Anyone have experience with a High Deductible Plan??

[toystory1130]

We have to make a decision on this soon regarding our healthcare changes. If anyone can share their experiences with a HDP with a HSA I would appreciate it.

 

[tvguy]

What do you consider a high deductible?

Ours went to $2,500 before it pays anything last year from $30 co-pay. , not sure if that will change this year. Took about 6 months for our family to meet the deductible, but it dropped our premium by $3,000 a year, so we are money ahead.
I did not use a FSA, I may this year. Had a very bad experience years ago with FSA and how it was administered. I think the laws have changed so what was an issue then, is illegal now.

 

[Gracie09]

We loved ours. We had a 5000 deductible and then the insurance company paid 100%. We put the money in a fsa. We had a bad beginning of the year that year, DD hospitalized, DH back surgery etc so by March we had hit the deductible and paid nothing for the rest of the year (other than premiums of course). Depending on your family it can be a great plan.

 

[#1hoosierfan]

We chose the high deductible plan this year. We are responsible for the first $5,000, and then our plan covers at 100%. My employer did put $1,000 in to my HSA, and then we elected to contribute the other $4,000 that was split among my 26 paychecks.

We have been lucky this year, in that we have no medical issues and have only paid for doctor visits and scripts. We will be rolling over about $4,000.

We do plan to contribute another $4,000 next year. We are already used to not having this money in our take home pay, so we plan to use that as our savings for the braces that I am sure the boys will need in a few years, or LASIK surgery for me.

 

[kymom99]

I have a high deductible plan with a HSA of $1500. Next year it will only be $500. My son and I are on a parent plus plan. We get one well check a year and I get a mammogram and gyn checkup paid at 100%. Very rarely do we need anything above these things. Ds does go to a dermatologist now and that is OOP along with the expensive prescription. We use the HSA to pay for those things and eye exams and glasses. My husband carries us on his dental. So far this has worked just fine for us. I have never hit my deductible, so having a lower one would not help us. Even if we did have to pay the max, hospitals will work with you to help you be able to pay what you owe. To me there is no sense in paying high premiums because something MIGHT happen. If we had chronic conditions my thoughts would be different, but we do not at this point. Humana even suggested that we take the lowest level of coverage based on our history.

This experience might illustrate my position. A couple years ago my husband had a kidney stone and had to go to the ER. He was admitted because the stone was large and needed to be pulverized. A piece of the stone then backed up into the kidney so they had to put in a stent to allow it to come back out. This meant he had to have another procedure a week later to remove the stent. Probably the worst scenario possible for a kidney stone as far as cost is concerned. His max OOP was $3500. I paid $1000 and told them I didn't have the rest so needed to set up a payment plan. I paid $110 a month till it was paid off. Since that is the most he will ever have to pay, it was not devastating in the least. I feel fairly comfortable putting the money I would pay for a higher premium towards something else. The good news is, this event happened in march of that year, so the rest of the year my husband paid nothing. We made sure he got a physical and several tests for some issues he was dealing with before the year ended.

I will add that I get a HSA with my plan from my employer for taking the higher deductible plan. The amount has decreased but so has my premium. I do not contribute to a FSA.

 

[Shelly F - Ohio]

We have the HDP and HSA.. We love it! This is our 4th year with this plan.

Does your employer require you to also pay a monthly premium. Our was zero and all we had to pay was whatever we wanted to put into the HSA acct. Now we $50 a month plus whatever we put in the HSA.

Well we don't go the dr that often so the first year we put enough into the HSA to cover the deductible. That first year we had very little in the way of medical bills so the remaining HSA money of course was ours to keep To use toward next years deductible. So the second year we did not have to contribute as much.

The main thing to remember the money you are putting into your HSA is yours to keep. Of course you can only use the money to pay medical bills. Rather than paying a monthly premium to an insurance company you are depositing money into a health saving acct.

There are tax benefits for this as well. The money you have taken out of your paycheck is pre-taxed!

What questions do you have about the plan?

 

[donknotts]

I have had a high deductible plan for several years and am happy with it. That being said, I have no chronic conditions and go to the doctor once or twice annually.

Too many people focus on the deductible. What you need to focus on is the Out Of Pocket Max. Consider if you get cancer, have a heart attack, etc in the next year- can you comfortably afford the out of pocket max for the next 1-2 years? If so (or you will be able to after you and your employer contribute to your HSA) then go for the HD plan. If not, think twice about it. For me and most people I know the first year or two with a HD plan is a gamble - once you have the out of pocket max saved in your HSA it's a much simpler decision.

 

[ckmommy]

It really depends on how your employer treats this plan. We have a choice this year:
A higher cost premium HDP--the higher $ due to 100% coverage for out of network dr's. $4000 deductible (100% coverage in network after deductible)

OR

A lower cost premium HDP--the lower cost due to 70% coverage for out of network dr's. $4000 deductible (100% coverage in network after deductible)

The thing for us is that DH's employer contributes money to our HSA for the deductible. For the higher cost HDP: employer pays all premiums plus contributes $2400 to the $4000 deductible to an HSA.
For the lower cost HDP: employer pays all premiums plus $4400 to the $4000 deductible to an HSA.

Because we are a pretty healthy family and are not attached to any of our physicians, we are going to choose the lower cost HSA. We will enjoy the whole deductible plus some being picked up by the employer. If we were attached to a dr. that was out of network and we saw a lot, we may have chose the other plan.

 

[thornton0511]

My family is on a high ded. plan through my company with BCBS, and we have been on this plan for the last two years. IMO this type of plan is great for healthy families. We have a $6000 deductible but the way I look at it,worst case scenario, something major happens that is the max I am out. Will we meet that ded. per person....probably not but for the most part we are a healthy family with no major heath issues. The premiums I pay are $67 bi weekly for our entire family (this will be up from $48 the last two years) and I love the low premiums! Forget copay plans lol. All well checkups (including the yearly woman appt) are covered 100% as well as immunizations and lab work. We do have to pay for sick visits but it's the negotiated charge that BCBS allows for the doc office to charge us and my company gives us a medical credit card with $1000 on it each year to go towards those out of pocket costs, and the unused funds roll over each year. I think we might have had to pay for one sick visit and the end of the year last year and that was it.

 

[mrsp1030]

We had a High deductible plan with my husband's former employer and this year we have 4 choices and we still choose this plan. His employer contributes 2300 towards the 4000 deductible. The new law allows you to roll over your HSA and take it with you even if you leave a job.

 

[Lisa71]

My nephew was diagnosed with a brain tumor at 2 1/2 and even with great insurance the bills will be large. His tumor was diagnosed in September and treatment will roll into next year so they will cap out both years. Some of his medications are very expensive and he will require multiple hospitalizations. If you can save it up and have it waiting just in case then it might work for you. They have an HMO but still have co-pays...also my sister may have to take unpaid time off to care for her son as her employer does not have family disability leave. Everyone is unique and you cannot tell the future. Best of luck either way but be aware you can make out fast.

 

[toystory1130]

We have the HDP and HSA.. We love it! This is our 4th year with this plan.

Does your employer require you to also pay a monthly premium. Our was zero and all we had to pay was whatever we wanted to put into the HSA acct. Now we $50 a month plus whatever we put in the HSA.

Well we don't go the dr that often so the first year we put enough into the HSA to cover the deductible. That first year we had very little in the way of medical bills so the remaining HSA money of course was ours to keep To use toward next years deductible. So the second year we did not have to contribute as much.

The main thing to remember the money you are putting into your HSA is yours to keep. Of course you can only use the money to pay medical bills. Rather than paying a monthly premium to an insurance company you are depositing money into a health saving acct.

There are tax benefits for this as well. The money you have taken out of your paycheck is pre-taxed!

What questions do you have about the plan?

My biggest concern is the first year. Not having that total deductible saved up. What if's... Also all of us are really healthy, we do not go to the Dr. very often BUT my DH is on a expensive med every month for life. ($450 a month)
The difference a month would be $350 in premium that we could save, but it would take almost the whole year to get to the deductible, and thats not counting the meds. I love the idea that any unused $$ gets banked, and they even have investment options but I'm worried about that 1st year. (and the meds)

 

[mrsp1030]

Does your plan have a medical cost estimator?our has an online tool to help you determine costs and best plan. To be honest, this is the future of health insurance and one reason we chose it to get ahead of the game.

 

[nunzia]

I thought HSAs were not allowed anymore? My DH has one grandfathered in that has been terrific! He has Hep C and is undergoing a very expensive treatment..he also had to have every imaginable check before treatment started since it is so rough on your body..after the deductible of $2,700 we paid some things with a percentage, but we haven't been charged one penny for the treatment..and we were told the usual cost is over 20K. It was a great plan, not sub par like ..some people...say

 

[crisi]

We've had one - this will be year four, and I love it.

Last year we spent most of the money we put in - we switched jobs and plans halfway through so ended up with two deductibles. And my husband has some back issues and did a sleep study - those things got expensive. But most years we don't come close to our deductible. We have ample saves to cover multiple years of out of pocket max, and did when we started, but now have a nice tidy amount in the HSA that would cover it for more than a year.

The key is the HSA. Because you put money into the HSA tax free and its your money and remains tax free as long as you use it for appropriate health care (covering your deductible and out of pocket max), it can end up - even if you do spend a lot on health care - cheaper than a traditional HMO. That will depend on your tax bracket and the premiums for each - as well as if your employer does any sort of match and if you can lay down a good base in your HSA before you need it.

The HSAs we've had have all come with websites to help manage the money. I just spent out the first one we had from two jobs ago - working on the second. What I need to do, and haven't bothered, is to figure out how and if I can transfer money from an old HSA into the new one.

 

[ceecee]

We had a choice until this year and now we don't. Our deductible is $4000 and then it pays 100%, we choose it even when we didn't have to and it worked out good for us. This year I went to the ER in extreme pain (kidney stone) so we had it met the first week of the year! DH's employer meets 1/2 in their FSA so we really only pay $2000.

 

[Mickeyluver37]

My biggest concern is the first year. Not having that total deductible saved up. What if's... Also all of us are really healthy, we do not go to the Dr. very often BUT my DH is on a expensive med every month for life. ($450 a month)
The difference a month would be $350 in premium that we could save, but it would take almost the whole year to get to the deductible, and thats not counting the meds. I love the idea that any unused $$ gets banked, and they even have investment options but I'm worried about that 1st year. (and the meds)

We have this insurance and I would agree the first year was the biggest challenge. I left my job, we switched to dh's employers insurance which was a HDHP and had a baby in January. I had no idea at that time that OBGYN's don't bill the entire 9 months- just 1 big fat bill at delivery, plus the hospital bill, separate anethesiologist bill, the paperwork seemed never ending.

We've had it 5 years now and I won't say I love it, but we've learned how to manage it, always have enough money in the HSA to cover what the insurance doesn't, and have just gotten used to having less money in Dh's check. It is what it is. The biggest benefit has been having over 10K in orthondontia for 2 kids flow through that HSA account tax free.

The IRS sets the minimum deductible, not your employer, but your employer can always choose to have a larger deductible. We have always had the minimum, with the employer paying half of the deductible into the HSA, but our premiums are still pretty high, at a cost of almost $5,000 a year, plus dh maxes out in HSA contribution, we are looking at benefit deductions of over $200/week in his check.

 

[budbeerlady]

We have a 2500 deductable and an HSA. I personally love it but I do know under the new health car law my plan will be going away. Something with HSA changes. But we use it to pay Dd braces, etc. We have had very little health issues over the years and my plan still covers physicals and such with a low co-pay.

 

[aclov]

I've been in one for the past few years and if you are healthy for the most part this is the plan for you. Lower premiums and higher deductibles but our company does give us a employer contribution which is ours to keep even if we leave the company and use for eligible healthcare expenses. Our company is really pushing this for next year so we are seeing employess move into this plan.

 

[JoiseyMom]

We have had a HD HSA plan for the past 2 years and will have the same next year also. We have a family deductible of 2800, so we pay until we hit that. Then we have 80/20 co insurance. We have a max OOP of 6k (family) and when that is met the insurance company covers all in network at 100%!

This year we met our 2800 in march and our OOP 6k in July. So now I pay nothing for any visits or meds. Not looking forward to January when we start over.

We do put the max allowed into the HSA and I just reimburse ourselves as it gets funded throughout the year. DH's company gives us about 1300 towards the 6550 max.

Thankfully most of the meds I need to get for DH and DS the drug companies have discounts on, so I just that at the beginning of the year until our co insurance starts.