New Health Insurance

[andy04]

My company just sent me this new Health insurance information. I am new to it... what does all this mean ??

Principal - 90/70 co-ins, $20 co-pay, 500(3)/500(3) ded, $1500(2)/3000(2) oop max Rx $10/25/40 (generic/preferred/non-preferred)
Net work - PHCS ( Private Health Care Systems)
Life Insurance - $15,000 benefit for Life and AD&D

 

[BrunoPuntzJones]

You pay $20 for "dr visits"
Your deductible is 500 (per person, dunno what the other /500 and (3) is, per family member i guess)
Your max out of pocket is 1500 (per person, dunno what the /3000(2) is, per family member i guess)
Your Rx's are $10 for generics, $25 for preferred (should have a list of what your insurance company prefers), and $40 for non-preferred (anything not generic and not on the list)

Rx payments are the same as co-pays in that they don't count towards the deductible.

You visit the doc 50 times during the year, it's $20 a pop. So you've spent $1000
Doc says he wants some x-rays, which run $500. Costs you another $500.

Now you've met your $500 deductible. Anything else now (excluding co-pays) is a percentage. That's what the 90/70 is (maybe in network/out of network? dunno offhand). So if you get a $1000 bill for something, they pay $900 of it, and you pay $100. Now you're at $600 out of pocket. Repeat until you hit $1500. After that you pay 0 out of pocket (except for co-pays).

AD&D is accidental death and dismemberment. You meet those criteria and you, or your beneficiary get $15,000.

Pretty good insurance, far better than average.

 

[Stifko]

That is a good plan. My deductible is $2000.
That stuff is so confusing. Seems like intentionally so!

 

[geckojohn]

Your health insurance seems like a good plan.. is it HMO or PPO?

But you might want to increase your life insurance benefits... seems rather low.

 

[SSSnail]

Yeah, keep in mind if you have PPO and visit a doctor, and if he has to do lab works (blood tests, urine tests, x-ray, etc...), that's usually goes out to a lab and you'll have to pay the deductible. Funny thing is that HMO will cover those expenses.

I have Aetna, and I think it's OK, just hate the deductible because I don't visit the doctor that often. So essentially, I pay them every month, and when it comes time for me to go to the doctor, I end up paying for the labs as well. Damned if I do, damned if I don't.

Edit: I think most HMOs don't have deductible. PPOs however, is the opposite; ironically, I pay more for PPO.

 

[MrWizzard]

Originally posted by: Stifko
That is a good plan. My deductible is $2000.
That stuff is so confusing. Seems like intentionally so!

You have lawyers to thank for that.

 

[minendo]

Originally posted by: Stifko
That is a good plan. My deductible is $2000.
That stuff is so confusing. Seems like intentionally so!

I love my $0 deductible.