<p>The rules & requirements are changing every year with ObamaCare as well as the various rules between states and employer plans.</p>
<p>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.</p>
<p>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.</p>
<p>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.</p>
<p>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?</p>
<p>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.</p>
<p>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.</p>
<p>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 :D.</p>
<p>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.</p>
<p>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).</p>
<p>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.</p>
<p>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.</p>
<p>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.</p>
<p>Thanks for the info, Steve. I’ll look into individual plans for our middle son (17).</p>
<p>Maine does not allow exclusions due to preexisting conditions as long as you’ve had continuous coverage, so that helps for this year for the older one (20).</p>
<p>I’m filling out paperwork for renewal right now, so I will ask about alternatives. Our business is so slow right now that every nickel makes a difference.</p>
<p>Does the AMT affect HSA?</p>
<p>Double check about switching from a group plan to an individual plan though. In all states as long as you maintain continuous coverage you can’t be dinged for preexisting conditions, that was part of HIPAA many years ago. It’s different in many states when switching between a group plan and individual plan. Are you using a broker? If not, find one. Insurance companies build broker commissions into premiums so you will pay the same if you use one or not. They can do all the leg work for you. :D.</p>
<p>dstark–affect how?</p>
<p>I am somewhat in agreement with maine though. When there was a larger difference between the PPO premium and the high deductible premiums, it was a bit more of a no brainer to choose the heigh deductible. Now with the premium differential being only $36 a month, the choice is much less clear.</p>
<p>I need to figure out the tax savings plus premium savings versus other potential costs. We pulled quite a bit out of our IRA/401k this year as it has been a very expensive year, so our marginal tax rate will be much higher than usual this year (plus lost a dependent deduction and no longer get the American Opportunity Tax credit for our daughter which has been nice the last couple of years). That makes the HSA contribution a little more beneficial this year. Not sure about next year. Really hope the medical costs go down at least a little, Hopefully won’t be doing a 1200 mile round trip every 2 weeks for medical treatments or renting an apartment in another city for 6 weeks for the same, won’t have a wedding to pay for. Hope the IRA/401k can be left alone a little. Can’t afford to keep pulling out money they way we did this year or I’ll end up living with one of the kids. Love em dearly, but I’m sure none of us want that!!</p>
<p>Do you lose the write- off of hsa if you pay amt?</p>
<p>dstark–as far as I know, no, but I am not a CPA. Hopefully someone else here is.</p>
<p>swimcatsmom-no, $36/month is not much of a difference at all. Most plans I see have a monthly difference for a family plan of $200, give or take a few. You do need to run the numbers. Keep in mind that if you reach your OOP max on a PPO, you still pay your office deductibles and more importantly (and expensively) your prescription co-pays on most plans, not all, but most. That can get expensive.</p>
<p>Another tip–HSA contributions are a good, legal, way to shelter money if you have kids going off to college…:D.</p>
<p>^ SteveMA…I was wondering about that. So I assume it is treated as retirement savings?</p>
<p>Mine are done with college - yay.</p>
<p>That is a good point about the co pays and one I had completely overlooked. Just checked the “options” details, and sure enough once I hit the max out of pocket of $8,000 on the HDHP I would not have to pay co pays on dr visits or prescriptions any more. On the PPO, the max out of pocket is $2,000 less but I would still have the copays for both. If I ever had to go on lovenox like my husband that would make a huge difference.</p>
<p>Thanks for that tip! Now if someone with a crystal ball can just tell me if I am planning to be healthy or sick next year that would make my decision making process a whole lot easier!</p>
<p>geeps20–yes. If you take your HSA funds out of your paycheck automatically, it shows up on your W-2 like your pre-tax health insurance payments would, thus showing a lower income to put on that pesky line on the 1040 :D.</p>
<p>Also, When you turn 65 there are a lot of things you can use your HSA funds for that you can’t earlier-like Medicare premiums, assisted living rent, etc. You can use the funds for whatever you want when you retire, withdrawls will just be subject to income tax, like an IRA, if they are not for qualified medical expenses. Before 65, those withdrawals are subject to income tax and a 20% penalty. So, there are definite advantages to having funds in that account. Also, most plans have a provision that once your account reaches a certain amount, usually $2000, you can move those funds into mutual funds, money market accounts, etc. with tax free growth :D.</p>
<p>swimcatsmom–figure for a low medical year, say 3 office visits between the 2 of you (there are only 2 on your plan for next year right?). How do those numbers compare? Then plan for meeting 1/2 of the deductible on both plans–how you meet that is DIFFERENT on both plans though. On the HD plan, ALL your medical expenses, co-pays, prescriptions, etc. will go toward your deductible, on your PPO plan they do NOT so on your PPO-plan for some tests, MRI"s, or whatever, that you would use your deductible for. Maxing out the plans is easy math, premium+OOP max-tax savings+co-pays/prescriptions=cost.</p>
<p>Does your insurance company have a website that will help you compare your plans?</p>
<p>You are right, Steve, that is what I meant, that the ObamaCare rules are changing the basic coverage on your same plan, so if one is considering a change or reviewing options, don’t assume either plan works the way it used to work.</p>
<p>For example, I am getting a shingles shot, that would have been subject to the deductible in previous years, now there is no deductible as it is preventative. I changed plans and had to review the new coverage, which has nothing to do with HSA v PPO and everything to do with new rules.</p>
<p>Our billed costs (total; not copays) run well less than $1,000 per year.</p>
<p>On not being able to use HSA money for non-dependents (son definitely isn’t a dependent), on copays se we can’t do that anyways now. Yes, there is a potential tax savings but I’m ignoring that to simplify things. Yes, it could be a benefit but I’d rather analyze things without that.</p>
<p>Our HD plan covers no prescriptions or doctor visits (except preventative) until the deductible is met. I’ve had some prescription this year (dental/oral surgery related) but mostly cheapos fortunately. I don’t think we came anywhere near meeting the deductible for either plan this year. But I know my BP is getting borderline or slightly above and my well check up earlier in the year my blood sugar was getting that way, so medical costs might change if I finally cave and start going to the doctor. I have been putting it off because we have had so much to deal with with my husband’s cancer this year. I actually had an appointment for a colonoscopy this year - Feb 14th would you believe, but that was one of the M D Anderson 2 day visits that turned into 2 weeks and I never rescheduled. (But that would be covered under the HDHP anyway). (and I never went back for the blood sugar check - I know I should, just really didn’t want to know this year - plus I had great plans to start a diet and exercise program and hoped that would take care of it)</p>
<p>You’re right, I need to go check on the plan’s web site. The little leaflet they sent out is not really detailed enough. If all goes well with H’s 3 month check up in Houston next week, I will do that when I get back. Otherwise it will just default into the program I am already in (HDHP), so not going to panic too much one way or another.</p>
<p>BCEagle91–without seeing your premium numbers I can tell you that almost always a HD plan is more cost effective for low users like you.</p>
<p>swimcatsmom–that is how all HD plans work, no company contribution until deductible is met. I hate to say “no coverage” because you do have coverage, you are just paying for the first portion of that, at a reduced rate in-network. Ask HR if they have a list of the federal preventative drug list. If you do need insulin (I think that is on the list) or HBP meds, if you can use one of the meds on that list, that is covered at 100%, if you need to that is.</p>