Insurance Advice

My husband works for a small engineering firm and they are changing the structure of benefits around in may different ways. They are doubling the deductibles and dropping some coverage. I totally understand the why part of it. But now they are talking about the “best” new offering is to take this one insurance plan and then pair it with an HSA which is similar but different from the current Flex plan we currently have. This new plan you pay all your appointments and medications up front until your deductible is met and then the insurance picks up the rest. There are no co-pays, but for us we would have to have a large chunk of change available to meet these payments out of pocket. Not only do we have our diabetic 2 year old daughter, but we have a 5 year old with allergies and a 1 year old boy (who seems healthy now, but his bull in a china shop earned him a broken arm just yesterday.) I know I hate making these type of decisions so my nerves might be most of the reason for my hesitation and utter dislike of these changes, but yet we have to make a decision BY Monday. Does anyone have any advice with this stuff or have a resource suggestion of where to turn to get help in picking the right plan for us? Please help us find a way to dumb down all this information and to make sense of everything.

Plus is it just me or should these businesses who make these type of changes and have all day long meetings with their employees to explain these new options invite the spouses who are VERY much affected by these things. My husband is good, but he got to listen to these people and now try to explain it to me which means I may not be getting everything I need to.

Thank You!
Ellen

Hi Ellen,

Not sure from your post if this is the only option you are being presented with. The “best” plan for one family is usually based on a family that has few health problems and can contend with a large deductible. Is the company making any deposits into the HSA or are you on your own? I would suggest speaking with your husband’s HR department or ask to speak to their broker or company representative who presented the plan. They should be willing to spend the necessary time to explain all of this to you. If it is still available to you, the flex plan you currently have may be a better option, given your situation. Good luck!!!

Patti

My sympathies with the HSA. It’s intended to make us saavy and wise consumers with our healthcare $'s. They are great for people with little medical issues as they are the people who will be able to grow their accounts. Not so nice for those with chronic health conditions as you probably won’t be able to ‘save’ more than you have to spend in a given year.

My advice is to try to do your best to total up what your expenses will be in a given plan. The first year is really tough because you don’t really have a clue what the dr.'s charge to the insurance company will be, what your prescription costs will be, durable medical equipment, etc. (Wouldn’t it be really nice if they had those signs like you see in the garages…) But, do your best estimating and make sure you are putting as much in the savings plan to cover what you think you will spend. Make certain to track your actuals (# of trips to the dr, # of prescriptions, and costs). Save this information so you can refine your elections for year #2.

I have a choice of an HSA or HRA with FSA on the side. I also options to buy down both my deductible and maximum out of pocket with higher premiums. I know I am going to hit my max out of pocket every year - this is level where all further claims will be paid at 100%. No matter how frugal I am with healthcare $'s, I will always hit it by the end of the year. So instead of looking for the best/lowest price, I tend to use as many services as possible to get to my yearly max as early as possible in the plan year.

Good luck

My family insurance is provided by my employer. Unfortunately, my employer is my father. there are 6 employees, but only 3 of us take the insurance. It has been a life saver, but it is very expensive. We have a $2500 deductible per person and a $6000 deductible for the family. So the insurance does not pay for anything until a person’s deductble has been met (or the enire family deduc. has been met). My employer does contribute $3000 to an HSA each year, but still leaves me with quite a bit of cost…