Life Medical Insurance Enrollment questions

Chief Roundup · 11-13-2019, 07:06 PM

Alright it is that time of year again. The college I work at it changing insurance companies from Blue Cross Health Advantage to UMR that is using United Healthcare.
The new company is pushing the High Deductible Health Plan. I am now trying to figure out if it is worth it for me to switch from my PPO/FSA to the HDHP/HSA.
I am not sure how to figure out the costs that would be different. They cannot provide me information ahead of time as to the "discounts we will get at our PCP" over what paying full price would actually cost. They cannot provide me information as to what prescriptions that I take will actually cost with the southern scripts, mail order company, that we will be required to use.

Any advice would be greatly appreciated.
Hoping that there is a medical insurance agent/consultant on here!!!

Hog's Gone Fishin · 11-13-2019, 07:11 PM

Don't get sick and don't get hurt. Cancel insurance.

Chief Roundup · 11-13-2019, 07:13 PM

Quote:

Originally Posted by Hog's Gone Fishin

Don't get sick and don't get hurt. Cancel insurance.

Can't live in dream world.

**2112** · 11-13-2019, 07:15 PM

If you plan on having a lot of procedures this year pay the higher premium payment with a lower deductible. If you don’t plan on procedures go for the lower premium hospital advantage with a higher deductible and a reasonable out of pocket expense for the year.

You gotta crunch the numbers to see what works best for you this year

Chief Roundup · 11-13-2019, 07:45 PM

Quote:

Originally Posted by D2112

If you plan on having a lot of procedures this year pay the higher premium payment with a lower deductible. If you don’t plan on procedures go for the lower premium hospital advantage with a higher deductible and a reasonable out of pocket expense for the year.

You gotta crunch the numbers to see what works best for you this year

I don't plan on procedures but I do have 3 scripts a month. That I have no idea about what the cost will actually be with no real or standard script deductible.

**2112** · 11-13-2019, 07:52 PM

Quote:

Originally Posted by Chief Roundup

I don't plan on procedures but I do have 3 scripts a month. That I have no idea about what the cost will actually be with no real or standard script deductible.

If you go to your insurance website you can compare plans. RX/Doctors et al

Just have to research it nowadays

Third Eye · 11-13-2019, 07:57 PM

Quote:

Originally Posted by Chief Roundup

Alright it is that time of year again. The college I work at it changing insurance companies from Blue Cross Health Advantage to UMR that is using United Healthcare.
The new company is pushing the High Deductible Health Plan. I am now trying to figure out if it is worth it for me to switch from my PPO/FSA to the HDHP/HSA.
I am not sure how to figure out the costs that would be different. They cannot provide me information ahead of time as to the "discounts we will get at our PCP" over what paying full price would actually cost. They cannot provide me information as to what prescriptions that I take will actually cost with the southern scripts, mail order company, that we will be required to use.

Any advice would be greatly appreciated.
Hoping that there is a medical insurance agent/consultant on here!!!

An HDHP is not a specific type of plan. If you were a PPO before, you’ll probably still be a PPO. As for your question, it’s kind of odd that they would ask you to sign up for a plan that you don’t know the details. I’m not even sure if that’s legal. They should have your pharmacy benefits information. I’d consider calling Southern Scripts.

Chief Roundup · 11-13-2019, 07:58 PM

Quote:

Originally Posted by D2112

If you go to your insurance website you can compare plans. RX/Doctors et al

Just have to research it nowadays

Now we had an hour long meeting. They didn't know and could not tell us any of that type of information.
I am thinking about calling my Dr which is in network with this new company and finding out their side of the $$$ info. I also thought about calling this new script company as well as my current Pharmacist and getting any and all info from them that I can.

Chief Roundup · 11-13-2019, 08:03 PM

Quote:

Originally Posted by Third Eye

An HDHP is not a specific type of plan. If you were a PPO before, you’ll probably still be a PPO. As for your question, it’s kind of odd that they would ask you to sign up for a plan that you don’t know the details. I’m not even sure if that’s legal. They should have your pharmacy benefits information. I’d consider calling Southern Scripts.

HDHP and POS are both PPO but you can only have an HSA with a HDHP.
Their responses were they didn't know each and ever Dr. charges and what the discount would be actually. Nor did they know the prices of every medicine and southern scripts discounts on each of those. Even though I could and was ready to give them a list.

BryanBusby · 11-13-2019, 08:04 PM

Quote:

Originally Posted by Third Eye

An HDHP is not a specific type of plan. If you were a PPO before, you’ll probably still be a PPO. As for your question, it’s kind of odd that they would ask you to sign up for a plan that you don’t know the details. I’m not even sure if that’s legal. They should have your pharmacy benefits information. I’d consider calling Southern Scripts.

They is a bit of a vague descriptor. Can't really expect the workplace HR lady to know any of that.

Chief Roundup · 11-13-2019, 08:08 PM

Quote:

Originally Posted by BryanBusby

They is a bit of a vague descriptor. Can't really expect the workplace HR lady to know any of that.

Not the case we had 2 reps from the Insurance Agency that this is all being outsourced through giving the presentation and answering questions for over 400 of us.

prhom · 11-13-2019, 08:09 PM

I think the main difference is that the HSA allows you to keep the money in your account year over year, whereas I believe FSAs you have to use during the plan year or the money goes away. I had a high deductible plan and an HSA for a while. If you are pretty healthy you aren’t going to spend much each year and save on premiums. You can put the deductible amount into the HSA and keep it in case you need it at some point.

If you are married or have kids then you probably aren’t going to save money with the high deductible plan compared to the lower deductible plan. At least that’s my experience as a married guy with kids. I have a plan with high premiums and low deductibles and everyone but myself uses it heavily.

Third Eye · 11-13-2019, 08:10 PM

Quote:

Originally Posted by BryanBusby

They is a bit of a vague descriptor. Can't really expect the workplace HR lady to know any of that.

Truth be told, I don’t have the faintest idea regarding the legalities involved in rolling out plans to an employee, I just design them and price them. I do know that I’ve never enrolled in a plan for which I didn’t know all of the details.

kccrow · 11-13-2019, 08:13 PM

Quote:

Originally Posted by Chief Roundup

HDHP and POS are both PPO but you can only have an HSA with a HDHP.
Their responses were they didn't know each and ever Dr. charges and what the discount would be actually. Nor did they know the prices of every medicine and southern scripts discounts on each of those. Even though I could and was ready to give them a list.

You are providing way too little information about the plans for anyone to help you whatsoever.

You should know the premiums, deductibles, and coinsurances/copays under the plans at the very least. Hard to compare the situations without that.

Normally every insurance company has a list of the prescription drugs and what tiers of the plan they fall under. Your HR lady isn't going to provide you that.

For all we know at this point is you could be comparing a 1200/2400 PPO 70% plan to a 1500/3000 HDHP 100% plan and so the benefits of the HDHP, especially if you contribute the deductible to the HSA, could far outweigh the PPO plan. We also have no idea how much you use the doctor and prescriptions you're on, which will factor into your choice. And, I doubt you'd want to divulge that information. You need to get more facts in order.

Chief Roundup · 11-13-2019, 08:16 PM

Quote:

Originally Posted by prhom

I think the main difference is that the HSA allows you to keep the money in your account year over year, whereas I believe FSAs you have to use during the plan year or the money goes away. I had a high deductible plan and an HSA for a while. If you are pretty healthy you aren’t going to spend much each year and save on premiums. You can put the deductible amount into the HSA and keep it in case you need it at some point.

If you are married or have kids then you probably aren’t going to save money with the high deductible plan compared to the lower deductible plan. At least that’s my experience as a married guy with kids. I have a plan with high premiums and low deductibles and everyone but myself uses it heavily.

Yes and no. You are correct that the HSA allows you to keep or roll over the money that you don't spend year after year.
You can only get the HSA if you get the High Deductible Health Plan which is that they don't pay a dime until I spend $3000 out of pocket which is also the maximum out of pocket expense. But I can put $3550 in it a year and anything I don't spend I get to keep tax free.
If I ever get over $2K in the account that I don't feel I will need I can roll it into a money market and let it make me even more money.

11-13-2019, 07:06 PM
Chief Roundup Admitted Planet Junky Join Date: Oct 2000 Casino cash: $-1458373	Medical Insurance Enrollment questions Alright it is that time of year again. The college I work at it changing insurance companies from Blue Cross Health Advantage to UMR that is using United Healthcare. The new company is pushing the High Deductible Health Plan. I am now trying to figure out if it is worth it for me to switch from my PPO/FSA to the HDHP/HSA. I am not sure how to figure out the costs that would be different. They cannot provide me information ahead of time as to the "discounts we will get at our PCP" over what paying full price would actually cost. They cannot provide me information as to what prescriptions that I take will actually cost with the southern scripts, mail order company, that we will be required to use. Any advice would be greatly appreciated. Hoping that there is a medical insurance agent/consultant on here!!!
Posts: 19,558

11-13-2019, 07:11 PM	#2
Hog's Gone Fishin Fish are scared of me Join Date: Nov 2001 Casino cash: $-1489523	Don't get sick and don't get hurt. Cancel insurance.
Posts: 40,646	2 0

11-13-2019, 08:09 PM	#12
prhom Veteran Join Date: Nov 2007 Location: Denver Casino cash: $7406013	I think the main difference is that the HSA allows you to keep the money in your account year over year, whereas I believe FSAs you have to use during the plan year or the money goes away. I had a high deductible plan and an HSA for a while. If you are pretty healthy you aren’t going to spend much each year and save on premiums. You can put the deductible amount into the HSA and keep it in case you need it at some point. If you are married or have kids then you probably aren’t going to save money with the high deductible plan compared to the lower deductible plan. At least that’s my experience as a married guy with kids. I have a plan with high premiums and low deductibles and everyone but myself uses it heavily.
Posts: 2,267