Holy healthcare cost increase Batman!

[darkxshade]

Depends on what the HDHP coverage is like. If the HDHP Kaiser plan offered wasn't in-network Kaiser providers only, I'd be all over it for the reduced premium, since my wife is guaranteed to hit her MOOP anyway. We just can't give up some of her non-kaiser providers that she's been seeing for nearly a decade.

Other than that though, our HDHP would cover 100% of everything needed after the deductible, including meds.

I guess that's true to an extent. You really have to do the math for yourself to figure it out, there's an annual health costs cutoff point where it becomes cheaper to just go straight EPO/PPO.

For me I would have to rack up an annual bill of ~$1600 before the HSA becomes less efficient.

The math goes something like this:
HSA plan takes $36 off/paycheck
PPO plan takes $58 off/paycheck

It obviously makes sense that if you go HSA the difference you otherwise would have paid to the PPO should go into the HSA account. My company also adds on top of that $1000/year to the HSA if I select that. There's no bonus offered for selecting the other plans.

So $1000 + (58-36)*26 paychecks = $1572

Of course, barring any major accidents, I'm otherwise pretty healthy and the most I ever racked up in medical bills was ~$500.

The great thing is that for every year you don't accumulate significant medical bills, the more coverage you actually get since the money accumulates. Especially since my HSA has an out of pocket maximum of $4k, I only need to stay healthy for 3 years out of every 4 and everything pays for itself.

 

[roguerower]

HSAs are awesome if you don't plan on racking up medical bills... my employer just started offering it and puts in 1k/year. I'm maxing that out in addition to my 401k. Tax free going in and tax free coming out if you use it right but it's best if you let it grow.

My company is pushing everyone to it with extra incentives this year for "early adopters". Their usual contribution is $750/yr, throw in the $500 early adopter bonus and my $1000 contribution and it should grow pretty nicely, especially since I have NO health problems at the moment (knock on wood). The $1250 I'll get this year will help to supplement whatever costs for Lasik that the FSA doesn't cover. I'll be getting the Lasik once I move back East and will have it done somewhere around D.C. and figure that I'll spend whatever I need to in order to make sure that my eyes get the best treatment possible.

 

[Gooberlx2]

I guess that's true to an extent. You really have to do the math for yourself to figure it out, there's an annual health costs cutoff point where it becomes cheaper to just go straight EPO/PPO.

Now that I think about it, it's more like a parabola on a cost/benefit graph. HDHPs (can) make a lot of sense for people with little/no medical issues AND people with lots of medical issues. It's people in the middle who are better off with a regular PPO (or HMO if that's their only choice).

Young and healthy:
- Low premiums
- preventative/routine physicals usually 100% covered
- Rarely actually have to see the doc
- HSA account acts like a IRA

Very sick (from most HDHP plans I've seen):
- single high deductible/MOOP
- no doctor co-pays after deductible
- no prescription co-pays after deductible
- 100% medical costs covered after deductible

Regardless of the pre-tax HSA benefits, the absolute maximum annual cost of a HDHP is premium + deductible. *sigh* If only we were offered a HDHP that was open to any provider instead of Kaiser.

 

[lokiju]

$84 a month for family PPO here.

One of the reasons I took this job. Was paying over $600 a month for the same coverage at my last job.

 

[Ns1]

PPO's have all switched to coinsurance (ie pay a &#37😉 while HMO's stay copay (pay a flat fee), so I'm gonna have to stick with the HMO again this year...

 

[Gooberlx2]

PPO's have all switched to coinsurance (ie pay a %) while HMO's stay copay (pay a flat fee), so I'm gonna have to stick with the HMO again this year...

Coinsurance after the deductible, up to the MOOP seems fairly typical for a PPO from my past experience. How was yours setup prior?

 

[Ns1]

Coinsurance after the deductible, up to the MOOP seems fairly typical for a PPO from my past experience. How was yours setup prior?

copays up until last year (I actually switched from PPO to HMO then)

they switched from copays for both PPO and HMO to coinsurance for PPO and copay for HMO

PPO reimburses 80% for in-network specialist after the deductible...HMO charges $25 copay for a specialist...

 

[Gooberlx2]

copays up until last year (I actually switched from PPO to HMO then)

they switched from copays for both PPO and HMO to coinsurance for PPO and copay for HMO

PPO reimburses 80% for in-network specialist after the deductible...HMO charges $25 copay for a specialist...

Oh, I see. So no co-pays at all for typical doctor visits? That is sucky. In my past PPOs, labs and stuff often had co-insurance applied. But the doc visit itself was a simple co-pay.

Does the co-insurance rate change after the deductible? If not, it kinda makes no sense to have a deductible at all, and just list the MOOP.

 

[Ns1]

Oh, I see. So no co-pays at all for typical doctor visits? That is sucky. In my past PPOs, labs and stuff often had co-insurance applied. But the doc visit itself was a simple co-pay.

Does the co-insurance rate change after the deductible? If not, it kinda makes no sense to have a deductible at all, and just list the MOOP.

HMO has a 15/25 copay for doctors visits.

PPO covers 100% preventative, but for everything else you pay 100% up to deductible, then 80/60 after annual deductible, up to MOOP...

Basically at the end of the day I don't know how a person who actually USES medical services pays for PPO healthcare

 

[Gooberlx2]

HMO has a 15/25 copay for doctors visits.

PPO covers 100% preventative, but for everything else you pay 100% up to deductible, then 80/60 after annual deductible, up to MOOP...

Basically at the end of the day I don't know how a person who actually USES medical services pays for PPO healthcare

What're the deductible and MOOP (individual/family)? Unless they're super low, yeah, that plan sucks ass. It sounds essentially like a HDHP with added complication and (probably) a higher premium.

Honestly, sounds like a strategic decision to push everyone towards the HMO by making the PPO so unappealing.

 

[Ns1]

What're the deductible and MOOP (individual/family)? Unless they're super low, yeah, that plan sucks ass. It sounds essentially like a HDHP with added complication and (probably) a higher premium.

Honestly, sounds like a strategic decision to push everyone towards the HMO by making the PPO so unappealing.

We have 2 available PPO plans...the following represents in-network care at my salary level

PPO1
Deductible: 450/900 individual/family
MOOP: 2000/4000
HSA: N/A
Monthly Premium: 70/140

PPO2
Deductible: 1500/3000 individual/family
MOOP: 3000/6000
HSA: 1 time 500/1000 contribution from Company
Monthly Premium: 55/110

PPO1 & PPO2 covers 100% preventative, all else 80% in network (after deductible), 60% out network

HMO premium is 76/154 (individual/family), no deductible, 1500/3000 MOOP, and copays on everything...

 

[mattpegher]

My employer pays 0% of my health insurance premiums directly, instead they give us a stipend of $1250/month for being a full time employee. This is intended to be used for health insurance premiums. The offer about 8 different plans from straight 80/20 to PPO to HMO to high deductable PPO. I choose a facility only high deductable. The PPO BC/BS with 1000 deductible costs about $1600/month. My plan costs $1000/month. It has a $5000/family deductable (2500/person). But I am able to put 5000/year into an HSA.

1000/mo = 12000/yr vs 1600/mo = 19200/yr
(HSA 5000/yr)
deductable 5000/yr 1000/yr

yearly cost 17000 20200

cost if I dont use
12000 19200
if the I dont touch the HSA i keep 5000/yr in an account that earns interest (small)
I can also choose not to invest in the HSA and end up paying taxes on an additional 5k/yr
With this plan all labs done at outpatient lab are included
PPO network well care covered.
No prescription plan but use the HSA (no plan discount)

I find that this is the best bang for my buck

 

[Gooberlx2]

My employer pays 0% of my health insurance premiums directly, instead they give us a stipend of $1250/month for being a full time employee. This is intended to be used for health insurance premiums.

Man, I wish I got a stipend.

 

[mattpegher]

Man, I wish I got a stipend.

One year my wife got a family plan from her employer and I got the whole thing in pay (15k). Had to pay taxes on it but hey who doesnt want the money if you dont need the plan.

 

[biostud]

What's with the whistling?

Free healthcare in UK

 

[mattpegher]

Free healthcare in UK

Was talking with some extended family about health care in UK, and Europe. One of the things that struck me, and I notice the same when I see visitors to US in my office. Europeans dont seek care anywhere near as often as in the US. They are much more willing to accept the fact that their illness may be viral and there is nothing that the doctor can do. They often ask me if I think that an antibiotic is necessary and if not they rather wait it out. This is very different than the average american, who cannot accept the possiblity of being sick for even a day. God forbid they stay home from work or try to rest for a few days to fight a viral illness.

 

[Dominato3r]

And what happens if you never get sick and have to pay thousands if not millions?

Wouldn't you rather have the *choice* (I know, shocking) to decide the level of coverage that is appropriate for your needs?

Nope.

"appropriate for your needs" doesn't sound right when talking about healthcare.

 

[trmiv]

Putting this back up because I need to make the open enrollment decision today. I really can't decide between these two plans. I'd love to get some opinions.

Premier:
Deductible: $300 Individual/ $600 family
Coinsurance: 90/10
Out of pocket $1800 Individual /$3600 family
Co-pays $20 primary, $35 specialist

or Standard
Deductible: $500 individual/ $1000 family
Coinsurance: 80/20
Out of pocket $3000 individual / $6000 family
Co-pays $25 primary, $50 specialist.

The premier costs me $323 per month pre-tax for my wife and I. The standard is $191 per month. With the $132 difference per month does it make sense to go with standard and just put the difference per month into savings? I'm 35, wife is 33. I'm really leaning towards just doing the standard plan with the big difference in monthly cost.

The premier plan just went up 20% across the board, btw.

 

[Corporate Thug]

Was talking with some extended family about health care in UK, and Europe. One of the things that struck me, and I notice the same when I see visitors to US in my office. Europeans dont seek care anywhere near as often as in the US. They are much more willing to accept the fact that their illness may be viral and there is nothing that the doctor can do. They often ask me if I think that an antibiotic is necessary and if not they rather wait it out. This is very different than the average american, who cannot accept the possiblity of being sick for even a day. God forbid they stay home from work or try to rest for a few days to fight a viral illness.

From what I understand, Europeans also don't work nearly as much hours as Americans do so its easier for them to accept being sick and stay home.

 

[OutHouse]

Was talking with some extended family about health care in UK, and Europe. One of the things that struck me, and I notice the same when I see visitors to US in my office. Europeans dont seek care anywhere near as often as in the US. They are much more willing to accept the fact that their illness may be viral and there is nothing that the doctor can do. They often ask me if I think that an antibiotic is necessary and if not they rather wait it out. This is very different than the average american, who cannot accept the possiblity of being sick for even a day. God forbid they stay home from work or try to rest for a few days to fight a viral illness.

most of that is employer driven. you stay home sick you have to get a dr note.

thank god my company does not have draconian policies like this.

 

[stag3]

i'm at 68 week for coverage right now for health/dental/vision
went up almost 20 a week for next year

 

[blinblue]

Putting this back up because I need to make the open enrollment decision today. I really can't decide between these two plans. I'd love to get some opinions.

Premier:
Deductible: $300 Individual/ $600 family
Coinsurance: 90/10
Out of pocket $1800 Individual /$3600 family
Co-pays $20 primary, $35 specialist

or Standard
Deductible: $500 individual/ $1000 family
Coinsurance: 80/20
Out of pocket $3000 individual / $6000 family
Co-pays $25 primary, $50 specialist.

The premier costs me $323 per month pre-tax for my wife and I. The standard is $191 per month. With the $132 difference per month does it make sense to go with standard and just put the difference per month into savings? I'm 35, wife is 33. I'm really leaning towards just doing the standard plan with the big difference in monthly cost.

The premier plan just went up 20% across the board, btw.

So your liability in the Standard over the Premier is $400 for the deductible, and then an additional $2400 for out of pocket. The costs of the co-pay is pretty minor, so I'll largely ignore that.
You save $132 a month, or $1584 a year. So it will take roughly 2 years of no major events (ie, a hospital visit that costs great than a few thousand) to break even. So take a look back at your medical bills, how often does a major event happen? I'd imagine that on average it will be less than once every 2 years (though perhaps not).

For me personally I'd go for the standard plan as I haven't had to see the doctor in years and I'm fairly certain my risk of a major event is pretty low.

 

[airdata]

The insurance plan at my company is BS...

The most recent changes removed deductibles all together. I have no idea what is covered or anything. I'd just assume be given a healthcare allowance since they claim they're paying some $400 per month to cover me...

Went to the ER last weekend and still waiting for bills to roll in.

 

[trmiv]

So your liability in the Standard over the Premier is $400 for the deductible, and then an additional $2400 for out of pocket. The costs of the co-pay is pretty minor, so I'll largely ignore that.
You save $132 a month, or $1584 a year. So it will take roughly 2 years of no major events (ie, a hospital visit that costs great than a few thousand) to break even. So take a look back at your medical bills, how often does a major event happen? I'd imagine that on average it will be less than once every 2 years (though perhaps not).

For me personally I'd go for the standard plan as I haven't had to see the doctor in years and I'm fairly certain my risk of a major event is pretty low.

Yea we have no major events recently. My wife does have a medical condition that requires specialist visits bi-monthly, but even that $15 difference doesn't make much difference.

 

[Imported]

I pay around $4/paycheck for vision. Dental/health is $0. Although I maxed my FSA this year to pay for PRK.. so thats about $200 a paycheck.