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[Health Care Threads merged - please stop creating new threads]

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We have been on a HDHP for the past year. My only issue with these are that they are pure profit to the insurance companies. If one doesn't ever go over their deductible or use any of the preventative care, those premiums are pure profit. Of course that will help off set those that do go over their deductibles. The problem is that it seems that HDHPs are priced high for what you actually get. Several hundred dollars a month on the individual market is high IMO for what amounts to no coverage if you don't have a catastrophic event where you hit your deductible. I think they are using these plans to subsidize all the other plans they offer, even the more traditional plans.
I'm not so sure about the HDHP being big profit makers as I think preventive @ 100% is mostly used by the insureds. Why not? It's everything else that you pay pay pay for until deductible. But if you hit deductible, then they cover most everything. Some years you come out ahead, some years they come out ahead, but at least you get your screenings and can contribute to an HSA.

It would be wonderful if everyone could have an HSA but they are only available w/ HDHP.

Mine is partially subsized so true cost masked. Still, cheapest monthly pay I have had in over a decade (not counting what I voluntarily have deducted from my paycheck to go to HSA). Prescriptions @ $4 shocked me.

If the monthly rate is good, and one can afford to divert cash to HSA, it could be a good way to go, at least short term, if one is generally healthy. Having a build up in the HSA is a valuable tool to have. Now that I have an HSA, I don't ever want to not be able to contribute to one. ymmv
 
The plans that are going away are the ones that don't meet the minimum requirements of ACA.

So you can sign up for a HDHP and avoid the tax penalties.

I have not examined all the policies available, so it makes some sense to have some of them be high deductible policies as long as they provide the minimum benefits of ACA.

I guess I could have been clearer about the policies that would sunset. Sorry for the confusion (maybe mine).
 
Did you mean to use OR in this sentence? I believe some of the plans offered on the ACA exchanges are in fact HDHPs. So they are not going away. The plans that are going away are the ones that don't meet the minimum requirements of ACA. These are not necessarily HDHPs. So you can sign up for a HDHP and avoid the tax penalties.

That is correct. Part of the confusion might be that many high deduct plans are indeed catastrophic only. That is not, however, the only flavor they come in.
 
I'm not so sure about the HDHP being big profit makers as I think preventive @ 100% is mostly used by the insureds. Why not? It's everything else that you pay pay pay for until deductible. But if you hit deductible, then they cover most everything. Some years you come out ahead, some years they come out ahead, but at least you get your screenings and can contribute to an HSA.

It would be wonderful if everyone could have an HSA but they are only available w/ HDHP.

Mine is partially subsized so true cost masked. Still, cheapest monthly pay I have had in over a decade (not counting what I voluntarily have deducted from my paycheck to go to HSA). Prescriptions @ $4 shocked me.

If the monthly rate is good, and one can afford to divert cash to HSA, it could be a good way to go, at least short term, if one is generally healthy. Having a build up in the HSA is a valuable tool to have. Now that I have an HSA, I don't ever want to not be able to contribute to one. ymmv

We signed up for a HDHP with HSA in 2013. I wish I had run the numbers much sooner. As this year alone it has saved us about $1500 over a traditional plan. That money now sits in an HSA. Now we have employer sponsored health coverage, so I am sure we would be paying a much higher premium on the individual market. If that were the case, we wouldn't have as much in an HSA.

An HSA is good if you can afford to stash cash in there. It is a truly great vehicle. You put money in tax free and take it out tax free. It also grows tax free if you invest it. You don't have to meet the minimum health spending that you have to have in order to take healthcare costs as a deduction when itemizing on your return.
 
We signed up for a HDHP with HSA in 2013. I wish I had run the numbers much sooner. As this year alone it has saved us about $1500 over a traditional plan. That money now sits in an HSA. Now we have employer sponsored health coverage, so I am sure we would be paying a much higher premium on the individual market. If that were the case, we wouldn't have as much in an HSA.

An HSA is good if you can afford to stash cash in there. It is a truly great vehicle. You put money in tax free and take it out tax free. It also grows tax free if you invest it. You don't have to meet the minimum health spending that you have to have in order to take healthcare costs as a deduction when itemizing on your return.

I'd love to hear more on this.
My employer does not contribute to the HSA anymore.
The HSA plan costs 2.75% of gross. The Traditional plan 3.4% and the HMO about 3%
With that saving in monthly premium diverted to HSA. I could never work out how to come out even let alone ahead.
It seems to only work well for young single highly compensated people who can use it as a 401k style top up.

Sent from my LT26i using Tapatalk
 
I haven't read all the responses in this thread but did want to let people know that the dreaded price increases in medical insurance did not happen to us. Our plans went up only about $2. They've gone up much more than that over the past years.

I haven't tried to get on the exchange to see if there are other plans out there that are better than DH's employer's plan.

I looked into the High Deductible plan offered a few years ago but figured we would end up paying more because the deductible was so high. We'd end up paying more in deductibles than we would save in premiums. I can see where it would be a good gamble for young people with no illnesses. Just this year DH has had knee and shoulder surgeries and told both times he will need replacement surgery sooner than later. Let that be a lesson to you folks who think it is macho to power lift. You shatter your cartilage.
 
I'd love to hear more on this.
My employer does not contribute to the HSA anymore.
The HSA plan costs 2.75% of gross. The Traditional plan 3.4% and the HMO about 3%
With that saving in monthly premium diverted to HSA. I could never work out how to come out even let alone ahead.
It seems to only work well for young single highly compensated people who can use it as a 401k style top up.

Sent from my LT26i using Tapatalk

I currently don't have a lot of healthcare usage. In the past it is possible that perhaps we wouldn't have been able to plow as much in to the HSA. I recently lost a lot of weight and have been taken off a lot of meds that under the HDHP probably would have eaten up some of that money.

Though I will agree. An HSA is best for the young and healthy. If you only have one or two office visits a year, and only take a couple of prescriptions, you can save quite a bit of money in the HSA.

In our plan the HSA was about $20 cheaper per pay period than the traditional plan. This was about 45% less. By putting that difference in to the HSA, it was $560 right there. Our employer does contribute to the HSA throughout the year. So between that and putting in the difference between the traditional plan premium and the HDHP premium I already had $1000 in there. We always contributed to a HCRA in the past. I always found myself at the end of the year finding stuff to buy in order to avoid the use it or lose it provision on a HCRA. This year, I just put the difference in the HSA I have had some healthcare usage this year with a couple doctors visits and some trips to the dermatologist. So it has used up some HSA contributions but I won't lose any contributions to the HSA that go unused.

However, the best thing about the HDHP is the negotiated rates. A doctor visit isn't over $100 and visits to the dermatologist are between $40 and $65. So the impact on the HSA hasn't been bad.

Another thing, if you do take regular maintenance medications, our plan pays for those at 80% with no deductible. Prescriptions for things like high blood pressure or cholesterol control do not impact you as much as you would think allowing you to keep that money in the HSA.
 
We are at the other end of the spectrum..last year our agent said we might want to consider the HDHP. Young people do not generally need this type of plan because a good coverage plan can be reasonable. We chose this type of plan because the premiums are much lower. To get a plan that would actually pay for doctor visits would cost over $6450 more per year. Our plan will pay 100% on everything after the $10,000 deductible. Out of pocket maximum is also $10,000. There are $30-$60 copays in the "better plan" and still relatively high copays on prescriptions and an out of pocket maximum of $12,700.

We do not need to budget our care on a monthly basis. The funds are in the HSA. We think the odds are that we will will not spend that $6450 on medical costs. If we do, it would probably mean we had something serious, in which case, the lower out of pocket maximum will come in handy. We can afford to gamble with a few thousand.

A lot of young people do not have the funds or the discipline to contribute to HSAs. They think they are invincible. That is why many have no insurance. They are taking a huge risk. Who will pay the bills if they get testicular cancer or fall while rock climbing. A HDHP at least keeps them from running up a huge bill if they get really sick and gets them those negotiated rates. (If we all have insurance..maybe the rates will not have to be negotiated?)
 
I think a HDHP is great for the young. Starting to save early is the best way to let your money grow. They should be saving while they do not need the funds, so their HSA goes up. While traditional plans are fairly cheap for the young, the HDHP are usually always cheaper. Even if one just puts in the difference of what they would bay between the two types of plans, they would have significant savings after only a few years.
 
We switched to a high deductible plan a few years ago and managed to hit the maximum deductible both years, negating any savings. My husband had to have gallbladder surgery one year and my daughter had a broken Talus the next. Both required so many tests and procedures that the costs escalated quickly. Then throw in some garden variety issues (allergies, asthma, RA) and we were out of pocket to the tune of $10k each year, in addition to our premiums. (Not sure why the company didn't have an HSA). Anyway we switched to Kaiser (HMO) and that has worked out great for us. Our premiums are comparable to our old PPO but our out of pocket is much less. When I read your stories I wonder what we did wrong, but in the end we feel good about where we are now.
 
I tried a high deductible plan for one year for my generally young and healthy son. Guess what, I called 911 for an emergency. The paramedics said he was alright but asked if we wanted him transported to the hospital. Silly newbie me said, sure, when I could have driven him then. Bill for the ambulance service? $2000, because high deductible plans do not pay for ambulance transportation. Hospital emergency room bill was a separate amount. I have shied away from high deductible plans thereafter.
 
...making health insurance companies cover pre-existing conditions and covering dependents till age 26 will have no impact on current rates?


What has been going on now with those 26 and below who where were not in school or covered by employer plans is lots of them have gone without. They were still able to get treatment even for big stuff that is written off when they can prove little income so then passed along... as nothing is free I think we can agree. Either your covering them with insurance or not but they do get treated one way or the other. Maybe it's like being on a teeter-totter :ponder:
 
We switched to a high deductible plan a few years ago and managed to hit the maximum deductible both years, negating any savings. My husband had to have gallbladder surgery one year and my daughter had a broken Talus the next. Both required so many tests and procedures that the costs escalated quickly. Then throw in some garden variety issues (allergies, asthma, RA) and we were out of pocket to the tune of $10k each year, in addition to our premiums. (Not sure why the company didn't have an HSA). Anyway we switched to Kaiser (HMO) and that has worked out great for us. Our premiums are comparable to our old PPO but our out of pocket is much less. When I read your stories I wonder what we did wrong, but in the end we feel good about where we are now.

I guess we are lucky with our employer sponsored HDHP in that our deductible is only $1250 with a $2000 annual out of pocket max. Next year it goes up to $2,500 with a $4,500 out of pocket max. So we would never have a huge bill in the $10,000 range. I think that is why even if we hit the max, we would still be close to break even vs a traditional plan.

With our old traditional plan, we had copays of $20 for the doctor and $40 for a specialist. An office visit in most of our cases is a negotiated rate of about $80-$100 and going to the dermatologist was between $35 and $65. So we really didn't have to pay much more above our old copays with our new HDHP.

They obviously don't work well if you have an emergency that requires surgery of a hospital stay. But that is the nature of insurance, you are taking a gamble either way.
 
I tried a high deductible plan for one year for my generally young and healthy son. Guess what, I called 911 for an emergency. The paramedics said he was alright but asked if we wanted him transported to the hospital. Silly newbie me said, sure, when I could have driven him then. Bill for the ambulance service? $2000, because high deductible plans do not pay for ambulance transportation. Hospital emergency room bill was a separate amount. I have shied away from high deductible plans thereafter.

I am not sure this is always the case. It is more that HDHP doesn't cover any medical services (except preventative care) until you reach the deductible.
 
We are shopping on the individual market. We can get a HDHP which would let us use our HSA with a much lower deductible. The plan with a $2800 deductible costs $6450 per year more. We are only risking $3650 by choosing the $10,000 deductible plan. Since we are older, 55 and 62, our rates are high. We will pay $785 per month for the $10,000 deductible plan. That is a savings of $540 per month in premium costs.

If our actual medical costs exceed $6450, then we lose on our gamble. Our best guess is that they will not. For 7 months this year with me having to go to Urgent care multiple times we are still likely to be under $3000 in actual medical costs for 7 months of coverage. When the worst case is only an extra $3650 in cost of premiums plus care for a year, that is a risk I can afford to take.
We all need to run the numbers and figure out what we are comfortable with. We are not comfortable paying for more insurance than we think we need.
I would rather put the money aside and get to keep it if my health stays good.
 
But I think it's wise to freeze one's credit with all credit reporting agencies as an added peace of mind.

A good idea. I did it and am happy I did, but it can be a hassle. For example if you want to change your auto insurance to a new provider, they will want to check your credit. To allow them to do so you have to call the Credit Agency the new company uses; ask them to allow access to your credit account for 24 hours; and give them your 6 or 8 digit security code. Still I'm glad I did it.

George
 
I am not sure this is always the case. It is more that HDHP doesn't cover any medical services (except preventative care) until you reach the deductible.

When I bought the high deductible plan I was calculating out of pocket for medical expenses only. The ambulance billed showed that my high deductible plan only paid them about $200, and I had to foot the rest of it. It was a sticker shock for me.
 
Signing up for Health Care :(

I just went into the government health care to sign up my family, everything with ok (copied off every page, before it was summited).

Got my email to review plans and low a behold - They have my Frist name misspelled:wall: . So I called gave the person all my info and after 15 mins waiting she comes back on the line and tells me : I'm sorry sir, but when can't do anything at this time. You'll just have to wait.: mad::mad::mad:

Thanks for letting me vent..

HAPPY THANKSGIVING EVERYONE
 
So is the misspelling a typo on your part or data that got corrupted in transmission?
 
The best thing to do when you run into a problem on ACA is just create a new account (need a different email address). It's usually much faster then trying to get someone from ACA to fix it.
 
zinger1457 ,Thanks, I'll try using a different email address.

maggiesmom
 
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SMHarman- No typo on my part. Going to try it with different email.
 
Yeah..figured out a way to lower costs and get better coverage

I have been researching insurance so much, I have been invited to become an agent. I am taking the course now. Have not been on TUG much because of this. Will be taking my licensing exam in a week or two. January through March, I will be working in a program to educate and enroll individuals called NC ENROLL.

In my personal search for the best individual coverage option, since we had the option to keep our grandfathered plan, we started looking at the breakdown of rates within the family plan of our grandfathered plan and our new options. Boy were we surprised!

I wanted to lower my deductible from $10,000 to $5000. My husband did not care about doing that for himself. He wanted the lowest rates. We thought we wanted to move me to a lower deductible policy and let him keep the 2013 plan, but when we learned the rate breakdown, that made no sense. Because the rate breakdown made no sense.

My husband is 62 and I am 55. Our new rate for the grandfathered 10k deductible plan was going to be $873/month. When I obtained the rate breakdown it was $558/mo for my husband and $315/mo for me..huge difference due to the slight age difference of 7 years. I loved the $315/mo for me but we needed to reconsider what to do.

So... I kept our grandfathered plan which will become an individual plan with a $5000 deductible and $5000 max out of pocket. (Our current plan had a $10,000 individual/$10,000 family deductible..definitely favored the insurer)
My husband moved to a new plan with a $5500 deductible and $5500 max out of pocket. The difference in his rates between the old $10k plan and his new $5.5k plan is only $25/mo. His new plan is $583/mo. and lowers his deductible and out of pocket by $4500.
I stay with the grandfathered plan at only $315/month and lowered my deductible and out of pocket by half to 5k. Both plans are HSA plans which continue to have large tax savings for us.

We were not sure BCBS would let us do this particularly since my hubby was the primary subscriber on the 2013 acct. My agent called BCBSNC and was told it can be done and how to submit it. Change forms are in. ( I hope it isn't like II and they come back and say no later. )

I also purchased insurance for my son for his Christmas present. I did this on healthcare.gov..Yes, it works. It has been for weeks.

My daughter and her husband are shopping the Maryland exchange. She said the prices are much better than COBRA. (They are young..27 and 30)

I applied the same bargain hunting and research efforts to this as many of us do to buy and use timeshares for the least possible dollar outlay. I am pleased with the outcome if we actually get what I signed us up for today. Keep your fingers crossed for me. Our combined rates are higher than last year but I am pleased with our new deductibles.

Sometimes you just have to think and execute way outside of the box!
 
As a side note, Insurance is a good career move. DO NOT stick with only Health Insurance, also get Life Insurance/Annuties. That way, once the Exchange Enrollment Period is up (March 31st), you can go on to sell Life Insurance to anyone. The biggest advantage is, if you sell for a year and make $36000 in commissions, you will make a minimum $36k per year in renewals (assuming you stay with the agency and your customers stay with you). Living in Florida - "Heaven's Waiting Room" - Medicare recipients are a BIG business.

The downside to Insurance Sales is it is 100% commission. If the agency gives you a salary, your commissions are lower, since they need to make money somehow.

TS
 
I have been researching insurance so much, I have been invited to become an agent. I am taking the course now.
....
I also purchased insurance for my son for his Christmas present. I did this on healthcare.gov..Yes, it works. It has been for weeks.

My daughter and her husband are shopping the Maryland exchange. She said the prices are much better than COBRA. (They are young..27 and 30)

I applied the same bargain hunting and research efforts to this as many of us do to buy and use timeshares for the least possible dollar outlay. I am pleased with the outcome if we actually get what I signed us up for today. Keep your fingers crossed for me. Our combined rates are higher than last year but I am pleased with our new deductibles.

Well done!
 
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