mamacatnv
That be a Mum Y'all - a Texas Mum
- Joined
- Nov 7, 2005
- Messages
- 10,885
I'm an HR chick but my company is too small to offer something like this and I am clueless!
Any experiences you all would care to share?
Good, bad and the ugly!
Preventive care is covered at 100% (is that regular Dr. visits, non specialists etc, or just physicals?)
If we end up with some sort of issue that results in us using up the deductible is the out of pocket portion something we can add to our Flex spending accounts for reimbursement?
If we use up all the deductible and then go to co-insurance how does that work?
DH needs to have a follow up colonoscopy next year, would that be preventative or in essence we would max out the deductible and more in one swoop.
FWIW this plan is thru CIGNA and there is a link in the email that DH has but it can only be accessed internally.....I hate when they do that, my DH is a benefit bonehead
Here is the email his DH's company sent out with a brief overview:
Consumer Driven Health Plans
A Consumer Driven or Consumer Choice Health Plan (CDHP or CCHP) is a high-deductible health plan that enables you to take a more active role in how you manage your health care and spending. One example is our new CIGNA Choice Fund HRA option, which offers a lower employee contribution than other options, pays 100% for preventive care services, and features a Health Reimbursement Account (HRA) funded by CO.
Health Reimbursement Account (HRA)
When you enroll in the CIGNA Choice Fund HRA plan, you are automatically enrolled in a Health Reimbursement Account (HRA). An HRA is an account funded by CO that you can use to pay for medical expenses before you begin to pay out-of-pocket.
One of the advantages of an HRA is that unused dollars roll over into the following year's fund to be applied to future, qualified medical expenses. The amount that can be rolled over is limited to the total amount of your annual deductible.
Beyond preventive care, any and all healthcare services will be paid for by either the HRA or you until the annual deductible is met. At that point, coinsurance is applied based on in or out-of-network care. Once your annual out-of-pocket maximum is met in-network, the plan then pays at 100% for the remainder of the plan year.
Expenses Covered by the HRA
Because covered services vary from plan to plan, it's important to read plan materials once they are available. Typically, you'll be responsible for paying:
your bi-weekly premium contribution (deducted from your CO paycheck);
any costs for services not covered by your plan;
any costs for services received after the HRA fund is depleted and before the deductible is met;
coinsurance after your plan coverage begins (up to your annual in-network out-of-pocket maximum).
If all your annual medical expenses are for covered services, and the total cost doesn't exceed the number of dollars in your fund, you won't have to pay any out-of-pocket costs.
Any experiences you all would care to share?
Good, bad and the ugly!
Preventive care is covered at 100% (is that regular Dr. visits, non specialists etc, or just physicals?)
If we end up with some sort of issue that results in us using up the deductible is the out of pocket portion something we can add to our Flex spending accounts for reimbursement?
If we use up all the deductible and then go to co-insurance how does that work?
DH needs to have a follow up colonoscopy next year, would that be preventative or in essence we would max out the deductible and more in one swoop.
FWIW this plan is thru CIGNA and there is a link in the email that DH has but it can only be accessed internally.....I hate when they do that, my DH is a benefit bonehead
Here is the email his DH's company sent out with a brief overview:
Consumer Driven Health Plans
A Consumer Driven or Consumer Choice Health Plan (CDHP or CCHP) is a high-deductible health plan that enables you to take a more active role in how you manage your health care and spending. One example is our new CIGNA Choice Fund HRA option, which offers a lower employee contribution than other options, pays 100% for preventive care services, and features a Health Reimbursement Account (HRA) funded by CO.
Health Reimbursement Account (HRA)
When you enroll in the CIGNA Choice Fund HRA plan, you are automatically enrolled in a Health Reimbursement Account (HRA). An HRA is an account funded by CO that you can use to pay for medical expenses before you begin to pay out-of-pocket.
One of the advantages of an HRA is that unused dollars roll over into the following year's fund to be applied to future, qualified medical expenses. The amount that can be rolled over is limited to the total amount of your annual deductible.
Beyond preventive care, any and all healthcare services will be paid for by either the HRA or you until the annual deductible is met. At that point, coinsurance is applied based on in or out-of-network care. Once your annual out-of-pocket maximum is met in-network, the plan then pays at 100% for the remainder of the plan year.
Expenses Covered by the HRA
Because covered services vary from plan to plan, it's important to read plan materials once they are available. Typically, you'll be responsible for paying:
your bi-weekly premium contribution (deducted from your CO paycheck);
any costs for services not covered by your plan;
any costs for services received after the HRA fund is depleted and before the deductible is met;
coinsurance after your plan coverage begins (up to your annual in-network out-of-pocket maximum).
If all your annual medical expenses are for covered services, and the total cost doesn't exceed the number of dollars in your fund, you won't have to pay any out-of-pocket costs.
