ASA Insurance Plan debacle!!!

[ASAFOE120]

So if I read this correct, we will pay $2400 out of pocket for prescriptions, DR visits, etc before any ins kicks in. Then, ins will pay 80% and we pay 20% till reaching $6000 (that includes the $2400) which is max out of pocket. Then ins pays 100% thereafter. Is this correct????

If so, then as long as you've got $6000 in your emergency fund, then no worries. I know its more out of pocket then what we are used to, but on the other hand, if your family is relatively healthy and you keep your emergeny fund at $6000, couldnt this save a family money by having less taken out of a paycheck?

Just wondering if I'm reading this right.

Blessed

 

[JoeMerchant]

So if I read this correct, we will pay $2400 out of pocket for prescriptions, DR visits, etc before any ins kicks in. Then, ins will pay 80% and we pay 20% till reaching $6000 (that includes the $2400) which is max out of pocket. Then ins pays 100% thereafter. Is this correct????

If so, then as long as you've got $6000 in your emergency fund, then no worries. I know its more out of pocket then what we are used to, but on the other hand, if your family is relatively healthy and you keep your emergeny fund at $6000, couldnt this save a family money by having less taken out of a paycheck?

Just wondering if I'm reading this right.

Blessed

That's correct. Keep in mind that the PPO costs you $2000 more in premiums. Add in the $1000 that ASA puts in, and you have to get to $3000 in health care costs to make the PPO better. Then if you have a lot of health care costs, the PPO could actually cost you MORE out of pocket.

Meeting the deductible is almost covered by the lower premiums.

 

[OCP]

So Skywest isn't offering any kind of match or money toward your deductible right? Other than $500 for the next 2 years. In talking with my family my mom works in a Hallmark store and they pay her deductible into her HSA every year. So where is that for us?

 

[jonjuan]

So if I read this correct, we will pay $2400 out of pocket for prescriptions, DR visits, etc before any ins kicks in. Then, ins will pay 80% and we pay 20% till reaching $6000 (that includes the $2400) which is max out of pocket. Then ins pays 100% thereafter. Is this correct????

If so, then as long as you've got $6000 in your emergency fund, then no worries. I know its more out of pocket then what we are used to, but on the other hand, if your family is relatively healthy and you keep your emergeny fund at $6000, couldnt this save a family money by having less taken out of a paycheck?

Just wondering if I'm reading this right.

Blessed

That's correct. My wife has had an HSA high deductible plan for 3 years. The company puts in $1,500/year, we put in $3,000/year. We are healthy and use very little of the money (knock on wood), and have the majority of the balance ($15,000) in one of the mutual funds offered. We hope to be relatively healthy and have a $100K balance in 20 years to be used for medical expenses. After you reach 65, you can also transfer the HSA balance to an IRA.
http://www.health--savings--accounts.com/article-19.htm

http://www.medplanaccess.com/hsa/overview.htm

 

[JoeMerchant]

So Skywest isn't offering any kind of match or money toward your deductible right? Other than $500 for the next 2 years. In talking with my family my mom works in a Hallmark store and they pay her deductible into her HSA every year. So where is that for us?

ASA is kicking in $500 for single, or $1000 for family. The deductible is $2400 (family), but keep in mind the PPO premiums will cost you $2000 more. Essentially, you are starting the year off about $3000 in the hole by choosing the PPO for the next two years. After you spend $3000, the PPO is better UNTIL you get to $6000, then the HSA is better again....

Clear as mud?

 

[JoeMerchant]

That's correct. My wife has had an HSA high deductible plan for 3 years. The company puts in $1,500/year, we put in $3,000/year. We are healthy and use very little of the money (knock on wood), and have the majority of the balance ($15,000) in one of the mutual funds offered. We hope to be relatively healthy and have a $100K balance in 20 years to be used for medical expenses. After you reach 65, you can also transfer the HSA balance to an IRA.
http://www.health--savings--accounts.com/article-19.htm

http://www.medplanaccess.com/hsa/overview.htm

Good job. The nice thing now is that you have that money available to buy COBRA or other health insurance if you lose your job....It provides a very nice safety blanket....Much better than relying on Washington DC.....

 

[OCP]

ASA is kicking in $500 for single, or $1000 for family. The deductible is $2400 (family), but keep in mind the PPO premiums will cost you $2000 more. Essentially, you are starting the year off about $3000 in the hole by choosing the PPO for the next two years. After you spend $3000, the PPO is better UNTIL you get to $6000, then the HSA is better again....

Clear as mud?

I read that they will supply the money, but they make it known that its a "one time cash incentive". After 2012 no more from them?

 

[outtahere]

The problem with the CDHP and kids, is that you will hit the 2400 in no time. With three kids, we go to the Dr. alot! I'd rather pay the higher premiums, it will cost me less out of pocket. If it were just me and my wife though, it would be a great deal. Sounds like the company is going to have to keep our PPO anyway due to our contract, but they will still be able to reduce costs by signing up more people to the CDHP. Now if the company was putting the full deductable into our account EVERY year, then that would be a different story. Guess they'll have to decide whats better for them in the long run. Just like PBS, sweeten the deal enough, and anythings possible.

 

[JoeMerchant]

The problem with the CDHP and kids, is that you will hit the 2400 in no time. With three kids, we go to the Dr. alot! I'd rather pay the higher premiums, it will cost me less out of pocket. If it were just me and my wife though, it would be a great deal. Sounds like the company is going to have to keep our PPO anyway due to our contract, but they will still be able to reduce costs by signing up more people to the CDHP. Now if the company was putting the full deductable into our account EVERY year, then that would be a different story. Guess they'll have to decide whats better for them in the long run. Just like PBS, sweeten the deal enough, and anythings possible.

Outtahere...How much do you figure you spend on copays and deductibles with the PPO per year? Knowing that number helps when crunching the numbers.

 

[ASAFOE120]

Thanks for all the info. One more question. Is our dental ins on this same plan? In other words, will the cost of dental visits come out of pocket and count towards the $2400 deductible or is that plan separate?

 

[outtahere]

Well, i figure between the three kids and myself (wife never gets sick), we probably go to the Dr. about 12-15 times per year. Right now the copay is $20.00 for the Dr visit, and $10 for each drug. Without the ppo, the Dr will probably be around $140, and each drug around $50. Just about every year on the CDHP, I would hit my deductable. Seems the PPO would be cheaper for me.

 

[wms]

Thanks for all the info. One more question. Is our dental ins on this same plan? In other words, will the cost of dental visits come out of pocket and count towards the $2400 deductible or is that plan separate?

Dental and vision are still under the PPO, but you can use the HSA for the copays rather than the FSA.

 

[JoeMerchant]

Well, i figure between the three kids and myself (wife never gets sick), we probably go to the Dr. about 12-15 times per year. Right now the copay is $20.00 for the Dr visit, and $10 for each drug. Without the ppo, the Dr will probably be around $140, and each drug around $50. Just about every year on the CDHP, I would hit my deductable. Seems the PPO would be cheaper for me.

Using 15 doctor visits, and 10 drugs, the HSA comes out better with the numbers you provided during the first two years with the $1000 dollars. That comes to about $2600 out of pocket. You have to break $3000 for the PPO to beat it.

 

[sweptback]

You guys are only discussing the family plan. I agree for that the HSA makes a little bit of sense.

For the single or two party plan, unless you're extremely healthy, moving away from the PPO is a step backward.

If ASA/SkyWest was serious about moving us to this plan, they should have given us yearly contributions into our HSA. If ASA paid my deductible every year into my HSA I would switch in a heartbeat!

 

[OCP]

You guys are only discussing the family plan. I agree for that the HSA makes a little bit of sense.

For the single or two party plan, unless you're extremely healthy, moving away from the PPO is a step backward.

If ASA/SkyWest was serious about moving us to this plan, they should have given us yearly contributions into our HSA. If ASA paid my deductible every year into my HSA I would switch in a heartbeat!

Agreed. Even if they had to pay it would still save them money over the PPO. So maybe that will actually happen.

 

[JoeMerchant]

You guys are only discussing the family plan. I agree for that the HSA makes a little bit of sense.

For the single or two party plan, unless you're extremely healthy, moving away from the PPO is a step backward.

If ASA/SkyWest was serious about moving us to this plan, they should have given us yearly contributions into our HSA. If ASA paid my deductible every year into my HSA I would switch in a heartbeat!

I only used the family plan because kids generate more trips to the doctor. You are correct that the numbers are less favorable for the single plan, but generally speaking, younger single folks don't go to the doctor much. If you don't use the doctor much, the HSA is much better than the PPO.

With the single plan, the most you can be out of pocket the next two years is about $2000 dollars each year....That's if something bad happens. If you don't go to the doctor, you have about $6100 in your HSA at the end of the two years.

 

[sweptback]

It's not just about going to the doctor that much. Prescription medication would be the big killer.

Some people could easily spend $100/mo on meds if they had to pay retail prices and not the co-pays.

 

[jonjuan]

I only used the family plan because kids generate more trips to the doctor. You are correct that the numbers are less favorable for the single plan, but generally speaking, younger single folks don't go to the doctor much. If you don't use the doctor much, the HSA is much better than the PPO.

With the single plan, the most you can be out of pocket the next two years is about $2000 dollars each year....That's if something bad happens. If you don't go to the doctor, you have about $6100 in your HSA at the end of the two years.

Bingo-The money becomes yours to store up now and spend when you really need it. It rewards those who don't have kids and take better care of themselves.

 

[JoeMerchant]

It's not just about going to the doctor that much. Prescription medication would be the big killer.

Some people could easily spend $100/mo on meds if they had to pay retail prices and not the co-pays.

If you are on those meds, then you do need to crunch the numbers....A single person who ends up with $100 a month in health care costs ends up about spending about the same either way....PPO or HSA.....

 

[JoeMerchant]

Bingo-The money becomes yours to store up now and spend when you really need it. It rewards those who don't have kids and take better care of themselves.

Exactly. I have about $9000 in my HSA now and don't need to rely on "Obama care"....It's growing tax free and provides a nice safety net....