<p>My employers website had a veritable ton of information along with web calculators and comparison tools. The problem there is that I need to go through it all. My gut feel is that it’s worthwhile to go with the HSA if our son is covered - we can do copays and such out of pocket. I might not bother and just leave it though for this year.</p>
<p>I’m going to ask others about it tomorrow - though they probably know less about it than I do. Next year won’t be fun for most people if what I’m seeing is common - $500 more for health insurance and the loss of the payroll tax cut.</p>
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<p>The differential is $1,500 which is what we’d most likely save. Is $1,500 worth peace of mind? I don’t know right now.</p>
<p>BCEagle91–is your employer contributing anything to your HSA? Yes, if you have a major illness, cancer for example, you will probably end up paying all of your out of pocket max. Do you have funds to cover that if you do? Do you have the funds to cover OOP max on the PPO (what is that, not sure if you said)? What is the difference between the OOP max on the HD and the OOP Max on the PPO? Is it more than $1500 plus whatever tax savings? That is the number you want for your piece of mind, not the $1500.</p>
<p>No. They are not contributing to the HSA. But they are contributing about $8,500 to the HDHP. The coverage is very, very close to the PPO plan offered. The difference appears to be in that the employer pays 10% of the bill instead of the copay and that the overall deductible limits are a lot higher.</p>
<p>It sounds nothing like what I hear of when other people talk about their plans.</p>
<p>What do you mean they are contributing $8500 to the HDHP? Is that their portion of the premium? They are paying part of the premium on your PPO plan too. As for coverage, define what you mean by that. Your coverage should be the same, meaning the same services are covered under either plan, how you pay for that is different. With a tax qualified HDHP there has to be a common deductible, I think you said $3000. You will pay the first $3000 of all of your medical expenses. Then there is a co-insurance part where you pay a small percentage and your company pays the rest–typically 90/10 or 80/20 with you paying 10 or 20%. Once you have paid 12,000 (I think that was your OOP max) you are done paying anything for that calendar year on a HDHP and on a PPO plan, you still pay co-pays but everything else should be covered at 100%. Not having an employer contribution to a HDHP does change the benefit of the HDHP some-the numbers get closer to the PPO usually.</p>
<p>Hmmm. So you can potentially save a max of $1,500 while the risk is $10K for OOP max. Our likely spending is probably around $500 so the savings would be $1,000 normally but one incident in ten years would wipe out the savings for ten years. I guess that this is why you need the tax benefits to sweeten things. With the HSA, there is also some requirement to manage the savings account so that’s investing. I didn’t take a look at the investment choices on the HSA.</p>
<p>It’s starting to look like a negative. I was hoping for some big savings but it doesn’t look like they can be had with our HDHP.</p>
<p>H’s company switched us to HDHP several years ago. It’s a PPO, by the way. The trick is to try to save beforehand so that you have money to cover the OOP until you get enough in the account to use for OOP. Leave some in at all times so that you have enough to cover costs that may come up early in the year when there is less in the account (assuming you contribute each pay period). </p>
<p>I didn’t think I would like the HDHP, but I actually do. It was killer the year S was on Accutane … we hit the deductible really fast! But once the deductible is hit, the coinsurance is easy to handle. Our Rx is changing this year, and we have copays rather than coinsurance for Rx … but if we were to hit our OOP max, all coinsurance and copays will end. That is definitely not always the case, though, from what I saw when I worked in group benefits. Many companies keep charging Rx copays even after max OOP is hit (which makes no sense to me …).</p>
<p>Re: free preventive care, only non-grandfathered plans are required to cover at 100%. If your plan is grandfathered, they do not have to comply.</p>
<p>I don’t invest our HSA money. I am not about to gamble that money! The account pays interest, and I figure a little bit of guaranteed money is better than a potential loss. You probably don’t have to invest.</p>
<p>BCEagle91–there are still out of pocket costs on your PPO too. I think that is the point you are missing. If there are no OOP costs other than copays on your PPO, great, go with that plan. I’ve never had a plan like that though.</p>
<p>kelsmom–it just depends on your risk tolerances. There are some very low risk options in our plan that get a fairly good return, way better than just a savings account.</p>
<p>BCEagle91–look at your plan summaries. I really doubt that you wouldn’t have OOP costs on your PPO if you had a major medical event. Likely, the costs are very similar. You haven’t run into them because you haven’t needed to use them yet. Look on your company website and see what the PPO lists for deductibles and co-insurance and then compare those to your HDHP.</p>
<p>I spent some time looking at all of this stuff.</p>
<p>I started out with the 18-page FAQ. I found that the company does contribute to the HSA but I had to go through a bunch of websites and documents to find the one place where it tells you how much the company contributes. In my case, it would be $1,200.</p>
<p>I also found out that I wasn’t enrolled in the plan that I thought I was this year. I can save $1,200 just by changing to the plan that I thought I was in. I think that some plans changed a year or two ago and I just assumed that I would keep the same plan but it looks like there were two as a result and I got put into the more expensive one by default. The HSA would save me an additional $1,440 per year.</p>
<p>The company makes the same contribution to the HSA as it would any other plan but they also give you an extra $1,200. So it looks like more studying is needed. Ideally I could find someone in the office that is using the HSA. Worst case, I just go back to the other plan and drop costs $1,200. That $1,200 that they kick in would probably cover all of our medical costs for the year outside of any catastrophe. I don’t know if our son would be covered though. So the HSA is still in play.</p>
<p>One other thing that I spotted was life insurance beneficiaries. I will probably make some adjustments there.</p>
<p>So you would save $2600 by switching to the HSA–does that include the $1200 company contribution to your HSA? If not, that savings alone makes up your deductible. After that you are paying 10% of your bills. Put that $3900 into your HSA. You still need to find the worst case numbers for all plans–what your total out of pocket costs would be. There should be a benefit summary SOMEWHERE in there that shows you your company contribution to the HSA, your deductibles (in-network, out-of-network) and your co-insurance for in and out of network.</p>
<p>My current plan is $1,200 above another similar plan which would be a traditional PPO which would provide me with what I need - just less coverage for out-of-network providers which I don’t use anyways. I didn’t need to pay that in 2012 - I didn’t pay attention for a year or two. The HSA is $1,440 less than that lower-priced PPO. The company would contribute $1,200 into the HSA. So I guess that the net amount back to me is $2,640. I don’t count the additional $1,200 because I could save that with the other PPO plan.</p>
<p>There is a benefits comparison tool but most of the things are similar between the EPO, PPO and HSA. The comparison is quite long too and the descriptions are pretty short. In a typical year, the $1,200 would probably cover all of our costs.</p>
<p>I’m considering a CDHP/HRA for the first time this year instead of an HMO. Still trying to figure out costs for each. If we all only have preventative and a minor illness the CDHP would be a good bet. I’m not clear on some aspects of it.</p>
<p>It has a 4000 deductible, the company puts in 2000 to an HRA. There is a section that says “payment limit” and it is 2400 for family…It says only expenses from coinsurance and copays cound toward out of pocket limit. SO, does that mean I pay 2000 deductible and then additional copays and stuff could be another 2400?? </p>
<p>xrays labs and imaging all subject to deductible. Hospital has $100/day for 5 days co-pay and the ded. applies.</p>
<p>My son went to the Er for stiches this year. The billed amount was $1600 and the payout was about 1000, all but $60 paid by HMO. This new plan says $60 copay and deductible applies. That means that if i had this new plan he would have owed $1600 ( or $1000???) ouch. That is some expensive stitches. </p>
<p>The new plan is $1600 less than the HMO choice. HMO covers everything that I get a referral for. S1 got stitches in 2012, S2 got an MRI and xrays. A year like that and I’ll blow through the 2000 the employer puts in, and I’ll be hesitant to get tests (which is WHY the employer and insurance LOVE these plans.)</p>
<p>I hate referrals, but I also hate paying bills.</p>
<p>Any thoughts on what kind of bills typically would be encountered that apply to deductible? All offered plans have the same Rx coverage.</p>
<p>njfootballmom–an HRA is different then an HSA, just make sure which one you have. For an HRA, you pay whatever bills and your company reimburses you up to whatever amount they are giving. You don’t get the tax deductions you would have with an HSA. As for your total out of pocket costs, it depends on how it is written. Ask HR if your deductible counts against your out of pocket max. The wording on your documents is odd and confusing. I read it two ways-one is that you have a co-insurance amount of $2400 above your $4000 deductible for a total out of pocket of $6400. The other is that you have out of pocket cost of $400 above your deductible. As for what bills apply to your deductible, pretty much every medial procedure would with the exception of preventative care since that is covered at 100% anyway and medications. </p>
<p>As for your example of the stitches-that is part of the Consumer Driven part–did he need to go to the ER for those stitches? Could he have gone to an urgent care or to your family doctor instead? Basically they want you to go to the most cost effective option. Not everyone has access to urgent cares, etc. so in that case the ER is the only option. DS needed a refill on a medication for his acne yesterday. The DR suggested a newer version of what he was using. I took out my cell phone and looked it up on our formulary–not covered, would have cost $180, the dr’s jaw just dropped. We got the current med he was using for $12.</p>
<p>Something else to consider with an HMO, since this is a college site, HMO’s do not work out of network. If your child is going out of your area for college, look into that VERY carefully. </p>
<p>Assuming you have a $6400 total out of pocket max, just doing the quick math, your company is giving you $2000, your premium savings is $1600, you are just $400 shy of your deductible with those 2 things. After that there is some kind of co-insurance usually where you pay a portion of the bill, 10% or 20% usually. Do you see something like that on your summary? Once you hit that out of pocket max, everything is covered at 100%, except medications. It sounds like you have office co-pays too–those may have to be paid as well. For a general office visit for say, strep throat, you typically only have to pay your co-pay for that visit. For the stitches, done in a dr’s office, you probably only have to pay your co-pay as well–depending on your exact plan. Without seeing your exact summary, it’s hard to say though.</p>
<p>I think that I’m going to go with the PPO plan at this point unless someone at work can come up with a good description of why an HSA/HDHP would work out better. I think that I need to see a bunch of examples too. That I can’t find anyone in the office with the HSA/HDHP is also a concern. Perhaps more people will look into it with the increases in healthcare costs this year. I’ll just take the cheaper plan, save $600/year and look at this again next year. The potential savings of the HSA/HDHP appear to be $1,800 at most with the employer contribution and HDHP discount.</p>
<p>My manager continues to look into this plan.</p>
<p>BCEagle91–so you are willing to spend $1800 more for your health care, not including the tax break you could be getting because none of your friends use it? :D.</p>
<p>I spent $2,400 more in 2012 so $1,800 more feels like a bargain. $1,800 is fairly small change even though I like to be efficient.</p>
<p>I spoke to another co-worker about the HSA. This is one of the smartest guys that I know on trading options and bonds. He said that he spent some time looking at it and it was too complicated for the amount of time that he wanted to spend on it and is just going with the PPO. He also mentioned that the company that manages the HSA gets monthly maintenance fees if the balance drops below $2,000.</p>
<p>The problem with the HSA seems to be the complexity. Busy employees don’t want complexity and paperwork and I guess that you can avoid that by paying more. Time is a luxury.</p>
<p>What I’d really like is another variant of the PPO with lower biweekly charges and higher copays and deductibles.</p>
<p>I think I understand it, and it is an HRA. I think it will work a lot like my current HMO except without referrals and it will require for me to pay for tests, xrays and such until my deductible is met, but company pays me back for the first 2000, AND I technically have already saved the 1600 in premiums. </p>
<p>I am at risk for paying money for tests, labs, e/r visits and $100/day (up to 500) for hospital. I guess the gamble is in how much of those tests etc we will need. I am way overdue for routine bloodwork and hubby keeps close eye on his cholesterol. I wonder how much that runs? I could try to get it in this year…he can for sure as he has the orders but hasn’t gotten there yet.</p>
<p>When my son needed stitches over his eye it was because he had a cut about an inch long from being elbowed. The urgent care place couldn’t give us an answer on the phone about whether they would do it (face and it was over 6 hours since injury–he’s 22 and need i say more…) They said they were busy so we went to the ER. They didn’t look busy but it still took hours. That is a situation where knowing prices would make a difference and it seems like ER’s should try to route certain patients to the urgent care as part of a health cost saving measure. (though hospital probably likes the business)</p>
<p>I have a pdf file of the summary if you think you’d have time to glance at it and tell me if you think I understand it properly. I believe if we do not have any big health issues the CDHP seems like a good value, but if we have a heart attack, cancer, sports injury (recreational only, football doesn’t look likely)…then not so much. (no reason to expect the above but we are 50 and 52 now so…) </p>
<p>It’s a tough decision to make. I might gamble on it because apparently taxes will be going up, not down.
Thanks</p>