Health Insurance

[Marilyn. 340]

ok so finally my hubster got his "information" packet for the company covered health insurance.

the packet is not very informative...

the insurance is through Kaiser....

my question is about a HSA ... it says there is a $1500 deductible per year and the company pays 40 percent of that...

I have no idea how a HSA works.. do you still have to pay a co-pay when you go see a doctor etc...??

underneath where it talks about the HSA it just says this...

$50 copay - $2.08 deduction per week

$20 copay - $8.77 per week...

I am not sure if that is related to the HSA or our other options....

[one...two...tree 2,762]

Ohhhh....Marilyn, DON'T opt for the HSA (savings account)! That really only makes sense for people who are young, single and healthy, IMO.

My company offered it to us and instead I chose an HMO plan. I saw the bill for our baby's week long stay in the NICU and it was close to $40g's alone! Although parts of the HSA plan cover catastrophic events, you will still be looking at paying about $5g's out of your own pocket before your insurance will pay. Also, you'll be having to deal with making sure the insurance pays the bill, whereas, with HMO's, the health care providers are not suppose to bill you for anything beyond the co-pays. So the statement we saw for little Joshua was just that....it even said, "This is NOT a bill." It sure gives me a peace of mind to have that kind of coverage.

Edited August 21, 2008 by Jabberwocky

[Marilyn. 340]

see my problem is they only gave us the info on the HSA plan.. and hubby said the guy told him it was the best plan.. that with the other one it was a 500 dollar copay for each night you are in the hospital...

i have no idea what other plans they have...

[Marilyn. 340]

so woth a HSA you wouldn't have co-pays right... I am just trying to figure out what the other things were on the letter they sent...

it says HSA and the info and then below it are the copays I listed above... I am trying to figure out if it is all together or 3 separate things

so with a HMO you only pay copays, nothing else??

hubby's last insurance was a PPO and we payed a copay plus 10 percent of the bill...

why does this have to be so confusing??

[Reba 2]

see my problem is they only gave us the info on the HSA plan.. and hubby said the guy told him it was the best plan..

its the best plan for the company because it costs them less money

[one...two...tree 2,762]

so with a HMO you only pay copays, nothing else??

hubby's last insurance was a PPO and we payed a copay plus 10 percent of the bill...

why does this have to be so confusing??

Well, you can read for yourself and I know it's confusing...a lot of people in the office were confused with the HSA, but once you look into it...they SUCK.

With an HMO - you only have your co-pays...no out-of-pocket costs and the hospitals, doctors, cannot bill you. I signed up with an Blue Shield HMO - 20 plan. Each doc visit is $20. Jinky's whole labor and delivery was a $1,000 co-pay, which is a bargain for what it really cost. Also, my teenage son recently was rushed to the hospital with a concussion (riding skateboard without a helmet). There's a $100 emergency room co-pay, but it is waived when the patient is then admitted into the hospital. He was there for about 3 days, had several CAT scans...can't imagine the cost, but the only thing I have to pay is $50 co-pay for the ambulance. My premium is about $180 a month for the whole family which is pretty low for what they cover.

I used to have Kaiser Permanente - they're non-profit and I think they do an pretty good job.

Edited August 22, 2008 by Jabberwocky

[SupportOAFJF 0]

A HSA is a Health Savings Account..what is does is takes money out and put it aside for u to use towards coverage thigs..u usually can use it towards ur deductible, some over the counter stuff..sometimes birth control u can also use it to pay for ur copays..one thng u must keep in mind is that if u don't use it by the end of the year u lose it..so it works well if u have to say have Physical Therapy where ur gonna be paying a copay each visit..or if u use birth control or ur doc is out of network and then u can use it for ur deductible...

[Ban Hammer 13,651]

also an idea to check for coverage online. what the company offers here sucks.

[SupportOAFJF 0]

so with a HMO you only pay copays, nothing else??

hubby's last insurance was a PPO and we payed a copay plus 10 percent of the bill...

why does this have to be so confusing??

Well, you can read for yourself and I know it's confusing...a lot of people in the office were confused with the HSA, but once you look into it...they SUCK.

With an HMO - you only have your co-pays...no out-of-pocket costs and the hospitals, doctors, cannot bill you. I signed up with an Blue Shield HMO - 20 plan. Each doc visit is $20. Jinky's whole labor and delivery was a $1,000 co-pay, which is a bargain for what it really cost. Also, my teenage son recently was rushed to the hospital with a concussion (riding skateboard without a helmet). There's a $100 emergency room co-pay, but it is waived when the patient is then admitted into the hospital. He was there for about 3 days, had several CAT scans...can't imagine the cost, but the only thing I have to pay is $50 co-pay for the ambulance. My premium is about $180 a month for the whole family which is pretty low for what they cover.

I used to have Kaiser Permanente - they're non-profit and I think they do an pretty good job.

the only thing with HMO's is that u cannot go out of network..and almost always need a referral to see a specialist

see my problem is they only gave us the info on the HSA plan.. and hubby said the guy told him it was the best plan..

its the best plan for the company because it costs them less money

absolutely !

see my problem is they only gave us the info on the HSA plan.. and hubby said the guy told him it was the best plan.. that with the other one it was a 500 dollar copay for each night you are in the hospital...

i have no idea what other plans they have...

ok..thats crazy

[Dan J 277]

Ohhhh....Marilyn, DON'T opt for the HSA (savings account)! That really only makes sense for people who are young, single and healthy, IMO.

My company offered it to us and instead I chose an HMO plan. I saw the bill for our baby's week long stay in the NICU and it was close to $40g's alone! Although parts of the HSA plan cover catastrophic events, you will still be looking at paying about $5g's out of your own pocket before your insurance will pay. Also, you'll be having to deal with making sure the insurance pays the bill, whereas, with HMO's, the health care providers are not suppose to bill you for anything beyond the co-pays. So the statement we saw for little Joshua was just that....it even said, "This is NOT a bill." It sure gives me a peace of mind to have that kind of coverage.

That's not quite right. With an HSA plan, you pay out of pocket for all care during the year up to the deductible, after that, all care is covered by the health plan.

An HSA is basically a savings account, which some special provisions. You can contribute pre-tax into this account (employer might match it), up to the yearly contribution limit. But you can only use it for medical related expenses.

[SupportOAFJF 0]

HSA...is just there so don't have to come up with all the money..especially for deductibles all at once...this is money the company pretty much puts on for u..and then deducts it from ur check per pay period..not a bad thing to have..ur company should have a list of things u can get at the drug store that u can get reimbursed for...u can also use it to buy baby meds and such

[Dan J 277]

A HSA is a Health Savings Account..what is does is takes money out and put it aside for u to use towards coverage thigs..u usually can use it towards ur deductible, some over the counter stuff..sometimes birth control u can also use it to pay for ur copays..one thng u must keep in mind is that if u don't use it by the end of the year u lose it..so it works well if u have to say have Physical Therapy where ur gonna be paying a copay each visit..or if u use birth control or ur doc is out of network and then u can use it for ur deductible...

That depends on your HSA. You can easily get one that does not do that.

[SupportOAFJF 0]

A HSA is a Health Savings Account..what is does is takes money out and put it aside for u to use towards coverage thigs..u usually can use it towards ur deductible, some over the counter stuff..sometimes birth control u can also use it to pay for ur copays..one thng u must keep in mind is that if u don't use it by the end of the year u lose it..so it works well if u have to say have Physical Therapy where ur gonna be paying a copay each visit..or if u use birth control or ur doc is out of network and then u can use it for ur deductible...

That depends on your HSA. You can easily get one that does not do that.

ok...all the one's i've come in contact with were all use it or lose it

[one...two...tree 2,762]

I guess it depends on how the HSA/health insurance is set up. I can't remember all the details for the one offered to me, but I know I looked into thoroughly and decided it would not be best for me and my family. I believe the total deductible for the entire family per year was $5g's ($2,500 per person). That's a lot of money to fork over before your insurance starts to pay anything, and it can be a bit daunting to keep track of every medical expense that you pay out of pocket, then submitting it to your health insurance. Just way too many negatives, IMO, for it to be advantageous for most families.

[tom&tata 2]

Maybe the $20 or $50 deductible is for prescription? Sounds like they have deductible but no copay for the medical coverage. If the max is 1500 - is it for 1 person or family? The company will put in 40% of the 1500 to the HSA and it is up to you if you want to contribute the rest of 1500 by payroll deduction or not.

If I were you, I would ask him to go to HR as ask for more details. A lot better if they have booklet with examples/scenarios. Insurance is a big decision - you don't want to mess up because usually you can only change once a year.

Good luck!