Hellobee Boards

with the lower deductible plan, do they put money into an HSA plan for you? Because, it seems like the extra $200 a month in premium pays is still less than the $3000 total that they are putting into the HSA fund, which goes towards paying off the $7000 deductible (so $4000 out of pocket). Versus paying $200 less per month but having to pay $6000 without any help.

The options you have aren't great, you aren't naive But one thing to clarify, the deductible, is that the individual deductible or the family deductible? My guess is that it's family, which doesn't mean that you would have that high for just YOU. It might be something like $2,000 individual/$6,000 family. Meaning your deductible would be $2,000 and then the remaining family members would each have $2,000 until the $6,000 total is met by 3 people.

If that's the case, it's not that bad!

But you can certainly check healthcare.gov for the government exchanges and see what you can come up with.

wow that's high! We have what is also considered a high deductible plan paired with an HSA and our yearly family deductible is $2500, (which I think is high.) After we meet our deductible, everything is covered 100% (and some services are always free.) Our baby is also due in January and I think it totally sucks that I'll basically have to immediately meet two deductibles back to back.

That being said, we LOVE having the HSA. It saves us so much money and is an absolutely wonderful little tax shield. If you go with a high deductible plan, my recommendation is to max our your HSA. I think the max yearly contribution is something like $6200, (or that range.) It's taken out of your paycheck pre-tax, and obviously lowers your taxable income. That money is yours forever and can be rolled into an IRA or invested or just used for health costs.

@Mrs. Blue: Is there a way you could take a picture of your options and post them (but crop out any personal info)? It's much easier for me to work through insurance stuff when I can see all the info at once. Or you could wall me, too, if that's better for you.

@Mrs. Blue: Yuck, those sound like DH's insurance options. We went with the high deductible/HSA option because at first, they gave about 50$ a month towards it. Now they don't, and it's just a crappy insurance plan. His 'family' plan is about 700$ a month, which is why LO is on my plan! Look into the TX health care exchange as well if you don't want to go through employer.

Anyhoo, it looks like with plan A (assuming these deductibles are individual, not family), you will end up paying $14,400 between premiums and deductibles. With plan B, you pay $14,800 (premiums+deductible - HSA contribution).

With them being technically that close in cost, take a look at things like out of pocket maximums & copays to see which is the better deal.

@Mrs. Blue: my insurance plan was 6000 high deductible this year - I feel ya. We met it in January when we had E.

I just got a chance to read your full post. What are your max oop expense? That will be critical to making a decision. And, are those deductibles family or individual? For example, my individual deductible was $3000 and family was $6000, I am on a high deductible plan that pays 100% after my deductible was met. So go figure, I hit my $3000 between dr visits and L&D, my dr ended up cutting me a check back because I'd overpaid. You'll have more medical expenses this year than not because you're pregnant so I'd probably go with a HD...but I'd have to take a close look at max oop and what pays after deduct met to make a final decision.

@Mrs. Blue: is there a Max out of pocket cost too? After you pass your deductible and your insurance pays 75%, is there a max...say $8000 and then after that , insurance covers everything 100%? @Bookish: is spot on. The lower deductible is less out of pocket before you hit the deductible but not by much so the max out of pocket might be the deciding factor.

Although presumably you have a young and healthy family, so for most years, you won't even come close to hitting your deductible. Let's say you have $4000 in medical costs for the year. With plan A, you spend $8400 for premiums plus $4000, which is $12,400. With plan b, you spend $10,800 for premiums plus $4000 minus the $3000 from your hsa, which is $11,800. So in normal years where you aren't spending a lot on medical costs, meaning no new baby and no major surgeries, it makes more sense to go with plan b.

@Mrs. Blue: I would ask each company more questions before making a decision.

Our plan has an individual and a family deductible, but the individual doesn't "count" if you have a family plan. It's their way of saying "here is what your plan covers. If you're on an individual plan, your deducible is XXX. If you're a family plan, your deductible is YYY."

Are either plans aggregated?

What is your OOPmax? What is your prescription plan options?
What is their prenatal plans? (Ours covers prenatal and delivery at 100%, our deductible does not apply.)

yeah, i would check on maternity coverage because i had a deductible of $3500 which i thought i'd pay for R's birth, but it was only $1600 because my insurance covered a good amount before having to meet any deductible!

@aegie: @MamaG: @Mrs. Blue:

<< individual deductible applies only when it's just employee. True family deductible applies when you are covering employee + family. So regardless of who is racking up the bills, you need to meet the family deductible, not the individual. >>

This will probably depend on your plan. Our insurance is a high deductible plan but definitely has an individual vs family deductibles. So with our insurance, each individual's deductible is $3000 and the family deductible is $6000. So each individual only has to pay $3000 and then once the family as a whole has hit the $6000, we (as a family) no longer have to make payments towards our individual deductibles.

@aegie: If I personally have $6000 in bills, I have to pay the $3000 deductible and then the 20% coinsurance (and my insurance pays 80%) after that.

@Adira: So your plan is not aggregated!

Our insurance company initially gave us the same set of information. We have a $500 individual and a $1,000 family deducitble. I was told that one person had to meet $500 before coinsurance kicked in. In actuality, the entire family had to meet $1,000 before coinsurance kicked in. It didn't matter if I had 1,000 in bills or $500, the entire family had to meet $1,000 combined before coinsurance kicked in.

Aggregated sounds so much better, though! One ER visit could easily be that $500!

@Adira: maybe I misunderstood your example then.

Ours has a $500 individual and a $1,000 family.
We were originally told that one person in our family had to meet the individual deductible before the co-insurance kicked in. That meant there's be a $500 balance left for my husband and Chloe to meet ($250/ea) before their coinsurancr kicked in.

For us, this was a huge cost savings. Our prescription benefits don't kick in until we've met our deductible-- so id get my advair filled ($450 out of pocket) once and my deductible was (almost) met. From there on after, each prescription is $35.

It would have been a huge cost savings for us, but customer service gave us the incorrect information. We have to meet $1,000 as a family before any benefits kick in. We pay 100% until the deductible is met.

@Adira: gotcha-- that's how ours was originally explained to us. I was told that it's called "non-aggregated". Our plan is aggregated, which apparently means all of us have to meet the deductible before anything kicks in.

But they could be lying again. Ha.

@Adira: that's exactly what happened!

@Adira: I was trying to point out that if you personally had $6000 in medical bills, yes, YOU would meet the deductible and co-insurance would kick in. FOR YOU. But your family members would not have met their deductible. So they would still need to pay out of pocket until that happens.

I feel like in that scenario, you're paying more out of pocket because everyone needs to meet a deductible.

I kind of like knowing that we all get to contribute to the deductible. but i guess that's preference.

@Adira: @aegie: it depends entirely on how your insurance is set up. Regardless, there is always a max. Each family member wouldn't pay the full deductible each.

My DH's is the way @Adira: was explaining. We had three people on the plan and it was $800/individual $2400/family. He met his $800 deductible and then was on co-insurance. Me and our daughter never met our deductible.

I think in @Adira's last example ifA, B, and C each had $2000 of expenses ($6000 total) the deductible would also be met even though no ONE person met the individual deductible and co-insurance would then kick in on the next expense regardless oh which person it was.

It is certainly plan dependent and worth clarifying.