Need Health Ins advice - High Deductibles??

[ringstrue]

I could very well get this job (I'm the only candidate, lol) and I'm looking over the benefits summary they gave me.

They have 2 plans: an EPO that "utilizes a high deductible, Health Reiumbursment Account" However, the employer funds the deductible. The bi-weekly cost is about $70 more than what I have now.

The 2nd is a PPO that is $100 more than that (so $170 more than my current amount).

My issue is that given the job's salary range, a $340/month jump in costs is sorta stupid and I need to negotiate higher pay. BUT, if the EPO is really a good option in the end then I don't need to negotiate for that reason (and also don't have as much leverage to, either).

Is there still more to consider with the EPO option? DH is really freaked out by it since he's read so much bad press on high deductible options (he writes an ins. blog) but if the employer is paying the deductible doesn't that take away the issue?

FWIW, this employer is highly rated in our area in term of a "best place to work".

[pamela]

High Deduc plans can be great especially if you are rarely sick. But only $100/ month difference in premium is small. Them paying the deductible is a good deal though because that means you don't pay anything for awhile, and then only about 20% usually until the out of pocket max. Remember with other plans you still pay a minimum of a copay for each visit.

[emisi]

I had a high deductible insurance that worked pretty well for us. If you don't get sick much, they're great. It covered all my wellness visits, covered my biannual dentist visits 100%. We switched because it wasn't as great with maternity coverage.

[caden]

I have a HDHP and I love it. I think HSAs are awesome and I wish everyone could have one. The only thing that sucks about these plans is saving the deductible, so your employer will have taken care of that. My HDHP is through DH's employer and they only fund a portion of the deductible. It's still worth it for us though b/c the month fee is much cheaper than what we paid for a low deductible HMO. that's not your case, unfortunately, but I thought I'd mention it. Is the deductible amount of the EPO (which I'm calling a HDHP here) the same as your OOP max amount? If so then you'd pay nothing (for covered treatments) except your monthly payments b/c the employer would be paying all of your charges from treatments. If the PPO option makes you pay copays, or a % of the charges, then you might come out even or ahead with the HDHP if your kid or someone tends to get sick more than once. Your coverage depends on what your employer offers. It doesn't have to do with the plan being a HDHP or low deductible. If the deductible of the HDHP option is less than the OOP max then after you hit your employer-funded deductible you'd pay (usually a % of the cost) until you hit the OOP max. If your deductible is high then this would only happen if a catastrophic event took place. With my plan the OOP max and deductible are the same amount. So after I pay my deductible it's all "free" to me. The only other consideration you might have is whether or not you'd want a PPO vs a EPO. If you don't go to the doc that often then it's probably NBD. I assume what's covered between the 2 plans are the same.

[UMaineTeach]

If they are covering the deductible go for #1.
I love everything about my HDHP except the deductible. Without the deductible it would be as close as you can get to socialized medicine with a huge network of doctors and hospitals.

[2vermont]

May 29, 2012 21:37:08 GMT -5 mr+ms said:

Ditto what caden said. Also, if your whole family is on the plan, know whether the deductible paid by your employer covers everyone, just yourself or some other combination.

For example, I got a plan to cover DD and myself. We each have a $3K deductible per benefit year. Our annual coinsurance is $5K each (I'm not even sure what this is tbh... it no longer says OOP max). So the "family" deductible & coinsurance is $6K & $10K. If we added one more person to the same plan the family deductible would stay at $6K & $10K - how charitable!

That's a really good point. Even if it just covers you, it's still better than most high deductible plans. It was extremely rare to find companies that paid (any)deductible when I was working in healthcare.

[Deleted]

High deductibles are great if you are very healthy or very sick. Not so great in between. SD was in the hospital earlier this year. The bill was $60k. We've paid our out of pocket for the year. Now my broken foot is free :-) Also now all our meds are free etc.

[Lurker loo]

Lurker chiming in...

It looks like it is an HRA not an HSA. My employer had this plan and it was great. They funded the in network deductible for families which was 4,000 for us. They get a big discount in the premium and fund the employees deductibles as it was incurred. Most times we would get reimbursed before we got the bill from the provider. You do have to keep track of more paperwork so that can be a little hassle if you have family coverage. Also if someone isn't good with managing money they risk spending the reimbursement instead iof using it to pay the bill.

Our Rx was subject to the deductible so we paid that oop when it was filled but got reimbursed after. I would put it on the cc because we would usually get the money before our cc bill was due. After the deductible was satisfied, Rx was subject to copays.

[ringstrue]

I'm actually not sure how this fit in with Mat. Leave. They seem to be using AFLAC for a lot of the other coverages like STD. I think if I get an offer I'm going to ask about their Mat. Leave.

The deductible is almost 4k for families and they cover that.