How do I pick a health care plan?
I Was a member of Kaiser in Stockton, CA and I was paying 160.00 a month for a "$25.00" deductable plan, I thought I was reasonable.
The packet of info we recieved HAS so many options, HMO, PPO , deductable plan, co payment plan... ARGH! it's too much!
We rarely go tot he DR. Unless it is for Check ups, Birth Contol or emergencies. How do I know what to choose?
For a plan similar to what I had before I was married, it's 324.00 a monh for both of us. is that expensive? it seems so high! ( not including, vision and dental)
My Hubby's Boss doesn't have anyone to explain this info- It's a company of 20 people.
Can any one help me out?
If you have the ability to pick a Health Care Savings Account (or HSA), you should take it.
HSAs are not for people with chronic conditions, but for normally healthy people in your situation, you should take that.
An HSA is an insurance policy (with a high deductible) and a cash account. The cash comes from a combination of your employer's contributions and your contributions.
The cash goes in tax free, accumulates in an investment whose returns are tax free and comes out tax free so long as you use it on health care costs. So its like getting free investment buildup. When you turn 65 you can still use the cash accumulation to pay health care costs tax free and if you want the money for anything else.you just pay your post retirement tax bracket rate.
Once you get an HSA.all the routine costs, monthly birth control, and occasional trips to the doctor from your cash account until you hit your annual deductible...then the insurance plan kicks in.
If you don't use all the cash in a given year, it rolls over to the next year and the next year, etc.
If you are a smart shopper of health care (buying birth control mail order at 60% off for example), then you save lots of money which can be rolled over and get better investment returns. If you spend and invest wisely.you will soon have way more than your annual deductible and you'll never have to worry about a big medical bill again.
Best of all...the plan goes with you even if you switch employers AND the health plan pays for all routine care like checkups, immunizations, etc.
You will have to pay a premium for the high deductible health plan (HDHP) and have to pay some of the cash portion of the account.but the insurance is much cheaper because of the high deductible and you will be way, way better off in the long run if you pick an HSA, shop and invest wisely and stick with it.
Well, your question is fairly broad... So, lets start with your monthly premium payments. $324.00 a month for 2 people in CA, for a plan with low copays is not unreasonable.
So, first rule of thumb: The lower the premium, the higher the deductibles/copays. The lower the deductibles/copays, the higher the premiums. The more expensive plans aren't necessarily better, you usually have more freedom to maneuver without using your primary/family doctor.
If you're happy with a copay based plan, and are also happy seeing the doctors currently on the plan, it is probably the least expensive option. The copay based plan is called an HMO. You probably need referrals to see specialists, except the obgyn. You know exactly how much it will cost to see the doctor, but you have to stay inside your plan.
The PPO will allow you to see specialists without referrals, regardless of the specialty type. It will probably cost more. Your insurance will not pay anything at all until you pay the entire deductible amount, per year, per person is met. So, if the deductible is large, and you only go to the doctor once or twice a year, you may not even satisfy your deductible...
**Try to call someone at the insurance companies they are offering coverage through. Most of the customer service people can explain the basic gist of the policies being offered to you. Good Luck.
If you don't use the plan so much - from what you said, you do pretty much routine care with the odd sickness, I would go for the one with the lowest premium. Sure, you're going to have a larger amount out of pocket for visits, but if you're going to the doctor once or twice a year, that's not such a big deal.
Figure this: the $324 a month for both of you (that's really good I pay $400 a month for just ME, my parents pay $675 a month for the two of them) is paying the insurance company just under $4000 a year. If you pick a plan that costs you let's say $200 a month in premiums, but has a $2500 deductible, the insurance is only getting $2400 a year of your money. BUT, here's where you save: if you and your husband each go to the doctor twice a year, the average bill costing you (when applied to the deductible) let's say $200. That's a total of $800 out of your pocket. You're saving almost $1000 a year. (I'm using numbers on the higher side to guesstimate.)
If you can get an HSA (health savings account) - I would do that as well. It's your pretax money that can be used for anything medically related - deductibles, copays, some even allow over the counter medications.
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