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Health Insurance Question - THIS IS NOT A POLITICAL THREAD!

Discussion in 'The OT' started by Herdfan, Oct 22, 2013.

  1. Herdfan

    Herdfan Well-Known Member

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    Teays...
    THIS IS NOT A POLITICAL THREAD!

    I was reviewing my rates for the upcoming year. We have been on individual policies for years and have been generally around a $2500 deductible.

    So as I was looking at the rates on what we had vs. what is going to be available 1/1, I noticed one thing. The Under 21 rates don't show much difference between a $5000 deductible and $500 deductible. I also noticed that child-only policies are available.

    I am seriously thinking of getting a child-only policy for my daughter in the Gold level with a $500 deductible since she uses typically is the biggest user of HI in the household anyway. The keeping the $2500 deductible for the wife and I. With her going Gold it will cost me an extra $17 month vs. having her on the $2500 plan as a family.

    Any thoughts on this?

    THIS IS NOT A POLITICAL THREAD!
     
  2. Bronxiniowa

    Bronxiniowa Member

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    Send me a PM. We'll discuss.
     
  3. yosoyellobo

    yosoyellobo Icon

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    If you don't mind me asking how much is a policy with $2500 deductible? $500 seems to be the way to go for your daughter. I am only asking just out of curiosity since I am cover by Medicare.
     
  4. fluffybear

    fluffybear Hall Of Fame DBSTalk Club

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    As long as you are getting the same level of care which you are getting today than putting the child on their own policy makes sense. Also be sure and verify that their doctor will accept that plan as some doctors may choose to accept one plan from a company but not another..
     
  5. Rich

    Rich DBSTalk Club DBSTalk Club

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    My wife was babbling something about a $5,000 deductible on our HI last night. Some new plan starting next year. She's still trying to understand what's going on and she keeps hitting me with factoids that seem a bit unbelievable. At tax time, the amount we get back varies widely each day she works on the taxes. I've learned to pay attention only when she sends the completed tax forms in. l think that's what's going on now. In any event, it's gonna change.

    Rich
     
  6. klang

    klang Hall Of Fame

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    I think the higher deductibles are the new normal. We had to switch to one two years ago for our employees group plan. Still waiting for the bad news for next year. :eek2:
     
    1 person likes this.
  7. Herdfan

    Herdfan Well-Known Member

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    We are currently paying $640/mo for all 3 of us with a $2500/$5000 Individual/Family Deductible. Come 1/1/14 an equivalent plan, but with $10 higher copays but better drug coverage, will be $830 for the 3 of us. Putting our daughter on her own plan raises the cost to $847.

    The big downside to doing this I can see is if each of us have a bad year, our total out of pocket could go from $7K to $13K as she would have her own out of pocket limit to meet. So as long as this didn't happen more than every 3 years, we would have on the $2K less deductible.

    Or we could say screw it and move all of us to the $500 deductible for $990.

    We have one participant in the state exchange and they are my current provider. Almost every doctor and hospital is in their network.
     
  8. Supramom2000

    Supramom2000 In Loving Memory of Onyx-2/23/09

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    I thought I heard a news report today about "Out of Network" providers not being accessible as part of the new ACA coverage at all. In other words, any sort of visit or tests or scipts would not be covered in any way, shape or form, and would not count towards your deductible.

    I have no proof this is true. And if it is, it might be limited to one plan, or one state, etc. I just wanted to make sure you check into all the fine print and all the possible unknowns before making the decision.
     
  9. James Long

    James Long Ready for Uplink! Staff Member Super Moderator DBSTalk Club

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    All of the plans by employer offers are deemed "affordable" - so I am out of the exchange. I have not figured out which plan I want to go with next year. Making sure the provider you choose are covered by the plans you choose is important. Read everything.
     
  10. EdJ

    EdJ Legend

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    It has been this way for many years. The higher the deductable, the lower the monthly premium. The lower the deductable, the higher the premium. This is really a good thing that both options are available. A person who is healthy and does not need to see the doctor very often only needs a high deductable policy. The policy then really only comes into play if something very bad (and expensive) happened to impact their need for medical care. And the opposite is that is somebody who requires a lot of on-going medical care. They would usually be better off with the low deductable and higher monthly premium.

    The bottom line is that every one is different and has to look really hard at their own health care needs to decide which way to go.
     
  11. EdJ

    EdJ Legend

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    This varies with the insurance company and the particuliar policy. The same insurance company may offer several different policies. Usually, a policy that allows covered out of network will be a bit more expensive.
     
  12. harsh

    harsh Beware the Attack Basset

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    These plans are often backed up by company-sponsored annuities that pay some or all of the deductible. My employer pays the last $4000 of the deductible from such a fund.

    This is obviously an issue that doesn't apply to those considering personal insurance (although having a set-aside of some sort to cover the deductible seems an imperative).
     
  13. harsh

    harsh Beware the Attack Basset

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    I'm not sure "many years" is accurate. Mine's been going up $1500/year for the last two years. Before that it was relatively stable.

    The reduction in the maximum FSA amount has made this more of an issue.
     
  14. klang

    klang Hall Of Fame

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    I agree, with group policies this is a more recent phenomena in my experience. I'm a bit more aware these days as I am more actively involved in the day to day running of the business my wife and I own. Our insurance broker has already hinted at 30% increase for 2014. Don't know yet if that will mean an increase in deductible too.
     
  15. James Long

    James Long Ready for Uplink! Staff Member Super Moderator DBSTalk Club

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    My former employer went to high deductible group insurance many years ago. The plan I had 10 years ago was basically catastrophic health coverage. It only would have helped if I was severely sick or injured. Five years ago they added an element of preventative care which saved a couple hundred per year in medical costs. I was glad to get away from them to a place where there is at least an option for a better plan.
     
  16. BattleScott

    BattleScott Hall Of Fame

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    Are the higher deductible plans eligible for HSA accounts?
    If so, a higher deductible family plan with an HSA account may be a better option.
     
  17. Herdfan

    Herdfan Well-Known Member

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    Yes. My provider offers 3 HSA plans, one at each "metal" level. The one at the Gold level with a $1300 deductible/$4600 max out of pocket is the most expensive plan available. Put it pays 90% after deducible is met.

    The Silver $2500 plan is right in line with other Silver plans.

    What I don't like about the HSA plans is they don't have prescription coverage until you meet your deductible. My daughter is on 2 asthma medications and asthma meds are not cheap. Alone they would come close to meeting her deductible in a year. Also, I like having a set Dr. Visit co-pay. Not so much for the cost, but I know when I take her to the Dr., it will be $25/35 and I am done. No more bills from the Dr.'s office with codes you can't understand. Pay at time of visit and you are done.
     
  18. EdJ

    EdJ Legend

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    I have been retired for many years. Back when I was working, the company offered several different medical plans to choose from. The price to me varied from cheap with a high deductable to higher premium price for a low deductable. The company covered the first xxx dollars of the total premium cost. After that, I picked the rest up as my cost of premium. If a company chose not to increase their share of the premium as the years went by, the options were to increase the cost to you or change the policy to increase the deductable or co-pays.

    The choices of different policies are nothing new. Of course, you would only see it if your employer chose to give you a choice between different policies.
     
  19. 4HiMarks

    4HiMarks Hall Of Fame

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    HSAs are great. They are much better than FSAs which have to be used up in the same year or forfeited. The lowered FSA limit definitely sucks, as it barely covers a crown from my dentist and that then shoots your wad for the entire year. With an HSA you can carry it over from one year to the next to have a cushion for unexpected non-covered expenses.

    If you have the option of a plan with an HSA, I urge you to take it and contribute the max. It's pre-tax money, so it reduces your tax burden, and if you wind up never using it for medical, you can spend it on anything you want after you reach retirement age, so it can act as a supplement to your 401(k).
     
  20. steve053

    steve053 Godfather

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    True, but it's still counted as income when withdrawn. I wouldn't be surprised if they implement a mandatory minimum distribution similar to IRA's at some point in the future.
     

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