Health Insurance Questions-WWYD?

[giramomma]

This is long. I hope this makes sense.

2016 was the first year that my workplace offered an HDHP/HSA health insurance option. We took advantage of it...just to try it, and I liked it, for the most part. (Praying for no broken bones is the part I don't like.)

The only reason why my workplace offered a HDHP/HSA option is because of the ACA. It was either that, or pay a crapton in penalties because our normal option is considered a Cadillac insurance program.

Now. I'm guessing, like others the ACA is going to be repealed. I think it's a matter of when, not if. And I can totally see it happening in the "First 100 Days."

My goal for my HSA is to minimally touch the money and let it grow over the next 15 or years until I retire. I'm likely going to retire at 58. I really like the idea of having money set aside, specifically for medical costs (outside of insurance premiums) for when I retire, but don't qualify for Medicare, etc.

Added to the mix, is that we get 11K of snowflake money a year. DH and I use that to fund IRAs, normally.

So. I have to make a decision like, today, about my health insurance for next year. Enrollment ends on Friday.

I was leaning towards doing the HDHP/HSA again.  My plan was to contribute 4K. In order to do that, we would need to live off of about 1500 of the snowflake money. I received blessings for that.

I'm wondering if I should contribute the max to the HSA, and use more snowflake money for our normal living costs.

Or, given all the instability, should I just go with my regular insurance option?

My premiums for family coverage are about $200. HDHP is 89. Obviously more is covered with the regular insurance. But, we're a healthy lot. With the HDHP, and excluding my teeth, our medical costs were $700 total for the year. If we would have had regular insurance, it would have been about $60.

WWYD?

[milee]

Go for the HD plan and HSA. Insurance won't change for this year, so make your decisions on what works this year, not what you're worried will happen.

[Tiny]

My premiums for family coverage are about $200. HDHP is 89. Obviously more is covered with the regular insurance. But, we're a healthy lot. With the HDHP, and excluding my teeth, our medical costs were $700 total for the year. If we would have had regular insurance, it would have been about $60.

On an aside: Is that every paycheck? so 200 * 26 = 5200 in payments for the year versus 89*26 = 2314 in payments per year?


I'm on Milee's side - I'd go with what works best for the next year and not worry too much about what will happen after that (until you get to next years re-enrollment).

[giramomma]

Nov 9, 2016 11:40:12 GMT -5 Tiny said:

My premiums for family coverage are about $200. HDHP is 89. Obviously more is covered with the regular insurance. But, we're a healthy lot. With the HDHP, and excluding my teeth, our medical costs were $700 total for the year. If we would have had regular insurance, it would have been about $60.

On an aside: Is that every paycheck? so 200 * 26 = 5200 in payments for the year versus 89*26 = 2314 in payments per year?


I'm on Milee's side - I'd go with what works best for the next year and not worry too much about what will happen after that (until you get to next years re-enrollment).

No. I get paid monthly, once a month. This year, with the HDHP, I took the difference in premiums and contributed that to my HSA.

I'm a public sector employee. I know my health insurance looks good. But it comes at a cost. In the last 10 years, I've had two 1% raises and one 2% raise. I'm also told how I'm lower than those on public assistance, the money I earn from my job isn't really mine and I have no right to it.  Can you imagine being at the same work place for 15 years, and being known as a "producer" and going above and beyond and still being at the lowest possible income for your pay grade?

And, we used to have good dental coverage, and now we have crap dental coverage.

I think I'm leaning towards maxing my HSA in 2017. Our state is also talking about self insuring, which would also happen in 2018. I think, self-insuring in itself isn't a bad thing. But, again, when lawmakers think that any gov't worker is the root cause for all of the state's ills...well..I get a little concerned about self insurance, because it's those lawmakers that are going to make the health care plan decisions.

[bean29]

I agree with what Milee said. Your plan will not change for the current year. It is what it is. Make your decisions based on the plans you have been offered.

I have an HDHP, and I had it before ACA went into effect. I expect we will continue to have it in the coming years.

I really am not sure how much our future health insurance is going to change. If we eliminate ACA, and go back to uninsured people using the ER, then what the hospital charges the insurance companies will have to be high enough to cover their losses from the uninsured.

Personally, I think there will be more gradual changes. I am hopeful that we will see prescription drug coverage become more affordable though.

[Deleted]

I don't think the HDHPs are going away even if ACA does.  Much like with 401ks and pensions, companies offering these now have a way to shift future cost increases on to you while keeping their contribution level.  It's win/win for them.

[justme]

Nov 9, 2016 11:54:37 GMT -5 giramomma said:

Nov 9, 2016 11:40:12 GMT -5 Tiny said:

On an aside: Is that every paycheck? so 200 * 26 = 5200 in payments for the year versus 89*26 = 2314 in payments per year?


I'm on Milee's side - I'd go with what works best for the next year and not worry too much about what will happen after that (until you get to next years re-enrollment).

No. I get paid monthly, once a month. This year, with the HDHP, I took the difference in premiums and contributed that to my HSA.

I'm a public sector employee. I know my health insurance looks good. But it comes at a cost. In the last 10 years, I've had two 1% raises and one 2% raise. I'm also told how I'm lower than those on public assistance, the money I earn from my job isn't really mine and I have no right to it.  Can you imagine being at the same work place for 15 years, and being known as a "producer" and going above and beyond and still being at the lowest possible income for your pay grade?

And, we used to have good dental coverage, and now we have crap dental coverage.

I think I'm leaning towards maxing my HSA in 2017. Our state is also talking about self insuring, which would also happen in 2018. I think, self-insuring in itself isn't a bad thing. But, again, when lawmakers think that any gov't worker is the root cause for all of the state's ills...well..I get a little concerned about self insurance, because it's those lawmakers that are going to make the health care plan decisions.

Self insured still use a healthcare insurance company to manage the plans. My parents were on a city plan that was self insured. Covered very similar to a plan with the same company once I was off on my own. I probably wouldn't worry too much about them going self insured - it's mostly all back end differences you don't see anyways.

[quince]

HDHPs were around before the affordable care act. They were popular with the push for care management because soaring healthcare costs were a problem even before.  They've had a different market penetration because of the ACA.  

[Tiny]

Nov 9, 2016 11:54:37 GMT -5 giramomma said:

Nov 9, 2016 11:40:12 GMT -5 Tiny said:

On an aside: Is that every paycheck? so 200 * 26 = 5200 in payments for the year versus 89*26 = 2314 in payments per year?


I'm on Milee's side - I'd go with what works best for the next year and not worry too much about what will happen after that (until you get to next years re-enrollment).

No. I get paid monthly, once a month. This year, with the HDHP, I took the difference in premiums and contributed that to my HSA.

I'm a public sector employee. I know my health insurance looks good. But it comes at a cost. In the last 10 years, I've had two 1% raises and one 2% raise. I'm also told how I'm lower than those on public assistance, the money I earn from my job isn't really mine and I have no right to it.  Can you imagine being at the same work place for 15 years, and being known as a "producer" and going above and beyond and still being at the lowest possible income for your pay grade?

And, we used to have good dental coverage, and now we have crap dental coverage.

I think I'm leaning towards maxing my HSA in 2017. Our state is also talking about self insuring, which would also happen in 2018. I think, self-insuring in itself isn't a bad thing. But, again, when lawmakers think that any gov't worker is the root cause for all of the state's ills...well..I get a little concerned about self insurance, because it's those lawmakers that are going to make the health care plan decisions.

 

 Yeah, your insurance cost does look good AND I get the trade off in raises/income. 

In the last 10 years I've had 2 years no raise and then a couple of years with 1% raises and now we're back to 2%...   But, I had higher insurance costs over those 10 years.   It's not a complaint and I'm not 'bitter' or angry because I don't see any unfairness/injustice.     

Again, I can't really complain. I'm mostly interested in what other people pay (and the trade offs).  I've been with the same employer for 20 years, and I'm single. I don't have much in the way of medical expenses - so I use to take the cheapest plan that would let me use doctors/hospitals near my home.  So I can't compare my expense to yours directly.  And I'm horribly out of touch with what other people are paying.  That's what prompted my question.

Here's this years "Individual and Spouse" rates.  It's biweekly - so 26 payments: 

HDHP biweekly (individual + spouse) = $197  = 5122annually 

Core PPO         (individual + spouse) = $253  = 6578 annually

Buy up PPO     (individual + spouse) = 301  = $6344 annually

There's all sorts of copays when I was on the PPO I use to 'budget' $90 (FSA) to cover copays each year. I hear my coworkers spend lots more than I ever did on copays.

[jkapp]

Nov 9, 2016 12:30:04 GMT -5 justme said:

Nov 9, 2016 11:54:37 GMT -5 giramomma said:

No. I get paid monthly, once a month. This year, with the HDHP, I took the difference in premiums and contributed that to my HSA.

I'm a public sector employee. I know my health insurance looks good. But it comes at a cost. In the last 10 years, I've had two 1% raises and one 2% raise. I'm also told how I'm lower than those on public assistance, the money I earn from my job isn't really mine and I have no right to it.  Can you imagine being at the same work place for 15 years, and being known as a "producer" and going above and beyond and still being at the lowest possible income for your pay grade?

And, we used to have good dental coverage, and now we have crap dental coverage.

I think I'm leaning towards maxing my HSA in 2017. Our state is also talking about self insuring, which would also happen in 2018. I think, self-insuring in itself isn't a bad thing. But, again, when lawmakers think that any gov't worker is the root cause for all of the state's ills...well..I get a little concerned about self insurance, because it's those lawmakers that are going to make the health care plan decisions.

Self insured still use a healthcare insurance company to manage the plans. My parents were on a city plan that was self insured. Covered very similar to a plan with the same company once I was off on my own. I probably wouldn't worry too much about them going self insured - it's mostly all back end differences you don't see anyways.

Self insured plans are getting worse now too.  It used to be, going self insured helped keep costs down.  But next year, our total out of pocket is going from $2500 to $5000 (for single) and more than double both numbers for a family plan.

And that is the cheaper plan (overall) even though it has higher premiums.  The cheaper premium plan for family coverage has the out of pocket topping out at over $13k! I don't know why anyone would choose that plan.  For cheaper premium single coverage, the out of pocket is $6550 but the annual premiums are only $700 cheaper. 

Needless to say, I'm wondering why our company is sticking to self-insurance.  We are a much bigger company now, so I would think we could get a much better deal with a classic insurance program.

[sesfw]

I also say go with what is best for you for 2017.  Then wait and see what this next year brings.

[justme]

Nov 12, 2016 12:03:27 GMT -5 jkapp said:

Nov 9, 2016 12:30:04 GMT -5 justme said:

Self insured still use a healthcare insurance company to manage the plans. My parents were on a city plan that was self insured. Covered very similar to a plan with the same company once I was off on my own. I probably wouldn't worry too much about them going self insured - it's mostly all back end differences you don't see anyways.

Self insured plans are getting worse now too.  It used to be, going self insured helped keep costs down.  But next year, our total out of pocket is going from $2500 to $5000 (for single) and more than double both numbers for a family plan.

And that is the cheaper plan (overall) even though it has higher premiums.  The cheaper premium plan for family coverage has the out of pocket topping out at over $13k! I don't know why anyone would choose that plan.  For cheaper premium single coverage, the out of pocket is $6550 but the annual premiums are only $700 cheaper. 

Needless to say, I'm wondering why our company is sticking to self-insurance.  We are a much bigger company now, so I would think we could get a much better deal with a classic insurance program.

The cheaper plan out of pockets are the same out of pocket for my hsa plan and we're not self insured. So going off it might not be any better for you.

Self insured is only cheaper only if your employees use the plan less than what your cost is for the insurance company to handle everything. It's probably more predictable than say self insuring car insurance like a lot of companies do, but one employee getting cancer can blow it out of the water. Just like one bad car accident and suddenly the company is out millions.

[emma1420]

I agree with others do what is best for you in 2017.

The ACA isn't going to be easy to repeal. It's going to take time for them to figure out how if they can keep the popular protections in place.  I'd be shocked if we saw anything sort of real change until 2018/2019.  It could happen, but I think it's unlikely.

[lund]

I agree that there probably will not be any changes until 2018, at the earliest.
It often takes at least two years to figure out and implement changes, especially big ones, and they often start with a new year, so do what is best for you for 2017, and keep your ears and eyes open to when/if changes are announced in order to be prepared.

[gooddecisions]

I think you're safe to get the HDHP and HSA. I've had them since way before ACA- I'm thinking at least since 2003. I haven't had more than 1-2% raises in at least 8 years either. I work for a private company, but attribute that to staying put for way too long. People don't usually get big raises for staying in their same positions, whether private or public. But, I heard my dad say the same thing for years and years working for the government. Trust me, the grass is not greener in private- you have to move and hustle more to get those big raises.

[Deleted]

Nov 13, 2016 6:55:18 GMT -5 gooddecisions said:

I think you're safe to get the HDHP and HSA. I've had them since way before ACA- I'm thinking at least since 2003. I haven't had more than 1-2% raises in at least 8 years either. I work for a private company, but attribute that to staying put for way too long. People don't usually get big raises for staying in their same positions, whether private or public. But, I heard my dad say the same thing for years and years working for the government. Trust me, the grass is not greener in private- you have to move and hustle more to get those big raises.

I agree.  I work for a large privately owned company and it's pretty well known the only way you get any kind of raise is change positions, go somewhere else, or if you're ballsy put in your notice and hope they try to get you to stay.  This year there were no raises...for anyone (thousands of employees), last year was 2% across the board, year before that only 1.

[zibazinski]

Remember the "lie" that you wouldn't be tied to your job because of health insurance? Looks like you are by needing the subsidy that employers give people in order to afford health insurance. Some of us don't have that luxury.