Stay with HDHP?

[chiefsfan1]

Its enrollment time work. We both work for the same employer. Currently we have the HDHP with her as the primary. The cost is cheaper by going Employee and spouse.

Rates are $142.00 a pay period, biweekly. Deductible is $4500 with max out of pocket of $6000.
No copays, pay discount rate till deductible is met then pays 90% to max OOP.
PM drugs are no cost but do not apply to deductible.

Traditional is $193.00 a pay period with a $3000 deductible and $8000 max OOP.
Copay of $40 or $60 for a specialist.

Employer gives money to the HSA as well but not to the FSA if we go traditional.

I also thought of going separate HDHP but that means more paperwork but may be better?
since its in her name I cant put money in the HSA from my pay check.

My reasoning is based on total cost if the worst case scenario happens. $6000 is lower than $8000. Could be flawed, not the sharpest pencil in the box...

 

[HerrStig]

Deductable amounts are the thing to watch, and they are NOT going down. Premiums don't seem to be dropping by 25 hundred bucks, either.

 

[chiefsfan1]

Originally Posted By: HerrStig
Deductable amounts are the thing to watch, and they are NOT going down. Premiums don't seem to be dropping by 25 hundred bucks, either.


Actual the HDHP went down $500 BUT the OOP went up $1000 and no longer pays 100% after deductible now 90% up to $6000.
They moved money around...

 

[JHZR2]

Some folks get bent out of sorts when I say this, but insurance should be for catastrophic issues. The HDHP looks good to me, but the question is how much you get back from the employer, and how much you would pay out of pocket per year typically.

For example. If your employer gives you $100 return of premium in the HDHP, your $4500 deductible is effectively a $3300 deductible oop.

For the traditional, once you hit $3000, then all you pay is the $40 copy until you hit the max? The math to do then is how many specialists you would see if you were on the HDHP, since 10% could be more than the copay (could be less too!).

Factor in the difference in premium against that and you'll get an answer. I suspect if you're reasonably healthy, the HDHP will come out ahead, even if you have years when you hit the deductible.

 

[Nyogtha]

Simply a difference of perspective.

A health plan is more like a vehicle maintenance plan IMO. A warranty and automotive insurance are for catastrophic changes.

Similar on a home, a health plan is more like a home warranty than homeowners' insurance.

I'm sure not everyone considers health changes like pregnancy and childbirth as a catastrophic event in order to be insurable.

 

[chiefsfan1]

Originally Posted By: JHZR2
Some folks get bent out of sorts when I say this, but insurance should be for catastrophic issues. The HDHP looks good to me, but the question is how much you get back from the employer, and how much you would pay out of pocket per year typically.

For example. If your employer gives you $100 return of premium in the HDHP, your $4500 deductible is effectively a $3300 deductible oop.

For the traditional, once you hit $3000, then all you pay is the $40 copy until you hit the max? The math to do then is how many specialists you would see if you were on the HDHP, since 10% could be more than the copay (could be less too!).

I found a calculator and plugged in numbers. The HDHP is cheaper no matter what scenario I put in. Then there is the discount on premium if you meet certain health metrics.

now the next question is do we stay combined or go individual? she would hit the $2250 deductible first using this years numbers.
Then we would be limited to the amount we can put in the HSA. IIRC $6750 for 2016.

Factor in the difference in premium against that and you'll get an answer. I suspect if you're reasonably healthy, the HDHP will come out ahead, even if you have years when you hit the deductible.