NWMR: High Deductible Health Plan

SavedByLove · October 2012

Is anyone on a High Deductible Health Plan? My one coworker swears it's the way to go, saying that even if you pay all deductibles it ends up being the same cost as the regular plan. Therefore, you can only save money.

I haven't crunched all the numbers yet but am not sure what to do. With a toddler (almost 16 months) I hesitate as you just never know. Plus, we may get pregnant next year and with all those doctor appointments I don't want to pay out the wazoo!

jeffsjayme · October 2012

We LOVE ours! But maybe it's because my DH's employer adds money to it.

So, we figured out what it cost us in premuims each month - what DH's employer adds, then that's the final cost.

So, $200/mo in premiums = $2400 cost

But, DH's employer adds $1,500 to the HSA each year, making it really cost $900.

Yes, we have a higher deductible than a PPO or an HMO, but those premiums are much higher per month AND the employer doesn't kick anything in.

We even had one this year with my pregnancy and it was great. Even assuming that I hit max-out-pocket for me as an individual (which with a birth I still didn't do!), it was still cheaper.

Plus, the money keeps rolling over each year until you spend it all or until you retire, in which case, it gets treated like an IRA, I believe. Genius!

But if the employer didn't contribute money, then it might be a wash.

Remember with a pregnancy, most of your expenses (at least mine) are paid the year you give birth, not the year you saw the doctor. Except for labwork and ultrasounds and if you were hospitalized. My doc's fee was $3500. I was pregnant in 2011 and 2012. The insurance that we had in 2012 is what had to pay the doc fee since that's when we delivered. We had the same insurance company throughout, but if you switched, that's what would happen. So if you got pregnant in 2013, but delivered in 2014, that's when it matters. So you COULD do a HDHP for 2013, switch to a PPO/HMO for 2014 if you were really worried about costs.

Don't forget too - that most of your doctor's appointments (assuming you have a healthy baby) are well baby and those should be 100% paid, no matter which insurance plan you're on.

But we love ours!

SavedByLove · October 2012

Thanks so much!! You gave such great info, I really appreciate it! I can't wait to crunch the numbers. My company pays $600, so not as much but still something! Only thing that stinks with my company is that we have to pay extra $100 for DH to go on my insurance but get paid $100 if I go on his. So it makes the decision that much harder! Anyways, thanks for the help!

groovygrl · October 2012

I just enrolled in one b/c it has a required HSA with it and my employer contributes the amount of the deductible intot he HSA and the monthly premiums were less than those for the PPOs so it seemed a no brainer since I have no chronic issues or major meds. Not much experience so far (though I have never had an HSA before so I am going to have to be organized about the receipts) but with their contribution it just seemed silly not to do it.

SharonB222 · October 2012

I've done low-premium HDHP for "typical" years and high-premium co-pay only for pregnancy years --- to make prenatal decisions (while loopy with hormones) based on health and not financial concerns. Mostly it's ended up being within $500 one way or another and although I suppose that adds up it hasn't seemed significant.

jeffsjayme · October 2012

I will add that one thing that I like is that the HSA continues to grow and grow. So if you have a few years where you use hardly any of the money, but are able to contribute quite a bit to it, you can get into the position where the balance of the HSA equals your total max-out-of-pocket for the family. Meaning, if everything bad in the world happened and you'd be liable for $10K of medical expenses as a family, and you had $10K in the HSA, you don't need to sweat anything. You got it covered. Then the following year, you can switch back to something more "safe" or "known".

My DH started the HDHP with HSA when he was single and just kept contributing the max to it, but took out very little. Now we have $20K in there, so it would take 2 consecutive years of us not contributing any more to it AND having to meet the full out of pocket as a family before we exhausted the money.

I like to think of it as a separate medical emergency fund for that purpose.

ccm1203 · October 2012

I handle the HR for my company and we are switching from a PPO to a HDHP. I set it up so the company contributes the individual deductible for the plan year. In most cases this will be a win win for the company and employee. The HDHP premium is a little more than half the PPO premium.

MammaBear81 · October 2012

Quick number crunch for us:

Low deductible: $300 per month (3,600 per year) in premiums, plus $1000 deductible, co pays and it was a 70/30 after the deductible.

High deductible: $90 per months ($1,080 per year) in premiums, plus $4,000 in deductible, co pays and it was 90/10 after the deductible. PLUS our employer contributed $2000 to our HSA (every year, and it carries over)

So we saved 2520 in premiums, +2K from the company that was more than the 4K deductible and we end up with better coverage after the deductible. If you don't spend 4K in services for the year, you get to bank that money.

just and FYI, one of the PP mentioned that pregnancy should be covered, it IS NOT in all plans. I had to pay out the 4K for my pregnancy in 2011 before the insurance kicked in, so just ask a lot of questions before you sign on the dotted line!

snicksnack · October 2012

I switched to one this year. Mine is 3,600, of which my employer pays 2K. The yearly premium I pay is less than 2K. It has no copays and once you meet the 3,600 (really only 1,600 I have to pay) it kicks into the normal ppo I had before. So it was a no brainer, although I am tracking everything spent this year so we can compare when it comes time to rejoin. There are two things you have to consider: are you a highly compensated employee whose employer takes the premium out pretax and do you have the money in the bank to cover upfront costs that may be associated with a higher out of pocket expenses? If you are highly compensated even though it appears you are paying more the amount you may be saving in taxes could make the more expensive plan a better one it all depends on your tax bracket. I ran every number overall and figured out worse case scenario say I got really sick the cheap plan would end up costing less than 1k more than the more expensive plan but if everything went as normal I would be out a couple 1,000 on the more expensive plan but it is insurance so I would not have been hit with a large bill at any one time because it would be covered in copays etc.. but I may have been paying for something I rarely use especially with well visits covered. It is a risk but as long as you have money in the bank to cover out of pocket expenses I think it is the way to go at least at my company.

Want a personalized experience?

NWMR: High Deductible Health Plan

Re: NWMR: High Deductible Health Plan

Choose Another Board

Search Boards