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Oct. 11th, 2015 09:03 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
miss_lucy21It's open enrollment for my benefits at work. And they have both raised the premium and the deductible, and the out of pocket limit on my health insurance (for those of you unfamiliar with US health insurance, what happens is I pay part of the insurance premium out of my paycheck, and my employer pays the rest. They raised the amount that comes out of my check twice a month. They also raised the amount that I have to pay before the insurance starts paying (the deductible) and the amount beyond the deductible that I have to pay before the insurance pays 100%). Our only options are high deductible plans, because the CEO believes that we should "take more responsibility for our health" and therefore, if you have a high deductible plan, that's incentive to be healthier. So, too bad if you have a chronic illness that's difficult to control. You should just be healthier.
I will admit that they do offer you the opportunity to "earn" up to $1000 in health savings credit that can be applied to most medical bills before your deductible is met. I think it's a bit coercive, but, you can get to $1000 without a huge amount of effort and mostly without having to actually speak to any wellness coaches or whatnot. And they do tier the premium payments- I pay the lowest amount, because I make under $60K. And the Affordable Care Act has mandated that certain things need to be covered 100% without regard to the deductible, so for most people, they are probably completely covered by the health savings credit (which also carries over year to year if you don't use it all).
Anyway, there's two plans. One has a higher premium but lower deductible, and it's the plan I've been on for the past couple years, because I tend to have a lot of medical expenses, so it gets me to the point where the plan starts picking up most or all of the tab faster. The second plan has a lower premium, but a higher deductible. So, you pay about half as much from your check, but you're out of pocket on the deductible a lot longer. Both plans have absolutely identical coverage- anything covered on the higher premium plan is also covered at the same amount on the lower premium plan. This sounds like a no-brainer for me, correct?
Except. I went through and added up all of my medical expenses for this year, minus all the surgery related expenses. Without the surgery, I wouldn't have made even my lower deductible for the year yet. Because I haven't been to the doctor nearly as much as I was in 2014 and there's been a lot less labwork, too. And the way things have been going since the surgery-- I haven't been on antibiotics since I finished up the ones from after the surgery, and I haven't even been sick enough to miss work more than once or twice (and I'm pretty sure one of those times was not sinus/respiratory related). Or even really actually sick at all (a little sniffly, yes. But I am allergic to everything, so).
So, if I wouldn't have made deductible this year without the surgery, and since at the moment, I really don't have a lot of reason to believe that next year is going to be extremely different from this year...why wouldn't I choose the lower premium plan? All the modeling tools on the website basically said I'd save at least $800 between the two in out of pocket costs. And if I put the maximum amount in my Heath Savings Account (different from the credits I talked about above- there's two separate things), I'll save about $800 in taxes because that money comes out of my check pre-tax.
Therefore, I am holding my breath, and choosing the higher deductible plan that's also going to cost me $60 less per month. It's a little scary- I'm betting on being at least as healthy as I am right now for next year, and if I'm wrong, I'm probably going to have to come up with some cash. But I gut-checked it with my Mom and she said she would do the same thing if she were me, and Lord knows that she is more than aware of what my medical needs are.
Here's hoping.
I will admit that they do offer you the opportunity to "earn" up to $1000 in health savings credit that can be applied to most medical bills before your deductible is met. I think it's a bit coercive, but, you can get to $1000 without a huge amount of effort and mostly without having to actually speak to any wellness coaches or whatnot. And they do tier the premium payments- I pay the lowest amount, because I make under $60K. And the Affordable Care Act has mandated that certain things need to be covered 100% without regard to the deductible, so for most people, they are probably completely covered by the health savings credit (which also carries over year to year if you don't use it all).
Anyway, there's two plans. One has a higher premium but lower deductible, and it's the plan I've been on for the past couple years, because I tend to have a lot of medical expenses, so it gets me to the point where the plan starts picking up most or all of the tab faster. The second plan has a lower premium, but a higher deductible. So, you pay about half as much from your check, but you're out of pocket on the deductible a lot longer. Both plans have absolutely identical coverage- anything covered on the higher premium plan is also covered at the same amount on the lower premium plan. This sounds like a no-brainer for me, correct?
Except. I went through and added up all of my medical expenses for this year, minus all the surgery related expenses. Without the surgery, I wouldn't have made even my lower deductible for the year yet. Because I haven't been to the doctor nearly as much as I was in 2014 and there's been a lot less labwork, too. And the way things have been going since the surgery-- I haven't been on antibiotics since I finished up the ones from after the surgery, and I haven't even been sick enough to miss work more than once or twice (and I'm pretty sure one of those times was not sinus/respiratory related). Or even really actually sick at all (a little sniffly, yes. But I am allergic to everything, so).
So, if I wouldn't have made deductible this year without the surgery, and since at the moment, I really don't have a lot of reason to believe that next year is going to be extremely different from this year...why wouldn't I choose the lower premium plan? All the modeling tools on the website basically said I'd save at least $800 between the two in out of pocket costs. And if I put the maximum amount in my Heath Savings Account (different from the credits I talked about above- there's two separate things), I'll save about $800 in taxes because that money comes out of my check pre-tax.
Therefore, I am holding my breath, and choosing the higher deductible plan that's also going to cost me $60 less per month. It's a little scary- I'm betting on being at least as healthy as I am right now for next year, and if I'm wrong, I'm probably going to have to come up with some cash. But I gut-checked it with my Mom and she said she would do the same thing if she were me, and Lord knows that she is more than aware of what my medical needs are.
Here's hoping.