Comparing HSA's

[4kitties]

Thanks for the warnings somarco and LGilmore! I checked both issues.

The deductible DOES count toward the OOP max. So the OOP total including deductible is only $4000.

And Rx is covered and counts toward deductible/OOP max. After the $4000 OOP max is reached all Rx is covered at 100% ($0 copay).

This just seems "too good to be true." How can the insurance company charge less for this plan than for the PPO plan? Is is really just the fact that they don't pay anything at all for the first $4000 of claims that makes this possible?

Just noticed that the HSA does not cover maternity but the PPO does - does that explain it? (I don't need maternity coverge).

THanks.

 

[Yagents]

This just seems "too good to be true." How can the insurance company charge less for this plan than for the PPO plan? Is is really just the fact that they don't pay anything at all for the first $4000 of claims that makes this possible?

quote]

Yes, it's true, that's why HSA's are almost always the best choice if you crunch the numbers. Lower premium, lower OOP, and tax deductions.

The premium difference is possibly due the maternity coverage, but mostly because the copay plan "helps" the consumer with smaller payments for smaller services before the deductible. If you are paying for everything up to the deductible using network pricing, typically you get a lower premium and lower OOP....the definition of "insurance".

Your mindset of high deductibles makes you a prime HSA candidate.

 

[LGilmore]

"I was trying to compare a BS Savings $4000 HSA ($4000 deductible, $4000 OOP max, 100% coverage after $4000 OOP max, online non-underwritten quote $343/mo), versus BS Spectrum PPO $5000 ($5000 deductible, $7000 OOP max, 100% coverage after $7000 OOP max, online non-underwritten quote $371/mo)."

"The deductible DOES count toward the OOP max. So the OOP total including deductible is only $4000.

And Rx is covered and counts toward deductible/OOP max. After the $4000 OOP max is reached all Rx is covered at 100% ($0 copay)."

So there is no co-insurance?

You might want to name the carriers and plans you're looking at. Something tells me you may be missing something.

 

[4kitties]

So there is no co-insurance?

You might want to name the carriers and plans you're looking at. Something tells me you may be missing something.

Blue Shield of California Shield Savings $4000/$8000. I cannot post a link (not allowed by forum to do that since I have posted <10 posts). It is on blueshieldca.com, under individual plans, then under shield savings

I have attached the brochure. Let me know if you want me to attach the EOC.

Please let me know if I am missing something. THANKS!

 

[Sales71]

There is a website all about HSA www.hsainsider.com it should help you compare if hsa is for you.

 

[LGilmore]

' have attached the brochure. Let me know if you want me to attach the EOC"

Thanks for posting that. Yea, a zero co-insurance plan in network. spiffy.

Now, check the network Md's. The nationwide reference may be about the bluecard program where blues work together, but they may not all be under the ppo network this plan is. They may fall to the outside feature, which really isn't that bad either.

Also check the drug formulary, to see how big it is as there may be drugs that aren't part of the plan formulary.

Again doesn't look awful, how much again and how old are ya?

In my state, no body offers a zero coinsurance, but the premiums reflect that by being pretty fair.

 

[4kitties]

' have attached the brochure. Let me know if you want me to attach the EOC"

Thanks for posting that. Yea, a zero co-insurance plan in network. spiffy.

Now, check the network Md's. The nationwide reference may be about the bluecard program where blues work together, but they may not all be under the ppo network this plan is. They may fall to the outside feature, which really isn't that bad either.

Also check the drug formulary, to see how big it is as there may be drugs that aren't part of the plan formulary.

Again doesn't look awful, how much again and how old are ya?

In my state, no body offers a zero coinsurance, but the premiums reflect that by being pretty fair.

I am 54. Non-underwritten online quote is $343/mo.

I don't presently take any meds or have any real problems that cause ongoing medical attention. I do have pre-ex conditions that mean I will have to go with a HIPAA plan - that costs $770/mo and will increase to $895/mo when I turn 55. All the HIPAA plans cost the same, so I am just looking for the one with the "best" coverage.

To try to check out the HSA $4000 Plan, since my husband does have multiple complex medical problems, I checked HIS prescriptions (all but one in formulary), doctors including multiple specialists (all are preferred providers), and all hospitals within 100 mile radius of our house (every hospital he has ever gone to, and all the hospitals you would WANT to go to, are preferred hospitals).

This still just seems "too good to be true."

LGilmore, you said "it doesn't look awful" - that is hardly a ringing endorsement. What do you see that you don't like?

Thanks.

 

[somarco]

Did you contact Dave Fluker, our resident HIPAA expert, as suggested in a different thread you started on the same topic?

 

[4kitties]

Did you contact Dave Fluker, our resident HIPAA expert, as suggested in a different thread you started on the same topic?

Not yet. I did visit his website. I spent today trying to compare EOCs, check providers etc. I will probably be able to contact him tomorrow.

Thanks.

 

[somarco]

I spent today trying to compare EOCs

You could save yourself a lot of time and grief by contacting him.

Suit yourself.