Lergnom

That is terribly confusing. It means this: you can set aside pretax money to pay medical bills and use those fine for a person on your plan who is also a dependent for your taxes. If the person is not a dependent for your taxes and you use pretax money, that's a violation. So say you have a 24 year old kid on your health plan but that kid files his or her own tax return. You can't pay deductibles, etc. for that kid out of pretax money from you. That pretax money is only for people on your tax return.

That is why they say the person on your plan who is not on your tax return can set up a separate pretax plan.

swimcatsmom

So weird and complicated. Thanks somemom and Lergnom. I will have to do some more research, but if the way we are interpreting it is correct (i.e. I can Contribute the full family max - plus the extra for me being an oldie - but am not able to pay D's expenses using the HSA even though the fact that of her being on the plan enables be to contribute the max), then that might sway me on the direction of sticking with the high deductible. I know I have a hefty dental bill coming up next year and my husbands prescriptions are always high - was in the Med D and out the other side the first 2 months of 2012 (meaning his out of pocket prescription costs exceeded $4700 by the end of Feb).

Need to get my brain around all this by Nov 15th!!

Seems like so many contradictory things - she is on the HD medical plan so i can contribute the max to the HSA because that makes it a family plan. But I can't use the funds to pay for her expenses. On the other hand, my husband can not be on the plan because he is already medicare eligible so I can't contribute anything based on him (wouldn't make a difference right now but once my daughter is off the plan it will). But I can use the HSA funds to pay for his expenses.

Vyse

Geeps, I see what you're saying. By decouple, I just mean they should offer HSAs with AND without HDHPs. If you're young and healthy, yeah, HDHPs would still be a great option. But we should give HSA options to people with PPOs too imo. I also agree with incentives for making good choices like not smoking and not being overweight. But some medical problems don't come about because of poor choices, they're just a matter of rotten luck.

swimcatsmom

AGREE!!!!!! Why not offer HSAs with any medical plan. That would be perfect.

BCEagle91

I do not get this right now. The total costs for the HDHP for us is $10,192. The total costs for PPO is $11,700. So there's a savings of $1,508 and there is a $10,000 family deductible. The HDHP plan attached to the HSA has to provide a lot more coverage for this to be worth it.

swimcatsmom

Ouch. That does not sond like a good deal at all. Our $2800 deductible is looking a whole lot better.

BCEagle91

The ten k deductible is for family. The individual amount is 2k.

I get the feeling that a lot of services are covered which makes this different from what other people report. The company pays about 8.5k.

swimcatsmom

With our HDHP, the individual deductible is only available if the HDHP is for an individual. If you have a family HDHP. the family deductible applies. Not $1400 for her and $1400 for me, but $2800 in total . I thought it was the same for all high deductible plans (the family vs individual, not the $ amounts), but I may be wrong. That was one of the things we had difficulty understanding the first time we considered the HDHP plan and I had to talk to the provider who confirmed that if we had the family plan we had the family deductible - no individual deductibles at all. You may want to check that out. (now our PPO is individual deductibles and a capped family maximum deductible, but not the HDHP)

HDHP's are required to cover certain preventative medicines and procedures. So mammograms, pap smears, colonoscopies etc are covered. Ours covers no prescriptions until the deductible is met except certain preventative ones such as birth control (not an issue for me).

There are so many different things to take into account. Need a little computer program that you can plug all my data in and it will tell me which plan will ultimately cost me the least.

BCEagle91

The 10k amount is max out-of-pocket. Max deductible is 3k.

The HSA coverage is almost the same as the PPO.

Just some minor differences in copay vs percentages and higher deductibles. So it is essentially a PPO with higher deductible limits and percentage company's instead of fixed dollar amounts. We could use this plan with a minimal contribution.

ucbalumnus

Re: ObamaCare Putting Squeeze on Health Savings Accounts

Presumably, this is reference to medical loss ratio minimum requirements, which are lower for HD plans than for higher coverage plans, because employee contributions to HSAs are not counted in medical loss ratios (even if they are just from premium or payroll deduction savings).

However, some employers which traditionally offered higher coverage plans offer HD plans with employer-funded HSAs, which presumably improve the medical loss ratio of the HD + HSA plan. It would not be surprising if such an offering were (a) cheaper for the employer, (b) advantageous cost-wise for the employee who uses little medical services, and (c) approximately break-even for the employee who uses lots of medical services, when compared to a higher coverage plan. (Of course, this does depend on the specific plans involved.)

The savings of HD plans comes in two ways: (a) less administrative overhead paying smaller claims through insurance, and (b) some level of self-rationing by the participant (i.e. instead of always wanting more, the participant may consider whether a given service is of value to his/her health, since there are some common medical services which are of dubious value in improving medical outcomes, even if they were free).

somemom

The rules & requirements are changing every year with ObamaCare as well as the various rules between states and employer plans.

Be sure to compare your plan offerings now, pick a couple of conditions- say, the way you use it now and then in case of something big-car accident, ER visit, surgery, cancer, heart, etc. and look through how these would each work for you and your family in each case.

SteveMA

swimcatsmom--she can open her own HSA IF she has her own high deductible plan. She can't if she is on your plan but you don't claim her as a dependent. That is one of the IRS rules for the HSA's. The key word is "dependent". You can put the max into an HSA if you have any family plan, that would be employee +1, employee+ spouse, or family plan--basically anything that isn't an individual plan you can contribute $6450 this year, + $1000 more if you are over 55.

somemom--in all states preventative care is covered at 100%-along with an IRS defined list of preventative medications. It's part of the health reform.

BCEagle91--your son can't be on your high deductible plan and use HSA dollars if he is covered under another plan, IRS rule. You also have to claim him as a dependent and if he is working full time, it's hard to prove you pay 50% of his support. Yes, your negotiated rates work on your HD plan too. Your HD plan has the same coverage as your other plans, you just have to pay more upfront. You said you are saving over $1000/year, did you include your tax savings with that too? If you are in say the 28% tax bracket and max out your HSA, you are looking at a tax savings over $3000/year on top of your premium savings, etc. Is' your deductible 10K or is your out of pocket max 10K. That is a big difference. Also, with a HD plan, there is no "individual deductible". One person could meet all of that deductible.--ok-saw your next post, you will pay the first $3000 of your medical costs, not including preventative care. You then pay a % of the next costs up to $10,000 out of your pocket, usually either 10 or 20%. At 20%, you are talking 50,000 in billed medical costs until you reach your OOP max. Do you have medical bills that high?

swimcatsmom-a HD plan should not prevent you from going to the dr at all. Cost wise, most of these plans are actually LESS expensive, by a LOT, over the year, but if you don't have any money to spend on medical bills in say Jan, Feb, yes, it's expensive up front. Our HD plan saves us about $5000/year over our PPO plan if we max the plan out (meet our out of pocket max--which we did last year). The big difference is that on a PPO plan, most likely your copays for office visits and prescriptions don't stop after you meet your "out of pocket max" so you will still pay those. With a HD plan, once you meet your OOP max, you are done paying anything for that calendar year. The savings we see is from premium savings, well over $200/month for us, tax deductions and no copays, etc.


geeps20--read the article again, it's hogwash....there has and will not be any changes to the HD plans or HSA's. The "government regulating these plans" already happens, there are certain requirement for a HD plan to be a tax qualified plan, and there has been for 10+ years. Some of those qualifications are that they have to have deductible limits and out of pocket maximums between certain limits, they have to have a common deductible, people on the plan can't have other insurance and can't be on Medicare/Medicaid/Tricare, etc.

somemom--what rules and requirements are changing--you are talking about additions to plan coverage, not how HD and HSA's work. Those changes are across all kinds of plans. Don't confuse this more .

SteveMA

GENERALLY--what I see in plan designs (part of what I do for a living) is that HD plans for low users and high users are the most cost effective. For singles and families with 3 or more people on the plan it is almost always more effective for a HD plan with a HSA. For people with 2 people on their plan, it gets a little murkier because they are generally subject to "family" deductibles..but also can put in the $6450 to the HSA. If your employer puts in a good amount into your HSA for you and your OOP max is $6000-8000 or less, GENERALLY the HD plan is good for everyone. It also depends on how much your employer pays toward premiums. 50/50 split TYPICALLY means the 2 people on a plan sometimes is better with a HD plan, sometimes not. Again, these are GENERALIZATIONS, but things to consider when you are starting to look at plans.

MaineLonghorn

My husband and I are the "group" for our business. HSA plans were a good deal a few years back, but they've raised the monthly premiums so much that now they're not worth it for us (yes, I run all the numbers carefully, since I'm an engineer).

We pay almost $14,000/year for an individual deductible of $5,000; family deductible of $10,000. At least up here, Anthem has rigged it so it doesn't make sense to get a lower deductible - you pay more in premiums than you get back, until you get up to $15,000 in claims.

With two sick sons, though, I can't complain. We make up most of the monthly premium through the reduced price we pay for meds. Some of the sticker prices are unbelievable. We pay $10 for one Rx that costs over $500 without the price break. There is also a bleeding disorder in our family. ONE dose of the med to prevent bleeding after surgery was over $21,000 a couple of years back, when DH had part of his thyroid removed, and he needed two doses! Yikes. I guess we're the people who drive up health costs, sigh.

SteveMA

MaineLonghorn--part of your cost issue is that you have 2 employees on your plan with sick children so you are getting hit hard for your claims history. If you spread that out over say, 8000 people, your rates would most likely go down. In your situation, if your kids are under 19, it might save you a boat load of money to get the kids on individual plans and keep you and your DH on your group plan (or all got to individual plans). It really depends on what you can get with your state but in 2013, kids under 19 are not subject to preexisting conditions. If they are over 19, something to consider for 2014.