lansbury

My health insurer called to make sure I knew that as I turned 60 last month the annual premium increase would be bigger this year than normal.

Bigger than normal means the monthly premium would increase from $368 to $570.

My current plan has a $500 deductible and a $6000 coinsurance and $30 co-pay. They suggested that I change plans to one which has a $2500 deductible, a $4000 coinsurance and a $20 co-pay, that would be $410 a month.

Does that seem like a good option or is there something I should be aware of. I have only visited my doctor twice since arriving here in November 2006 and both of those were for a minor sinus problem caused by an allergy.

I looking to see if they are some pitfalls I could be missing before agreeing to change plans as having been in the US for just over a year I am still not really knowledgeable about these matters.

robin1234

The one with the lower premium sounds like a good idea - if you don't visit the doctor or have any other incidents, then you save a couple of thousand in premiums over the course of a year. I've always felt that the important feature of medical insurance is how well it covers you in terms of catastrophic events; injury, illness or accident that costs hundreds of thousands or millions of dollars. Presumably both these plans are equal in that respect?

farmerwife

I have a Regence BlueCross BlueShield of Oregon individual plan with a $5000 annual deductable. $20 office copay, $100 ER copay, 50% prescriptions, 80% in network coverage.
Insurance is $537 per quarter. This makes the premiums affordable for 'the aging' while providing coverage for serious stuff.

farmerwife

Rates for BCBS Oregon here - http://www.regence.com/docs/OR/rates/allPlanRatesOR.pdf

For Blue Selections Premier age 60-64, $20 office copay, $2500 deductable, the rate is $372 per month.

RoadWarriorFromLP

I'm no expert at this (and I was born here, go figure), but I thought that "coinsurance" was typically offered as a percentage of costs, not as a dollar figure. You might wish to clarify what this means.

One coverage that I would look for is whether the policy pays for non-generic prescriptions. Should you need them for an extended period, the cost of these drugs if you were to pay for them yourself could bankrupt you. While many medications are offered in generic form, some are not. Since insurance is supposed to protect you from catastrophe, not having this coverage is, in my view, a gross oversight, but many policies do not include it.

lansbury

At the moment the cost I quoted takes account of this years annual increase

lansbury

The coinsurance is 20% but as I read it once you had paid $4000 in any year they then covered 100% after that.

It pays 50% of non generic prescriptions with no annual limit.

lansbury

I appreciate all the comments.

The plan they were offering seesm to be almost as good as the one I'm on, if not better in places for a good bit less. Made me wonder if I had overlooked some disadvanatge to it.

Duncan Roberts

Basically, you need to look a the small print to see what exactly the plans are. For instance, the plan I have now has a $2000 deductible but last year I paid $200 towards that and had over $20,000 paid by the insurance company. I know somebody who has a $2000 deductible and the insurance wont pay anything until he has paid that $2000 in full which means he has to pay for all his medical stuff as if he had no insurance until he's paid $2000. Price wise it might look better but until you go through it with a fine tooth comb and apply your life situations to it, you can't really tell.

The biggest variable is what happens in the upcoming year health wise, that you can't predict 100%.

limeynus

You might want to look into a HSA (Health Savings Account) plan - this is similar to what Duncan Roberts was talking about in his post - Blue Cross has one here in CA where you pay $1,500 (single) and you pay all costs up to that amount after that everything is covered 100% if you do not use the $1,500 it is rolled over to the next year - I believe it is tax deductable and I believe if it is not used eventually it becomes a form of savings!

I know we have my boss on it ... but I don't know too much about them! They are apparently the "hot" new item when it comes to healthcare!

farmerwife

We had looked into that, but it was more expensive for us - because the deductables are not really that high compared with the $5000 or $7000 annual deductable plans, therefore the premiums are way too high (for the older age brackets). The interest on the savings accounts are pathetic. The basic office visits were applied to the deductable, instead of being a reasonable copay. The older farmers round here think the HSA s are a bit of a fad compared with a basic high deductable plan.
Probably the HSA's would work best for younger folk, or for those whose employers are paying the premiums.

farmerwife

Are you thinking about the BCBS Oregon Blue Selections Premier? That is what we have, it has worked fine for us.
(BTW - are you going to Clackamas County Fair in August? We could say Hi)

meauxna

$537 per quarter.. how do you mean per quarter--that is the premium???

Would you PM me the name of that particular plan? I know they are state specific and I'm looking ATM.
thanks

Bob

another thing to look at, but life time max limit on the cheapo plan could be less, like $1M total cover, so you could be borked if you got hit by a bus and survive...

farmerwife

$2 million per member; OH and I have separate plans.
On the borked when hit by a bus scenario, it could probably be the nursing home/long term care stuff that could get you. A whole nother ball of wax subject.