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Hey guys -- what are your thoughts on these two different plans? After the standard deduction, I'll be in the 12% federal tax bracket for 2018. Premium forPPO for employee + spouse = 161$/month Deductible in network: 200$/400$ in network 700/1400 Out of network Out of Pocket Max: 2000/3000 and 3500/6500 Co insurance: 10% in network 25% out of network Office visits: preventative: free / Primary care 20$ / Specialist 25$ Hospital in patient: 500$ per person, 10% Outpatient: Deductible and Coinsurance Premium for HSA Plan for employee + spouse = 121$/month Deductable: 1500/3000 and 3000/6000 OOP Max: 3500/7000 and 7000/14000 Co insurance: 10% and 30% Office visits and hospital : deductible and co-insurance Company gives 1500$ free in your HSA. Even with the free 1500$, seems HSA plan seems like a bad deal. For only 480$ for the whole year, seems like the PPO is way better. Am I wrong?
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Nov 1, 2018 23:04
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Mourne posted:Hey guys -- what are your thoughts on these two different plans? After the standard deduction, I'll be in the 12% federal tax bracket for 2018. PPO - in a worst case scenario you'd pay $4932 for the year ($1932 in premiums + $3000 out-of-pocket max) HSA - in a worst case scenario you'd pay $6952 for the year ($1452 in premiums + $7000 out-of-pocket max - $1500 HSA benefit) If you travel a lot, the out-of-network max on the HSA plan would gently caress you if you or your spouse had an emergency
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Nov 2, 2018 04:32
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Mourne posted:Hey guys -- what are your thoughts on these two different plans? After the standard deduction, I'll be in the 12% federal tax bracket for 2018. 
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Nov 2, 2018 05:41
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Sigma: I know you're biased against HMOs but I can never seem to make them not the best financial solution. I rarely pay more than $750-1k in copays so my total out of pocket plus premium is around $7500. Based on your analysis that seems like whatever bullshit they have is worth it? Did I interpret that right? My open enrollment ends today and at this point sticking with HMO unless you bring some interesting perspective I'm missing. Thanks!
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Nov 2, 2018 12:12
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I finally got my enrollment options for 2019 and for the first time I'm seriously looking at the PPO vs the HSA. My company offers three levels of coverage, two PPO and one HSA. Actual benefits coverage on all of them are identical (All preventative care is 0% cost, coverage for all conditions/procedures are equal across all options, all have me pay 20% coinsurance after deductible is met if in-network, etc). I am solidly in the new 24% tax bracket, as in with deductions like 401k/HSA maxed I won't be able to knock myself down into the 22% bracket. Single Coverage Only (It's just me, no spouse/kids). I live in NYC and don't travel for work so it's very easy to find UHC In-Network doctors, so I'm not really concerned about Out Of Network costs. Option A: PPO High Cost $226/mo | $2,712/yr Deductible(In/Out): $600/$1,200 OOP Maximum (In/Out): $2,000/$4,000 Option B: PPO Low Cost $180/mo | $2,160/yr Deductible (In/Out): $1,200/$2,400 OOP Maximum (In/Out): $3,000/$6,000 Option C: HSA $148/mo | $1,776/yr Deductible(In/Out): $2,300/$4,600 OOP Maximum (In/Out): $5,500/$11,000 HSA Contribution Limit: $3,500 (no employer contribution) HSA Investment ability starts at $500 Am I missing any other pertinent information? Should I fill out that google doc when I'm at home? I'm a generally healthy 35 year old dude and really don't go to the doctor outside the random strep throat / sinus infection kind of deal where I need some kind of drug I can't get OTC. I would like to start going for more preventative care checkups now that I have real insurance and now I can but that doesn't affect which option I take since they're free on all options. I feel like in the case of assumed low spend I'd want to go with the HSA and use the money saved on the cost from option A to put into the HSA itself. I know I will not be able to max the HSA contribution this year, but I should be able to put in $1,200 at minimum in 2019. Fhqwhgads fucked around with this message at 18:27 on Nov 2, 2018 |
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Nov 2, 2018 14:51
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TraderStav posted:Sigma: I know you're biased against HMOs but I can never seem to make them not the best financial solution. I rarely pay more than $750-1k in copays so my total out of pocket plus premium is around $7500. Based on your analysis that seems like whatever bullshit they have is worth it? Did I interpret that right? With your pack of kids and prices of plans, the HMO sounds like not a bad option frankly. HMO's I've had offered never made financial sense, but my company had PPO and HDHP's at pretty fair prices. Fhqwhgads posted:I finally got my enrollment options for 2019 and for the first time I'm seriously looking at the PPO vs the HSA. My company offers three levels of coverage, two PPO and one HSA. Actual benefits coverage on all of them are identical (All preventative care is 0% cost, coverage for all conditions/procedures are equal across all options, all have me pay 20% coinsurance after deductible is met if in-network, etc). I am solidly in the new 24% tax bracket, as in with deductions like 401k/HSA maxed I won't be able to knock myself down into the 22% bracket. Single Coverage Only (It's just me, no spouse/kids). I live in NYC and don't travel for work so it's very easy to find UHC In-Network doctors, so I'm not really concerned about Out Of Network costs.  You'll be spending less money with the HSA up until a point - quite a fair amount of billed services, too. Unless you get quite sick next year, I'd say its the best option. Providing your HSA allows investment options, I'd suggest you max your HSA before 401k - saves FICA.
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Nov 3, 2018 06:59
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SiGmA_X posted:You'll be spending less money with the HSA up until a point - quite a fair amount of billed services, too. Unless you get quite sick next year, I'd say its the best option. This is really cool! Thank you for charting this. My HSA does allow investment options and I need to read up on what those options are, but yeah, it looks like I'll be going HSA next year.
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Nov 3, 2018 13:51
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edit: wrong thread
EugeneJ fucked around with this message at 04:58 on Nov 24, 2018 |
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Nov 22, 2018 07:01
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This may be a little bit on the too-specific side, but I need a sanity check here because I'm not sure I fully understand what's going on here. I'm trying to figure out how the FEHB's BCBS Standard and Basic benefit plans differ in their coverage. "Basic" implies less coverage. But it has lower premiums, no deductible, and no coinsurance that I can see. Maybe the only way the basic plan is "worse", cost-wise, than the standard is in copays, which are like $5-$10 higher, so who cares. It looks like that co-insurance/copay difference extends even to many of the medical services in the brochure for the plans. The only major downside of the basic plan I see is that it appears there's potentially no coverage at all when receiving care at non-PPO organizations. BCBS seems to have a pretty large network for this plan in my area (DC), so I guess the potentiality of being in an emergency situation with no in-network providers around seems pretty low. Like, low enough that the differences in benefits just don't make sense to me. Is there something else I'm missing? Are networks restricted by location somehow? Is there some weird 3rd thing? (As context: my husband has had leukemia a couple times and we (or at least I) fully expect it to come back. He needs to get regular check-ups to catch it as soon as possible if it does. He's on Tricare for now, but the military's planning on separating him, so he would lose eligibility.)
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Dec 2, 2018 15:14
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Czolgosz posted:This may be a little bit on the too-specific side, but I need a sanity check here because I'm not sure I fully understand what's going on here. The big difference that I see is the basic plan only covers in network services and you are on the hook for any out of network expenses. This can be pretty devastating if you travel or run into a major issue requiring hospitialization where not every doctor who sees you will be in network. The standard plan covers out of network stuff but not very well and even when it does it still allows for balance billing. The standard plan does have a slightly lower out of pocket max, so that's nice. If you are thinking cancer in the future the standard is probably your best bet so you don't have to worry as much about out of network costs especially if it would mean not being able to see your preferred specialist. The standard plan also has a better inpatient hospital rate at $350 per admission vs $175/day (max of 850 per admit).
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Dec 4, 2018 05:15
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For the first time ever in my career, I opted for the HSA option cause it just made financial and practical sense to me. However, I do have some logistical questions that I'm hoping you guys can answer. In-Network details: Provider: Aetna Ded: $2000 Coinsurance: 10% OOP Max: $3450 HSA Contribution by employer: $750 ($375 Jan 1st, $375 July 1st). At $1000, I can invest my funds so I will look to add $250+ after July 1st, but might do it sooner. Debit card will be provided. From what I can tell, I should be using this card for ALL qualified medical expenses whenever possible, correct? Doctor visits, prescriptions, and any other bills that come my way. I could use another payment method and then look to get reimbursed from Aetna, but I don't see any scenario where I may need to do that except for when my HSA account itself just doesn't have enough money in it. The doctor visits and prescriptions count towards my deductible (looks like I pay in full for those), and they do count towards my OOP Max, correct? Weaponized Autism fucked around with this message at 14:01 on Dec 5, 2018 |
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Dec 5, 2018 13:46
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Weaponized Autism posted:For the first time ever in my career, I opted for the HSA option cause it just made financial and practical sense to me. However, I do have some logistical questions that I'm hoping you guys can answer. This is also for my edification since I'm also going HSA for the first time this year, but why wouldn't you use another payment method and just reimburse yourself from the HSA (assuming you keep every receipt in the case of an audit)? If I have the money in my HSA, wouldn't I still want to use my CC which gets me 1.5% rewards points, and then reimburse myself from my HSA to pay off the CC charge to collect that extra bonus?
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Dec 5, 2018 14:59
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I have been banking my HSA money and paying for most medical expenses OOP. My goal is to save the HSA for true emergencies and uncovered things like kids’ braces, and eventually use it as a retirement account. When I use the HSA I charge it through a credit card to get the 2% Citi cash back. No good reason not to.
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Dec 5, 2018 15:08
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Weaponized Autism posted:For the first time ever in my career, I opted for the HSA option cause it just made financial and practical sense to me. However, I do have some logistical questions that I'm hoping you guys can answer. Whether you use those funds for medical expenses is up to your strategy with the HSA. One advantage of using the HSA funds (either directly with the card or via reimbursement) is that you can pay those costs completely pretax (hsa contributions don't even have payroll taxes assessed) and if you have a lot of oop expenses that can be handy. But since gains in your HSA grow tax free and you can use HSA funds in retirement for anything (just pay income tax) or medical expenses (tax free) it can make sense to use the HSA as another tax advantaged retirement vehicle. That's what I do with mine and I pay oop and don't reimburse. One nice thing too is you can keep documentation of those oop payments and if in the future you're tight on cash you can reimburse yourself then. Just be careful since expenses older than 5 years can draw suspicion. You also need to ensure those expenses weren't paid for via other tax advantaged means. As far as reimbursement from Aetna that won't happen. Even if Aetna is the admin of your HSA any reimbursement would come from your funds in the HSA. Fhqwhgads posted:This is also for my edification since I'm also going HSA for the first time this year, but why wouldn't you use another payment method and just reimburse yourself from the HSA (assuming you keep every receipt in the case of an audit)? If I have the money in my HSA, wouldn't I still want to use my CC which gets me 1.5% rewards points, and then reimburse myself from my HSA to pay off the CC charge to collect that extra bonus? The biggest reason is it makes the claims process a lot easier since usually it will only work for authorized retailers and products. Some HSA admins are poo poo about that though and you'll end up filing a bunch of paperwork anyway. If you reimburse you'll need to submit documentation every time. But ya getting some reward points with it is nice too.
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Dec 6, 2018 03:42
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Fhqwhgads posted:This is also for my edification since I'm also going HSA for the first time this year, but why wouldn't you use another payment method and just reimburse yourself from the HSA (assuming you keep every receipt in the case of an audit)? If I have the money in my HSA, wouldn't I still want to use my CC which gets me 1.5% rewards points, and then reimburse myself from my HSA to pay off the CC charge to collect that extra bonus? Raldikuk posted:The biggest reason is it makes the claims process a lot easier since usually it will only work for authorized retailers and products. Some HSA admins are poo poo about that though and you'll end up filing a bunch of paperwork anyway. If you reimburse you'll need to submit documentation every time. But ya getting some reward points with it is nice too.
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Dec 6, 2018 07:53
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Raldikuk posted:Helpful response. Thanks for this, I forgot about out-of-network services at in-network hospitals which would completely screw us. I thought about it more and basically our health costs are pretty bi-modal: either close to 0 or the out of pocket max (before we were married, he got over $2 million worth of care over a couple years). Given that, it seems most reasonable to carry a plan with a sane out of pocket max for combined in/out of network services. Oddly enough, I think that's the same HDHP I have right now. Or maybe I'm just backing myself into not changing--hopefully I'm not still missing anything.
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Dec 6, 2018 16:06
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