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    Health insurance plans

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    • D
      Dashrender
      last edited by Dashrender

      I hope what someone just told me isn't true, but holy crap if it is. Also, those that are not part of the US healthcare system, please start a separate thread to talk about how bad we have.. thanks!

      First things first, I'm going to describe my current healthcare plan.

      My employer offers both PPO and High Deductible (HD) plans. I opted for the HD plan.

      My plan works as follows:
      Premium per month: $338
      Employer pays $282, I pay $56
      My deductible is $5350/yr which I'm 100% responsible for, after the deductible is met, the insurance company pays 100% of covered costs.

      Because I partake in a HD plan, Uncle Sam allows me to use a Health Savings Account (HSA). I can contribute a max of $3350 pretax to my HSA. This is typically done through direct deposit when I'm paid, The HSA portion going into the HSA account, and the rest goes into my checking/saving/whatever account.

      **Edited for corrected numbers

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      • D
        Dashrender
        last edited by

        I consider my plan pretty OK, perhaps not great, but definitely not bad.

        Now the other plan I just heard about (and also confirmed is completely possible) is as follows:

        Premium per month: unknown
        Employer pays 100% of premium
        Deductible is $8000, after which 80% of covered costs are paid.

        HSA is the same as above as federally mandated.

        This plan seemed outrageous at first, but after an offline discussion, it is this way because the employer wanted a lower premium cost.

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          Dashrender @Dashrender
          last edited by

          @Dashrender said in Health insurance plans:

          Premium per month: unknown
          Employer pays 100% of premium
          Deductible is $8000, after which 80% of covered costs are paid.

          HSA is the same as above as federally mandated.

          With a plan like this, the insurance seems damn near pointless with the exception of major medical.

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          • D
            Dashrender
            last edited by

            When considering jobs - considering the difference between these two stated insurance plans can have sever consequences against your income.

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            • M
              momurda
              last edited by

              Your deductible is 5350? Doesn't that mean you pay everything out of pocket, essentially every year? Unless youre going in for major surgery or a couple of MRI/CT scans every year you are paying out of your pocket, plus youre also paying for insurance. Plus you put more money in an HSA?
              Youre paying 8k/year for insurance out of pocket, plus what your company is paying the insurance company.
              That seems a bit out of control/way too much. why have employer health insurance if youre paying more than your employer every month.

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              • K
                Kris_K @momurda
                last edited by Kris_K

                @momurda said in Health insurance plans:

                Your deductible is 5350? Doesn't that mean you pay everything out of pocket, essentially every year? Unless youre going in for major surgery or a couple of MRI/CT scans every year you are paying out of your pocket, plus youre also paying for insurance. Plus you put more money in an HSA?
                Youre paying 8k/year for insurance out of pocket, plus what your company is paying the insurance company.
                That seems a bit out of control/way too much. why have employer health insurance if youre paying more than your employer every month.

                HSAs are for depositing pre-tax money which can later be used to pay for such expenses. So it's not $5350+$3350. His deductible is still $5350, its just a big part of it ($3350) can be paid for using pre-tax money.

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                  momurda @Kris_K
                  last edited by

                  @Kris_K
                  Thanks for the clarification. I never go to the doctor so I never follow the in and outs of the insurance scam.

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                  • K
                    Kris_K @momurda
                    last edited by

                    @momurda said in Health insurance plans:

                    @Kris_K
                    Thanks for the clarification. I never go to the doctor so I never follow the in and outs of the insurance scam.

                    They all look like a big scam until something major happens. Then you're happy you don't have to file for bankruptcy.

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                    • M
                      MattSpeller @Kris_K
                      last edited by

                      This post is deleted!
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                      • C
                        coliver @MattSpeller
                        last edited by

                        @MattSpeller said in Health insurance plans:

                        @Kris_K said in Health insurance plans:

                        They are a big scam considering the system you could have

                        FTFY

                        Surgery this year, two hospital visit follow ups, multiple trips to the clinic for checkups and additional drugs.

                        ~$50 (drug costs)

                        There he goes breaking the OPs rules.

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                        • M
                          MattSpeller @coliver
                          last edited by

                          @coliver Apologies I didn't see that

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                          • B
                            BRRABill @MattSpeller
                            last edited by

                            @MattSpeller said in Health insurance plans:

                            @coliver Apologies I didn't see that

                            Canadians ... always flaunting their superior stuff.

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                              MattSpeller @BRRABill
                              last edited by

                              @BRRABill said in Health insurance plans:

                              @MattSpeller said in Health insurance plans:

                              @coliver Apologies I didn't see that

                              Canadians ... always flaunting their superior stuff.

                              I am honestly sorry for that, I failed to read all of his post. I have to tell you though that it breaks my heart and frustrates me to no end that such an otherwise intelligent and progressive country could fail to make a system to compete with our broken, leaking and creaky health care system.

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                              • D
                                Dashrender @momurda
                                last edited by

                                @momurda said in Health insurance plans:

                                Your deductible is 5350? Doesn't that mean you pay everything out of pocket, essentially every year? Unless youre going in for major surgery or a couple of MRI/CT scans every year you are paying out of your pocket, plus youre also paying for insurance. Plus you put more money in an HSA?
                                Youre paying 8k/year for insurance out of pocket, plus what your company is paying the insurance company.
                                That seems a bit out of control/way too much. why have employer health insurance if youre paying more than your employer every month.

                                You have a few things misunderstood.

                                Yes, my deductible is $5350, and that does I mean I have to pay for 100% of covered expenses until I reach $5350/yr. The HSA is money I put into an account Pre-tax that I can use to pay the deductible with. So the $3350 I put into HSA is used toward the $5350, leaving me to pay $2000 with post tax dollars. Assuming I'm in a 30% tax bracket, this saves me $1005 versus paying all post tax.

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                                • P
                                  pchiodo @Kris_K
                                  last edited by

                                  @Kris_K

                                  It's a bit more than that - By $600 in premiums. So more like $6K on the first plan. Still F'd if you ask me.

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                                  • D
                                    Dashrender @pchiodo
                                    last edited by

                                    @pchiodo said in Health insurance plans:

                                    @Kris_K

                                    It's a bit more than that - By $600 in premiums. So more like $6K on the first plan. Still F'd if you ask me.

                                    So to those ... oh wait.. I don't want to go and break my own request 🙂

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                                    • D
                                      Dashrender @pchiodo
                                      last edited by

                                      @pchiodo said in Health insurance plans:

                                      @Kris_K

                                      It's a bit more than that - By $600 in premiums. So more like $6K on the first plan. Still F'd if you ask me.

                                      Correct, my max out of pocket for covered things in a year are $5350 + $600 = $5950

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                                      • D
                                        Dashrender
                                        last edited by Dashrender

                                        Now, as I mentioned my company offers a PPO plan as well.

                                        PPO Plan:
                                        Premium per month: $484
                                        Employer pays $343, I pay $141
                                        Normal office visits $50 copay, Speciality Office visits $50 copay, pharmaceuticals $5-50 ea
                                        Deductible $600, toward non clinic visits
                                        After deductible pay 20% until patient has an out of pocket expense of $2850/yr

                                        total max out of pocket $4542

                                        FYI, We do not have a FLEX plan for these plan members. For those that don't know, a FLEX plan is a bit like a HSA plan (see above). It has lower maxes, typcially $2000 I think, and what you don't use by the end of the year is forfeit to the plan holder.

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                                        • D
                                          Dashrender
                                          last edited by Dashrender

                                          Full disclosure - one might ask - hey wait Dash, why did you pick the HD plan when the out of pocket max is higher than your PPO plan?

                                          A few things, I have only met my the max spend two times in the last 5 years for pre existing conditions that are now resolved, so I don't expect anything new along these lines.

                                          Also, my company provides another benefit. Anyone who uses the HD plan, the company pays for the remaining deductible (remember it is $5350) after the employee pays the first $2000.

                                          This makes my real max out of pocket $2000 + $672 = $2672
                                          All of which is tax deductible.

                                          1 Reply Last reply Reply Quote 1
                                          • scottalanmillerS
                                            scottalanmiller
                                            last edited by

                                            I can't get healthcare in the US. The Obamacare plans don't cover people in my situation. So we are stuck without any means of getting health insurance even as American citizens.

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