High deductible health plan (HDHP) tips/tricks?

[persa]

We're switching over this year and I'm nervous I'm going to mess it up. We have 3 kids, one of whom has a medical condition that requires meds, supplies and DME. We have a $2600 deductible, then 10% copay till $4600 OOP max then 100%. Well checks are covered.

What are the best ways to keep organized with health care spending to make sure we're on top of it?

Also any tips to "work the system" at all? For example I need new $$ glasses (progressive lenses) that aren't covered by insurance so I'm going to order them this week to chip away at my deductible. I figure our couples therapy that we're about to start will chip away at it too, haha.

We have an HSA card that gets added to on a biweekly basis so I'm also wondering how to best manage/keep organized when expenses exceed HSA availability.

We also have some expenses from 2016 that we'll can pay using the HSA card so I'm going to need to keep track of what was a 2016 expenditure and what is 2017 (and therefor deductible worthy).

Thanks in advance!

[gummybear]

Have you looked into secondary insurance for your child with special medical needs? What state are you in? Some have loophole laws that can get your child coverage regardless of income. That can help enormously with the high deductible plans.

[cinderbella]

Does your deductible count toward your OOP max?

[persa]

Jan 1, 2017 23:54:07 GMT -5 cinderbella said:

Does your deductible count toward your OOP max?

Yes it does.

[gault]

Be careful with your glasses. If they're not covered or out of network, they will count towards the out of network deductible.

[persa]

Jan 1, 2017 23:47:56 GMT -5 gummybear said:

Have you looked into secondary insurance for your child with special medical needs? What state are you in? Some have loophole laws that can get your child coverage regardless of income. That can help enormously with the high deductible plans.

No I haven't, I've not heard of that.

[persa]

Jan 1, 2017 23:58:22 GMT -5 gault said:

Be careful with your glasses. If they're not covered or out of network, they will count towards the out of network deductible.

I have a vision plan but it only gives 20% discount towards new glasses no matter what. But I'll double check before plopping down the money, thanks.

[JayhawkGirl]

Vision didn't count toward my HDHP, but that's plan specific.

I just assumed we would hit our family OOP max each year, which we did.

[tealblue]

My vision doesn't count towards my medical deductible. The discount on my contacts was essentially what I paid for my vision insurance, so I ended up dropping It completely.

I'm not sure you can use your 2017 HSA funds for 2016 expenditures. I assume you were not on a HDHP for 2016, so you probably won't be able to use your HSA to pay for those.

For the first year, I kept track of expenses in excel since I didn't have a good amount of funds in my HSA. I paid what I could from the HSA card and then I reimbursed myself later for the other expenses once I had accrued enough in the HSA. Since then, I have not had to do that as I have enough saved in my HSA (and my work throws $1000 in January).

[livinitup]

Jan 1, 2017 23:58:30 GMT -5 persa said:

Jan 1, 2017 23:47:56 GMT -5 gummybear said:

Have you looked into secondary insurance for your child with special medical needs? What state are you in? Some have loophole laws that can get your child coverage regardless of income. That can help enormously with the high deductible plans.

No I haven't, I've not heard of that.

Yes, you are going to want to check into Medicaid and CHIP - Children's Health Insurance Program. CHIP is a federal program administered through the state. Your child may be entitled/qualify even if your income is too high for you/your husband to qualify. I'd look into county offices for information and especially non-profits that specialize in children's services and/or Navigators for ACA (Affordable Care Act). Open enrollment is through Jan 31st, but children can almost always enroll throughout the year.

ETA: I'd also check through your child's billing office where you get medical care. Those folks are extremely knowledgeable, handle every plan out there and can answer all kinds of insurance questions.

[lilafowler]

I hate HDHP. They're the only ones my employer offers now though.

[Jalapeñomel]

Your glasses are separate from your medical, I'd imagine, and will not count toward your deductible.

Your 2016 expenditures cannot be paid for with contributions in 2017 unless they were dated and billed in 2017.

Keep all your receipts for RX, co-pays, bills, etc.

[readyin07]

Jan 2, 2017 7:22:57 GMT -5 lilafowler said:

I hate HDHP. They're the only ones my employer offers now though.

Me too and I can't say it enough. The only Years we meet our deductible is when I have been pregnant. With 2 kids at home we have just enough medical "issues" to cost us a small fortune and not enough to get our deductible met and have things kick in. My kid had an ear infection and it took 3 trips to the dr plus a 4th final follow up to get the meds right...ended up costing us $1k. For an ear infection. Tell me how that is reasonable.

[abcdefu]

I have a high deductible and chronic conditions as well. For tax purposes, I keep all my receipts for copays and deductibles, mileage to and from appointments, and any parking and toll expenses.

I usually hit my deductible around July, sometimes earlier. I try to schedule any appointments I can in December in order to get all my prescriptions filled before the new year. This gives me some breathing room in January and February.

For my glasses and contacts, I make one appointment per year to see an ophthalmologist, but buy my glasses from a franchise like AB. I just make sure I take my glasses to my ophthalmologist so he can confirm my prescription.

I also have plans with Af..lac. so I get reimbursed some expenses for well visits and tests. You just have to be careful because they have strict policies.

If I think of anything else I do, I'll edit this post. I definitely feel your pain when it comes to insurance.

[readyin07]

With a child with a health condition you will probably be a great fit for a hdhp. I doubt things like glasses will count towards your deductible though. You can use your hsa savings to pay for them definitely. I would front load as many Dr appts and med refills as you can in the first part of the year if you know you will hit your deductible..

[spankswife]

My biggest tip is max out your HSA, it is tax free money. If you can't max it out, at least put in your annual deductible.

Your glasses won't go towards your deductible but you can most likely buy them with your HSA card. (So therefore contribute more towards your HSA than just your deductible). If you need to see an opthomologist, this may go towards your deductible, check your plan.

The hardest part is the amount your doctor charges isn't always right. In a perfect world they would bill you the exact contracted rate after the fact but most doctors won't do that, they want to be paid upfront. So you have to check your account after and compare. Usually the difference is less than $10, but sometimes it's much more.

Honestly I really like our HSA, don't be nervous

[thebreakfastclub]

If you have access to Costco, get your glasses there.

I got 2 pairs, with all of the lens upgrades, for $150. Great service too.

[mekia]

Jan 2, 2017 7:22:57 GMT -5 lilafowler said:

I hate HDHP. They're the only ones my employer offers now though.

Same here. They changed this year. I'm nervous especially with 2 little kids.

[dancelnow]

I prefer to use my HSA like an emergency fund and pay all medical expenses I can out of my take home pay. That way anything massive can be taken care of without stressing me too much.

[VeryViolet]

So just to add on about the glasses, just because you can use your hsa card for something doesn't mean it counts towards your deductible.

Are you maxing out your hsa contribution on top of what your employer puts in? If you aren't and you can afford to you should. The last two years I made it to march and January respectively before I hit my deductible. Any big medical event will usually hit the deductible (surgery, overnight at the hospital, etc.)

What that means is that the bills usually well exceed what is in my hsa. This is true for big events but also depending on how much drugs/DME cost monthly you may find that to be true until you hit your deductible. So keep in mind that most places are happy to work with you on a payment plan especially when you tell them you have an hsa. Also, you can reimburse yourself out of your hsa. I don't know if this is company specific or not but also for the first year of my hsa my company could approve advancing hsa money rather than depositing biweekly.

Good luck I kind of hate my hdhp but since I hit my OOP max in March last year it hasn't been awful because everything was covered. Now new year new health insurance nightmare.

[revolution]

Check with your insurance co to see if they offer the ability to create an account with them. I sign into my insurance site and my numbers are spelled out very nicely. I see what was billed, paid by me, and paid by them. I see where I am in relation to my deductible and can view all of my eob's. It is very helpful.

[kkfeb04]

Jan 1, 2017 23:59:33 GMT -5 persa said:

Jan 1, 2017 23:58:22 GMT -5 gault said:

Be careful with your glasses. If they're not covered or out of network, they will count towards the out of network deductible.

I have a vision plan but it only gives 20% discount towards new glasses no matter what. But I'll double check before plopping down the money, thanks.

Your vision is separate from your health plan. It will not count towards your medical deductible.

Is  the $2600 for the family? It seems low for a HDHP.

I have two kids with ASD on a waiver program and still wouldn't ever choose the HDHP plan. I would be screwed if something happened to me especially the first few months.  Their therapies stop being covered at 20 visits for OT and SLP and wouldn't count towards my deductible of $6700. Not all of their providers accept the waiver so I would also have to pay for those.  The HSA isn't like your FSA where you have the full amount in the account. Something happens now and you only put $50 a pay, guess what you don't have anything in your account to pay it. You can't use it for 2016.   

There's really no tricks to work the system, you will be paying until you meet everything. 

[mmmomof2]

The nice thing about an HSA, at least at my DH's work, is that we can change our contribution at any time and it can roll over. The FSA was not as flexible. I always thought our premiums were high for not much coverage, but talking to my mom friends at school it sounds average ($170/biweekly paycheck for family coverage). When I worked at a Fortune 100 company it was much lower for HMO 100% coverage.

The only time we hit our deductible is when DD had her tonsils/adenoids removed. We then got DH's vasectomy for FREE. LOL. This year DD needed stitches and DH needed to go to the orthopedic doctor (luckily he doesn't need surgery), unless something else happens I highly doubt we'll hit the deductible.

When I don't have the funds in the HSA account I put it on a personal credit card. I keep track in Quicken and I then spend the money whereever (grocery store, costco) and attach the receipt to my Quicken report. I doubt I'll ever be audited (knock on wood!), but it's good to have the paper trail. I keep a file folder on my desk for all current year medical receipts and EOBs. When we do our taxes it gets put in the file for recordkeeping. 

[demofea01]

My biggest suggestion would be to make sure you are contributing enough to your HSA that it will have at least enough to cover your deductible. If you can contribute extra, that's even better. The funds roll over from year to year and it's awesome to stash extra funds in there during years when you don't have as many medical expenses for years when things hit the fan.

[esdreturns]

To all the people saying your vision won't count towards the deductible, that's not always true. Many health plans DO cover vision, however, this is something that is most definitely plan specific, so make sure you check yours. Even if it doesn't, you can still use your HSA funds to buy glasses or contacts.

My best advice would be to put in as much money into your HSA as you can. It's pre-tax so that's benefit.

[isabel]

$4,600 total OOP for the whole family is considered a high deductible plan? ::sobs:: God, my work insurance sucks.

[usm]

We also have a high deductible plan with a special needs child. We will hit our 6K deductible this week.

I always have services submit to insurance and then bill me. I do not pay bills at the time of service because if they wait to submit, even a day, our deductible could be met. I don't trust them to issue a repayment check. Our insurance also offers a discount on most services prior to deductible and I want to make sure I get that. I just explain it's easier to know what I owe when I compare bills to EOBs.

I keep EOBs and compare to bills to determine what I owe. Keep in mind this may mean you meet deductible before actually paying the bills. Our plan has things they cover 100% that offices have tried to bill me for before actually filing because they look up our co-payment amount.

I keep an accordion folder of bills, receipts, and records of ANY type of medical expense. We use it for deductions at the end of the year.

[fluffycookie]

Jan 2, 2017 10:27:27 GMT -5 usm said:

We also have a high deductible plan with a special needs child. We will hit our 6K deductible this week.

I always have services submit to insurance and then bill me. I do not pay bills at the time of service because if they wait to submit, even a day, our deductible could be met. I don't trust them to issue a repayment check. Our insurance also offers a discount on most services prior to deductible and I want to make sure I get that. I just explain it's easier to know what I owe when I compare bills to EOBs.

I keep EOBs and compare to bills to determine what I owe. Keep in mind this may mean you meet deductible before actually paying the bills. Our plan has things they cover 100% that offices have tried to bill me for before actually filing because they look up our co-payment amount.

I keep an accordion folder of bills, receipts, and records of ANY type of medical expense. We use it for deductions at the end of the year.

This is what we do as well. Sometimes it's nuts what the billed rate is versus the contracted insurance rate. We will hit our deductible (4K, no coinsurance expect on DME and copays for prescriptions) in the beginning of February due to DS's medical treatments. I was nervous switching to a HDP, but last year we hit in by the end of January and the only thing we had to pay was for a brace for my foot which was 30 and medication copays.  

[readyin07]

Jan 2, 2017 10:27:27 GMT -5 usm said:

We also have a high deductible plan with a special needs child. We will hit our 6K deductible this week.

I always have services submit to insurance and then bill me. I do not pay bills at the time of service because if they wait to submit, even a day, our deductible could be met. I don't trust them to issue a repayment check. Our insurance also offers a discount on most services prior to deductible and I want to make sure I get that. I just explain it's easier to know what I owe when I compare bills to EOBs.

I keep EOBs and compare to bills to determine what I owe. Keep in mind this may mean you meet deductible before actually paying the bills. Our plan has things they cover 100% that offices have tried to bill me for before actually filing because they look up our co-payment amount.

I keep an accordion folder of bills, receipts, and records of ANY type of medical expense. We use it for deductions at the end of the year.

I am finding more and more offices are making me pay upfront and refuse to bill. It is such a pain because then it is obviously on me to double check all the time that I was billed correctly. I paid $100 for an Obgyn visit last month. Wouldn't bill me. Fine. They actually underbilled me and I owed like $7 and change. Which they then mailed me a bill for and I had to turn around and write a stupid check and find a stamp for. Annoying!

[dove]

Jan 2, 2017 7:22:57 GMT -5 lilafowler said:

I hate HDHP. They're the only ones my employer offers now though.

Ditto. It's the only one MH work offers. We met it every single year by the first quarter thanks to constant monitoring of the hole in the head.