Healthcare 2016

[rosarugosa]

My employer is making the following changes for 2016:

Switching providers from BC/BS to Aetna United Healthcare
Adding a high deductible plan with HSA (deductible $1500 per person & $3000 family, OOP $3425 PP & $6850 family, weird aspect is that no coverage kicks in until family deductible is met if more than one person insured & OOP works same way, company contributes $500 for indiv coverage & $1000 for family plan for HSA)
PPO plan still offered but price tag has increased by about $78 per month for family plan (dedt $600 per person, & cov kicks in for each person once indiv dedt is met, OOP has increased from $2000 to $3000 per person)

Are other Forum members who are corporate employees seeing similar trends? I love the idea of the HSA, but with DH's significant health expenses it will not be the most cost effective choice for us, unfortunately). I do suspect the PPO plan will go away one of these days.
Actual price tags for family plan (indiv plan is usually exactly half):
PPO $3718
High Dedt/HSA $2990 (with company contribution of $1000)

[Tradd]

My employer began offering the very high deductible/ HSA last year. I didn't go for it because I've got some knee issues and could end up with surgery eventually. I also don't have the savings to make it feasible. I'm also only insuring myself and the ppo cost was ok for just me. I think I pay about $150 a paycheck for everything including dental and vision. I just hope we stay with the same insurance company. Works fine for me.

[oldhat]

My employer made similar changes a couple of years ago. Three plans, each with higher deductibles but at lower cost to you. My plan has a $1,500 deductible but my employer kicks in $750 to the HSA each Jan. 1.

When I examined my company's plans, it was pretty clear that if you had significant health issues you were probably best off with the plan that cost you more in contributions but which had lower deductibles and covered more. Obviously, a higher deductible plan was most advantageous to younger people who are less likely to need any kind of medical care in a typical year -- they got preventive care free and could keep the $750.

In my case it was more or less a wash. In terms of health I fall somewhere in the middle. I have some issues that require maintenance (high BP and a chronic eye condition) and so I always blow through my deductible. That money is a write-off, as far as I'm concerned. I don't even think about it. After that, the co-pays are pretty standard -- $20 for an office visit, etc. However, if I opted for the more expensive plan, the higher contributions would, I figured, end up costing me about the same as blowing through the deductible, after which the costs would be pretty similar.

The difference was the HSA, which was not available with the higher-cost plan. I've been able to fully fund mine for several years and it now has about $12K in it, which will go a long way toward covering my deductibles after I retire (expected in spring of next year). I will still have several years to Medicare at that point, so I'll likely be picking up another high deductible policy (through Obamacare, without which I could not consider retirement at this point) and will be footing many healthcare bills out of pocket. But because of the tax advantage, each dollar that goes into the HSA is worth at least $1.25 in reality.

Bottom line is you have to look at the specifics of your situation and slog through the coverage each plan offers. My company offered a cost calculator; maybe yours does too. Good luck. Maybe one day we Americans will decide to join the rest of the civilized world and create a sane healthcare system to replace the current confusing, inefficient mess. In the meantime, we have to deal with the stress and headaches.

[jp1]

OP, So what exactly kicks in once the per person deductible is met? In other words, if no one else in your family needed healthcare but DH used $1500 he still would have to keep paying out of pocket 100%.

I switched to our high deductible plan when it was first offered almost two years ago. I have no defendants, SO has his own insurance. I have, at least as of today, no health issues. My employer contribution to the HSA is $1000 per year and I've been putting in $1500 per year. Even though I'm not young it's working for me. If I were just getting out of college I'd be thrilled with this option. The idea that I could possibly build up years of HSA would have been awesome.

SO, on the other hand, has significant health issues so he has always stuck with his employer's PPO.

[rosarugosa]

JP1: Our scenario for the past few years has been significant expenses for DH & little/none for me.
Under PPO plan, once DH meets $600 deductible, the ins pays 80% or 90% depending on the type of services. If he hits $3000 OOP, then anything else for him is covered at 100%. I would have my own dedt & OOP max.
Under the new plan, he would essentially have to meet a $3000 dedt before 80% or 90% kicked in, and his effective OOP would be $6850. I find that to be weird and kind of counter-intuitive. If the plan worked like the PPO with us each just needing to meet a $1500 dedt before coverage kicked in, I would have gone for it and tried to max out the HSA account each year for the triple-tax savings (probably by directing other savings to the HSA).

[Gardnr]

I joined an HSA the second it was offered. I stuff away that pre-tax $ for future medical expenses and pay my current expenses out of pocket. HSA plans generally require coverage of health screenings at 100%. YMMV.

[freshstart]

I am still waiting to hear how my former employer changed things to see how COBRA will be affected. I want to know and I really don't want to know. I have to meet with a NYS Marketplace guide to help me see if there is a better plan through them. Their website is a mess, I waded through page after page of holistic and doctors of osteopathy and gave up, I had not put any of that in my search terms.

[rodeosweetheart]

Unfortunately, spurred on by this interesting conversation, I forced myself to watch my company's video "about next year" only to find it had absolutely no information at all, just a lot of "you've probably had a lot of changes in your life this year, so make sure to learn all about our new plans"--but no new plan information. Ugh.

[freshstart]

haha- now THAT's very familiar. And then they send teams around to explain our new benefits but they cannot answer basic questions and get very deer in the headlights. Ugh, hand me the plan documents and let me figure it out myself. But those cost too much to print, so getting one is like pulling teeth. Last year, no one knew our dental plan had changed companies until we went for dental work and our insurance claims were denied. So an email came out about the "new" dental plan the following August! oops, they said

[Williamsmith]

separate healthcare entirely from employers or get back representation or someday there will be no need for explanations.

[bekkilyn]

What's currently annoying me now is that I keep getting emails from healthcare.gov informing me that my subsidy status for 2016 may be threatened due to events in 2014. I didn't use Obamacare in 2014 and only signed up for it *this* year on July 1st due to being dropped by student insurance, and they approved my 2015 proof of income for this year. Why they would suddenly be basing things on 2014 instead of 2015 *when I actually signed up*, I have no clue.

Single-payer really can't come fast enough.

[freshstart]

Single-payer really can't come fast enough.

+1

how do they even calculate your income to see if you get ACA credit if you enroll before the year is over? If they go by '14 for '16, I'm dead. Did you find applying onerous and did you have to send proof of your income or a bunch of documents?

[bekkilyn]

+1

how do they even calculate your income to see if you get ACA credit if you enroll before the year is over? If they go by '14 for '16, I'm dead. Did you find applying onerous and did you have to send proof of your income or a bunch of documents?

I sent them the taxable IRA statement from which I had drawn my income for 2015 (mostly used for school tuition) and then they approved my 2015 deductible. There are a bunch of different types of proof of income that they will accept. I have no idea why they are now annoying me about 2014 for 2016.