, decision.
I'm just thinking about 2020 and building up HSA funds. I can always change back for next year.
|
|
Deleted
Joined: Apr 17, 2024 20:46:09 GMT -5
Posts: 0
|
Post by Deleted on Nov 5, 2019 14:34:42 GMT -5
Also, the HSA 1500 has an aggregate deductible and OOP max, the family as a whole works towards the one number. The PPO and the HSA 5000 have separate individual and family numbers.
|
|
|
Post by The Walk of the Penguin Mich on Nov 5, 2019 14:46:24 GMT -5
What is going on with Carrot's legs these days? I think that that might drive your decision. Honestly, knowing he might need surgery in the future, I would be reluctant to go with the HSA. I know that even after my hip replacements, I kept myself insured to the hilt because shit happens sooooo quickly. We always have big medical bills, but most of it is just standard care, check ups/rx etc. At least hitting our family deductible and its not unusual to hit our OOP max. With the HSA I know exactly how to budget. For the PPO I have to budget for higher premiums and still plan on hitting our OOP max. I don't understand how the PPO is a better option (when deductibles and oop are similar between both plans). Her deductible and her OOP max is higher for both HSA plans, if Carrot needs surgery. A major orthopedic surgery, you can assume you'll hit your OOP max.
|
|
justme
Senior Associate
Joined: Feb 10, 2012 13:12:47 GMT -5
Posts: 14,618
|
Post by justme on Nov 5, 2019 14:50:57 GMT -5
You only get any savings with the 5000 if no one gets sick. Otherwise you are out a LOT of cash potentially. I know I'm looking at this from someone who will always hit a $1500 deductible. You save $1924 going with the 5000 (heh the name is cracking me up). But if you spent that money on the 1500 one you'll be at the deductible and only paying 20% while you'd still be paying full freight on the 5000.
Not to mention with the individual deductibles you're at risk for spending more - you could have two people at $3k and one at 4k before you hit your 10k family deductible.
I'm not quite sure how to account for the one kid being covered by his dad.
Also, generics aren't always cheap when you're paying the full price. My generic Imitrex is over $100 before I hit my deductible and there's a steroid cream I sometimes use for my eczema that's $80 before. Some of the sick meds like antibiotics can be pricey too and not always one of the free options.
|
|
hoops902
Senior Associate
Joined: Dec 22, 2010 13:21:29 GMT -5
Posts: 11,978
|
Post by hoops902 on Nov 5, 2019 14:51:56 GMT -5
Ultimately, it obviously comes down to 2 key issues.
1. Are you able to largely self-insure? If you can't afford to pay the deductible, or max out of pocket on a plan, I would typically advise not to go with that plan.
2. How likely do you think a high-cost event is? It sounds like you think the likelihood is low this year.
It sounds like the HSA 5000 is a good fit for you based on both of those items.
|
|
justme
Senior Associate
Joined: Feb 10, 2012 13:12:47 GMT -5
Posts: 14,618
|
Post by justme on Nov 5, 2019 14:53:25 GMT -5
We always have big medical bills, but most of it is just standard care, check ups/rx etc. At least hitting our family deductible and its not unusual to hit our OOP max. With the HSA I know exactly how to budget. For the PPO I have to budget for higher premiums and still plan on hitting our OOP max. I don't understand how the PPO is a better option (when deductibles and oop are similar between both plans). Her deductible and her OOP max is higher for both HSA plans, if Carrot needs surgery. A major orthopedic surgery, you can assume you'll hit your OOP max. If she knows it'll happen I agree on PPO. But between the PPO and 1500 it's only ~$1000 more if you hit OOP max - and then everyone in the family would be covered.
|
|
hoops902
Senior Associate
Joined: Dec 22, 2010 13:21:29 GMT -5
Posts: 11,978
|
Post by hoops902 on Nov 5, 2019 14:55:28 GMT -5
You only get any savings with the 5000 if no one gets sick. Otherwise you are out a LOT of cash potentially. I know I'm looking at this from someone who will always hit a $1500 deductible. You save $1924 going with the 5000 (heh the name is cracking me up). But if you spent that money on the 1500 one you'll be at the deductible and only paying 20% while you'd still be paying full freight on the 5000. Not to mention with the individual deductibles you're at risk for spending more - you could have two people at $3k and one at 4k before you hit your 10k family deductible. I'm not quite sure how to account for the one kid being covered by his dad. Also, generics aren't always cheap when you're paying the full price. My generic Imitrex is over $100 before I hit my deductible and there's a steroid cream I sometimes use for my eczema that's $80 before. Some of the sick meds like antibiotics can be pricey too and not always one of the free options. I'm not sure I'd say "if no one gets sick"...there are a lot of ways to get sick without making the cost high enough to warrant a different plan. I think that's important, because nobody should ever really rely on "no one gets sick". To that same point though, I also don't love the idea of trying to "time" which plan to go on which year (with the exception of obvious years you know you'll need high coverage)...with so much variance to health, it's more of a long-term forecast and an ability to absorb shorter term periods of variance.
|
|
bean29
Junior Associate
Joined: Dec 19, 2010 22:26:57 GMT -5
Posts: 9,910
|
Post by bean29 on Nov 5, 2019 14:57:13 GMT -5
I think I agree with the HSA 5000. If you get through the year with no large medical expenses, you will have a cushion for Carrot's future medical costs.
|
|
Deleted
Joined: Apr 17, 2024 20:46:09 GMT -5
Posts: 0
|
Post by Deleted on Nov 5, 2019 15:28:13 GMT -5
Also, generics aren't always cheap when you're paying the full price. My generic Imitrex is over $100 before I hit my deductible and there's a steroid cream I sometimes use for my eczema that's $80 before. Some of the sick meds like antibiotics can be pricey too and not always one of the free options. The prescriptions confuse me. I don't know how that would work out. I thought mine were just less than the $15 copay because that's all I've been paying (generic Imitrix for me is $8 and it says the plan paid nothing), but I looked it up and full pay is about $90-$140 depending on where you go and if you use a coupon. I don't understand why I pay less than the $15 copay unless it's one of those deals where the insurance negotiated a price? I'm with Blue Cross Blue Shield - TX, but all the prescriptions are handled through Express scripts, so I kind of thought they'd be the same, but maybe not.
Anyhow, I looked up the "list price" of all three meds I take and only the Imitrix is spendy, the other two are really $10-$15 full price. I could stock up on the Imitrix this year. I still have 3 refills of 9 pills plus 6 in my purse. I rarely go through more than 2 a month (I break them in half), so it's possible I could make it through the year without even having to refill that one.
|
|
Deleted
Joined: Apr 17, 2024 20:46:09 GMT -5
Posts: 0
|
Post by Deleted on Nov 5, 2019 15:35:09 GMT -5
I'm thinking if something goes bad, it's probably just going to be with ONE person in the family, so the HSA 1500 looks less appealing to me because of that. I figure worst case, Max OOP is $6750 with the HSA 5000 vs $8000 with the HSA 1500 and I paid $1900 more in premiums.
We just never have come close to even the $750 deductible. This year we're at $168 towards our family deductible.
|
|
raeoflyte
Senior Associate
Joined: Feb 3, 2011 15:43:53 GMT -5
Posts: 14,698
|
Post by raeoflyte on Nov 5, 2019 15:56:32 GMT -5
I'm thinking if something goes bad, it's probably just going to be with ONE person in the family, so the HSA 1500 looks less appealing to me because of that. I figure worst case, Max OOP is $6750 with the HSA 5000 vs $8000 with the HSA 1500 and I paid $1900 more in premiums.
We just never have come close to even the $750 deductible. This year we're at $168 towards our family deductible.
I think you'll hit more of your deductible with the HSA. Any sick visit you're going to be paying the full amount (minus the insurance negotiated discount) in full until you hit your deductible. Strep tests including sending out for a culture run us about $180 until we hit our deductible instead of a deductible. If you're trying to save everything in your hsa then you have more expenses. I've been on an HSA for at least 5 years. I'm always tempted to try our ppo to see what out of pocket expenses look like but the fear of paying just as much along with higher premiums keeps me from doing it.
|
|
justme
Senior Associate
Joined: Feb 10, 2012 13:12:47 GMT -5
Posts: 14,618
|
Post by justme on Nov 5, 2019 16:05:45 GMT -5
Does everything go towards your deductible or does your plan have things like a doctor visit copay and the deductible is just for things like labs? Besides the free wellness visits all my doctor/urgent care visits are over $100. I think my thyroid labs run around $50 or so.
|
|
engineerdoe
Established Member
Joined: May 22, 2013 17:10:26 GMT -5
Posts: 497
|
Post by engineerdoe on Nov 5, 2019 16:11:13 GMT -5
The main difference between a PPO and HSA is the cash flow. Calculating premiums for the year and meeting the OOP totals all those plans technically "cost" the same. Just understand that a doctor's appointment (not preventative care) will now cost you about $150 to $200 instead of the nice $20 or $35 co-pay. If your employer deposits that $1000 at the beginning that isn't as big a deal as you will have the cash in the HSA already. I would confirm with HR or the insurance broker, that the HSA plans will still allow you to use Express scripts and just know that the negotiated price can still go up.
|
|
bean29
Junior Associate
Joined: Dec 19, 2010 22:26:57 GMT -5
Posts: 9,910
|
Post by bean29 on Nov 5, 2019 16:20:04 GMT -5
I'm thinking if something goes bad, it's probably just going to be with ONE person in the family, so the HSA 1500 looks less appealing to me because of that. I figure worst case, Max OOP is $6750 with the HSA 5000 vs $8000 with the HSA 1500 and I paid $1900 more in premiums.
We just never have come close to even the $750 deductible. This year we're at $168 towards our family deductible.
I think you'll hit more of your deductible with the HSA. Any sick visit you're going to be paying the full amount (minus the insurance negotiated discount) in full until you hit your deductible. Strep tests including sending out for a culture run us about $180 until we hit our deductible instead of a deductible. If you're trying to save everything in your hsa then you have more expenses. I've been on an HSA for at least 5 years. I'm always tempted to try our ppo to see what out of pocket expenses look like but the fear of paying just as much along with higher premiums keeps me from doing it. Same, I actually thing I would spend less on the PPO. Waiting for the numbers to come out for next year.
|
|
hoops902
Senior Associate
Joined: Dec 22, 2010 13:21:29 GMT -5
Posts: 11,978
|
Post by hoops902 on Nov 5, 2019 16:26:07 GMT -5
The main difference between a PPO and HSA is the cash flow. Calculating premiums for the year and meeting the OOP totals all those plans technically "cost" the same. Just understand that a doctor's appointment (not preventative care) will now cost you about $150 to $200 instead of the nice $20 or $35 co-pay. If your employer deposits that $1000 at the beginning that isn't as big a deal as you will have the cash in the HSA already. I would confirm with HR or the insurance broker, that the HSA plans will still allow you to use Express scripts and just know that the negotiated price can still go up. Can you show the math you're using to show they all cost "the same" if you hit the premiums plus max OOP? For PPO it would be $12,400, HSA 1500 it would be $10,244, HSA 5000 would be $13,820...I'm not sure I'd call $3,500 nothing (difference between HSA 5000 & HSA 1500). That's also making a pretty large assumption that you're going to hit Max Family OOP amount for the year (not just one person in the case of the PPO & HSA 5000, but multiple people).
|
|
Deleted
Joined: Apr 17, 2024 20:46:09 GMT -5
Posts: 0
|
Post by Deleted on Nov 5, 2019 16:38:20 GMT -5
Does everything go towards your deductible or does your plan have things like a doctor visit copay and the deductible is just for things like labs? Besides the free wellness visits all my doctor/urgent care visits are over $100. I think my thyroid labs run around $50 or so. I seriously don't understand this billing at all. We're supposed to have office copays. $30 for Primary care, $65 for specialist and $100 for urgent care. Copays go towards max OOP and not deductible (I think anyhow). However, I almost never get charged anything. I have NEVER been billed more than $24 for an urgent care visit and while I used to fight with them because they would charge me $65 for my annual primary care visit to get it back to $30. This year they charged me nothing for that. This is our list of charges and what I paid this year. 10/26/2019 $150.00 $24.78 - urgent care 9/11/2019 $1,674.00 $0.00 - colognoscopy 9/11/2019 $3,844.09 $0.00 - colonoscopy 8/28/2019 $162.00 $0.00 - Mammogram 8/28/2019 $340.00 $0.00 - Mammogram 8/24/2019 $302.00 $0.00 - Physical 8/22/2019 $485.00 $0.00 - Labs 8/6/2019 $212.00 $0.00 - ODS physical (needed EKG) 7/18/2019 $49.00 $17.69 - ODS physical (needed EKG) 7/18/2019 $521.57 $0.00 - ODS physical (needed EKG) 5/9/2019 $174.00 $30.00 - Urgent Care 4/26/2019 $20.00 $4.00 - recheck at urgent care 2/21/2019 $128.00 $65.00 - Specialist 2/7/2019 $193.29 $0.00 - Eye Doctor 2/4/2019 $150.00 $24.78 - Urgent Care If I have to start actually PAYING this stuff it would suck.
|
|
engineerdoe
Established Member
Joined: May 22, 2013 17:10:26 GMT -5
Posts: 497
|
Post by engineerdoe on Nov 5, 2019 16:41:30 GMT -5
The main difference between a PPO and HSA is the cash flow. Calculating premiums for the year and meeting the OOP totals all those plans technically "cost" the same. Just understand that a doctor's appointment (not preventative care) will now cost you about $150 to $200 instead of the nice $20 or $35 co-pay. If your employer deposits that $1000 at the beginning that isn't as big a deal as you will have the cash in the HSA already. I would confirm with HR or the insurance broker, that the HSA plans will still allow you to use Express scripts and just know that the negotiated price can still go up. Can you show the math you're using to show they all cost "the same" if you hit the premiums plus max OOP? For PPO it would be $12,400, HSA 1500 it would be $10,244, HSA 5000 would be $13,820...I'm not sure I'd call $3,500 nothing (difference between HSA 5000 & HSA 1500). That's also making a pretty large assumption that you're going to hit Max Family OOP amount for the year (not just one person in the case of the PPO & HSA 5000, but multiple people). Well in order to meet the max OOP that would also include a bunch of dr appts at $25 a pop so that would get the PPO and HSA 5000 closer to the same since co-pays are typically not applied to the deductible and OOP. I do agree that HSA 1500 is an outlier and is the best deal if it is true that the deductible and OOP is just the one number between individual and family. And yes my statement is made on the assumption that you hit the Max Family OOP and it would likely never happen. I used that assumption to show that when it comes down to it, if you are using your insurance and meeting these OOP max's even for the individual the numbers are roughly the same (except for that HSA 1500) and it just becomes a cash flow reason to pick one over the other. Based on the employer contributing to the HSA is why I would choose that route (my employer contribues $90 a month so $1080 over the year).
|
|
engineerdoe
Established Member
Joined: May 22, 2013 17:10:26 GMT -5
Posts: 497
|
Post by engineerdoe on Nov 5, 2019 16:55:07 GMT -5
Does everything go towards your deductible or does your plan have things like a doctor visit copay and the deductible is just for things like labs? Besides the free wellness visits all my doctor/urgent care visits are over $100. I think my thyroid labs run around $50 or so. I seriously don't understand this billing at all. We're supposed to have office copays. $30 for Primary care, $65 for specialist and $100 for urgent care. Copays go towards max OOP and not deductible (I think anyhow). However, I almost never get charged anything. I have NEVER been billed more than $24 for an urgent care visit and while I used to fight with them because they would charge me $65 for my annual primary care visit to get it back to $30. This year they charged me nothing for that. This is our list of charges and what I paid this year. 10/26/2019 $150.00 $24.78 - urgent care 9/11/2019 $1,674.00 $0.00 - colognoscopy 9/11/2019 $3,844.09 $0.00 - colonoscopy 8/28/2019 $162.00 $0.00 - Mammogram 8/28/2019 $340.00 $0.00 - Mammogram 8/24/2019 $302.00 $0.00 - Physical 8/22/2019 $485.00 $0.00 - Labs 8/6/2019 $212.00 $0.00 - ODS physical (needed EKG) 7/18/2019 $49.00 $17.69 - ODS physical (needed EKG) 7/18/2019 $521.57 $0.00 - ODS physical (needed EKG) 5/9/2019 $174.00 $30.00 - Urgent Care 4/26/2019 $20.00 $4.00 - recheck at urgent care 2/21/2019 $128.00 $65.00 - Specialist 2/7/2019 $193.29 $0.00 - Eye Doctor 2/4/2019 $150.00 $24.78 - Urgent Care If I have to start actually PAYING this stuff it would suck. Based on what you have listed here, you wouldn't meet your individual deductible nor the family one. Physicals and mammograms would still be no cost as they are preventative. Not sure about the EKG for ODS and the colonoscopy would depend on age and I think you may be too young to meet the age requirement but obviously you somehow meet the risk requirement to get one. My vote is always to go HSA route especially if your employer is going to contribute to the account. So yes, you would receive a bill for $150 for a Urgent Care visit but not for the physicals, mammograms and labs. Not sure about the eye doctor either. I guess it depends if the visit is for medical or vision.
|
|
justme
Senior Associate
Joined: Feb 10, 2012 13:12:47 GMT -5
Posts: 14,618
|
Post by justme on Nov 5, 2019 17:00:12 GMT -5
Does everything go towards your deductible or does your plan have things like a doctor visit copay and the deductible is just for things like labs? Besides the free wellness visits all my doctor/urgent care visits are over $100. I think my thyroid labs run around $50 or so. I seriously don't understand this billing at all. We're supposed to have office copays. $30 for Primary care, $65 for specialist and $100 for urgent care. Copays go towards max OOP and not deductible (I think anyhow). However, I almost never get charged anything. I have NEVER been billed more than $24 for an urgent care visit and while I used to fight with them because they would charge me $65 for my annual primary care visit to get it back to $30. This year they charged me nothing for that. This is our list of charges and what I paid this year. 10/26/2019 $150.00 $24.78 - urgent care 9/11/2019 $1,674.00 $0.00 - colognoscopy 9/11/2019 $3,844.09 $0.00 - colonoscopy 8/28/2019 $162.00 $0.00 - Mammogram 8/28/2019 $340.00 $0.00 - Mammogram 8/24/2019 $302.00 $0.00 - Physical 8/22/2019 $485.00 $0.00 - Labs 8/6/2019 $212.00 $0.00 - ODS physical (needed EKG) 7/18/2019 $49.00 $17.69 - ODS physical (needed EKG) 7/18/2019 $521.57 $0.00 - ODS physical (needed EKG) 5/9/2019 $174.00 $30.00 - Urgent Care 4/26/2019 $20.00 $4.00 - recheck at urgent care 2/21/2019 $128.00 $65.00 - Specialist 2/7/2019 $193.29 $0.00 - Eye Doctor 2/4/2019 $150.00 $24.78 - Urgent Care If I have to start actually PAYING this stuff it would suck. I dunno, I have United Healthcare and I can download everything to excel and it shows billed, what they paid, what I paid. So I could easily figure out the average cost for visits I knew I was going to go to and then figure out other average costs of things I might have. I did it a few years ago so I don't remember exactly.
|
|
Deleted
Joined: Apr 17, 2024 20:46:09 GMT -5
Posts: 0
|
Post by Deleted on Nov 5, 2019 17:03:05 GMT -5
I seriously don't understand this billing at all. We're supposed to have office copays. $30 for Primary care, $65 for specialist and $100 for urgent care. Copays go towards max OOP and not deductible (I think anyhow). However, I almost never get charged anything. I have NEVER been billed more than $24 for an urgent care visit and while I used to fight with them because they would charge me $65 for my annual primary care visit to get it back to $30. This year they charged me nothing for that. This is our list of charges and what I paid this year. 10/26/2019 $150.00 $24.78 - urgent care 9/11/2019 $1,674.00 $0.00 - colognoscopy 9/11/2019 $3,844.09 $0.00 - colonoscopy 8/28/2019 $162.00 $0.00 - Mammogram 8/28/2019 $340.00 $0.00 - Mammogram 8/24/2019 $302.00 $0.00 - Physical 8/22/2019 $485.00 $0.00 - Labs 8/6/2019 $212.00 $0.00 - ODS physical (needed EKG) 7/18/2019 $49.00 $17.69 - ODS physical (needed EKG) 7/18/2019 $521.57 $0.00 - ODS physical (needed EKG) 5/9/2019 $174.00 $30.00 - Urgent Care 4/26/2019 $20.00 $4.00 - recheck at urgent care 2/21/2019 $128.00 $65.00 - Specialist 2/7/2019 $193.29 $0.00 - Eye Doctor 2/4/2019 $150.00 $24.78 - Urgent Care If I have to start actually PAYING this stuff it would suck. Based on what you have listed here, you wouldn't meet your individual deductible nor the family one. Physicals and mammograms would still be no cost as they are preventative. Not sure about the EKG for ODS and the colonoscopy would depend on age and I think you may be too young to meet the age requirement but obviously you somehow meet the risk requirement to get one. My vote is always to go HSA route especially if your employer is going to contribute to the account. So yes, you would receive a bill for $150 for a Urgent Care visit but not for the physicals, mammograms and labs. Not sure about the eye doctor either. I guess it depends if the visit is for medical or vision. But those costs are all full price before the network discount, I'm assuming I would still get the discount moving to the HSA still under BCBS? Like the urgent care costs are $123 after discount, Carrot's specialist is $105, the colonoscopy was only $2300 instead of the list $5518 (don't need another one of those for 10 years)
|
|
hoops902
Senior Associate
Joined: Dec 22, 2010 13:21:29 GMT -5
Posts: 11,978
|
Post by hoops902 on Nov 5, 2019 17:11:36 GMT -5
Based on what you have listed here, you wouldn't meet your individual deductible nor the family one. Physicals and mammograms would still be no cost as they are preventative. Not sure about the EKG for ODS and the colonoscopy would depend on age and I think you may be too young to meet the age requirement but obviously you somehow meet the risk requirement to get one. My vote is always to go HSA route especially if your employer is going to contribute to the account. So yes, you would receive a bill for $150 for a Urgent Care visit but not for the physicals, mammograms and labs. Not sure about the eye doctor either. I guess it depends if the visit is for medical or vision. But those costs are all full price before the network discount, I'm assuming I would still get the discount moving to the HSA still under BCBS? Like the urgent care costs are $123 after discount, Carrot's specialist is $105, the colonoscopy was only $2300 instead of the list $5518 (don't need another one of those for 10 years)
I can tell you when we moved from a PPO to HSA under the same insurance that all of the network discounts stayed the same. Nothing really changed other than the billing piece of copay, deductible, OOP, etc. I'm going to assume that some of the different pricing you're seeing is a lot of what I see as well. Pricing/billing is so messed up that you have to keep an eye on things to keep from getting overcharged. It also means that often you'll get undercharged for things you assumed you'd have to pay for.
|
|
|
Post by The Walk of the Penguin Mich on Nov 5, 2019 17:25:37 GMT -5
What do the out of network deductibles look like?
|
|
weltschmerz
Community Leader
Joined: Jul 25, 2011 13:37:39 GMT -5
Posts: 38,962
|
Post by weltschmerz on Nov 5, 2019 17:25:54 GMT -5
PPO HSA 1500
HSA 5000
Annual Premium
$4400 $3244 $1320
Wellness Credit
$600 $600 $600
Employer HSA Contribution
$0
$1000 $1000
Deductible $750/$2250 $3000 $5000/$10,000
Max OOP
$4000/$8000 $8000 $6750/$13,500
Scripts
Copay ($15/$45/$65)
20% after ded
20% after ded
WTF?
|
|
NastyWoman
Senior Associate
Joined: Dec 24, 2010 20:50:37 GMT -5
Posts: 14,308
|
Post by NastyWoman on Nov 5, 2019 18:03:41 GMT -5
What happens if DS1 attends an out of state college? Will he still be (double) covered? Will he even remain covered by his dad after he turns 18? While my kids were in college I always ended up with the most expensive option since that was the only one offered that provided out of state coverage
|
|
Deleted
Joined: Apr 17, 2024 20:46:09 GMT -5
Posts: 0
|
Post by Deleted on Nov 5, 2019 18:15:52 GMT -5
What do the out of network deductibles look like? That's a little ugly, but I haven't ever had anything be out of network.
|
|
Deleted
Joined: Apr 17, 2024 20:46:09 GMT -5
Posts: 0
|
Post by Deleted on Nov 5, 2019 18:28:55 GMT -5
What happens if DS1 attends an out of state college? Will he still be (double) covered? Will he even remain covered by his dad after he turns 18? While my kids were in college I always ended up with the most expensive option since that was the only one offered that provided out of state coverage He can stay on our plans until he's 26. I guess I never asked ex and just assumed he'd keep him on because he has to have family coverage for all his other kids and it doesn't cost more. The network coverage is the same on all three, we're not limited to in-state. All the university healthcare centers he's interested in take it as well as the surrounding communities...maybe not everybody, but there are providers popping up on the search for all those towns.
|
|
|
Post by The Walk of the Penguin Mich on Nov 5, 2019 18:31:32 GMT -5
What do the out of network deductibles look like? That's a little ugly, but I haven't ever had anything be out of network. My surgeon was out of network for my insurance. He was the best surgeon I could find to do the job, and this was one place where I was not going to cheap out on. Also, even though only my surgeon was supposed to be OON, the hospital (which was in network) sent their labwork out to a contracted facility that was OON for my insurance. That was the only battle of about 6 that I lost with my insurance company. Take home message, don't assume it will all be in network.
|
|