Help with two medical plan choices

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SimonJester
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Joined: Tue Aug 16, 2011 12:39 pm

Help with two medical plan choices

Post by SimonJester » Mon Oct 30, 2017 1:41 pm

At Megacorp I am trying to decide between two medical plans both HDHPs
I would like some input on which plan to go with. I have been using Plan A for the past several years, however the costs have gone up this year and they added a new prescription deductible.

Both plans have the same providers, cover 80% after deductible is met.

Plan A Cost per Month: $292.32
Plan B Cost per Month: $183.76

Plan A Deductible $3,000
Plan B Deductible 3,300 In Net / $6,400 out

Plan A Out of Pocket Max: $11,000
Plan B Out of Pocket Max: $13,000 In net / $26,000 out

Plan A prescriptions now have $200 deductible then 20% co insurance, prescription do not count towards the $3,000 deductible
Plan B prescriptions count towards the $3,300 deductible which has to be met then convert to 20% co insurance

Plan B allows for an HSA, Plan A allows an FSA.

As a family we are generally healthy, have a few prescriptions one of which is now being considered preventative by both plans. One prescription will run about $100 - $200 a month and if I go with Plan B I might just run it outside the prescription plan (ie good RX)

So I am sort of leaning towards changing to Plan B and putting the $100 per month difference in the HSA. The HSA rolls years to year and I can take it with me if I leave my employer.
"They who can give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety." - Benjamin Franklin

Muri
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Re: Help with two medical plan choices

Post by Muri » Mon Oct 30, 2017 2:09 pm

We had an experience with everyone in our family being healthy, and then one child was diagnosed with a serious illness. We paid the entire in and out of network max for three years because some of the providers we needed were out of network. That would be $39,000 out of pocket in one year for you with plan B. That's the downside; we hit the out of pocket maximums in just a few months. As long as you can cover the worst case scenario you can do either.

SimonJester
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Re: Help with two medical plan choices

Post by SimonJester » Mon Oct 30, 2017 2:21 pm

Hmm under plan A In network and out of network max are the same, so an in network claim reduces the OOP Max and deductible for both In network and Out of network. I need to see if it will work the same with plan B.
"They who can give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety." - Benjamin Franklin

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dm200
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Re: Help with two medical plan choices

Post by dm200 » Mon Oct 30, 2017 3:44 pm

Do you have other choices besides these high deductible plans - that might lower your risks in case of serious conditions?

I suspect (especially with children) that significant portion of high or very high cost medical conditions happen to those in generally good health.

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tarnation
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Re: Help with two medical plan choices

Post by tarnation » Mon Oct 30, 2017 4:17 pm

SimonJester wrote:
Mon Oct 30, 2017 1:41 pm
Plan B allows for an HSA, Plan A allows an FSA.
Not sure what you mean here?? When I see HDHP, I infer that means a plan that qualifies for an HSA. Also, you can have a limited expense FSA along with an HSA.
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SimonJester
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Re: Help with two medical plan choices

Post by SimonJester » Mon Oct 30, 2017 4:25 pm

dm200 wrote:
Mon Oct 30, 2017 3:44 pm
Do you have other choices besides these high deductible plans - that might lower your risks in case of serious conditions?

I suspect (especially with children) that significant portion of high or very high cost medical conditions happen to those in generally good health.
There are other plans but their monthly costs are significantly higher in costs. Both children are almost off to College, we will insure them until 26 or until they have their own insurance.


tarnation wrote:
Mon Oct 30, 2017 4:17 pm
Not sure what you mean here?? When I see HDHP, I infer that means a plan that qualifies for an HSA. Also, you can have a limited expense FSA along with an HSA.
I guess Plan A is not officially a High deductible plan per IRS so it does not qualify for HSA, its called a CDHP (Consumer Driven Health Plan).

So according to the plan administrator on Plan B the in network and out of network deductibles /OOP Max are completely separate, so that is something to watch out for. We could control that for the most part by selecting in network providers, which has never been a problem before.
"They who can give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety." - Benjamin Franklin

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