Bob

So the missus just got her info for the new years medical insurance enrolment. Not entirely terrible this year.

PPO Plan through Aetna.

Premium has gone up a smidge, it's now $220 a pay cheque, which is twice a month. There's a $20 discount for non-smokers.

Cover has gone up from 70/30 to 80/20.

The co-pay has gone up $5 to $30 a visit, $55 out of network or specialist. Minimum deductible has gone down from $3K to $2.2K for the family plan and there's no deductible for imaging services such as x-rays nor lab costs to worry about now. Prescriptions are the same at $10/35.

They have offered a high deductible plan this year, but it's shit. It's $60 a month cheaper for a family plan so we're not bothering.

It is quite a saving if you're getting a single person coverage. It's a little bit of savings if you're getting coverage for yourself and spouse or a child, but any more than that and it's the family plan and there's really no saving.

So how about you lot? Got off better or worse this year?

Noorah101

My company also had major changes this year (United Healthcare). They completely did away with the plan I was on (EPO). Now we have a choice of PPO or HDHS (high deductable, health savings account).

The premiums, deductable, and out of pocket went up for the PPO, so I switched to the HDHS plan. I think I'm better off this way...lower premium and I save my own money. It's just me on the plan, and I rarely go to the doctor. The once a year well woman exam is covered as it was in the past.

Rene

kodokan

Anthem PPO HD plan, with a $2.6k family deductible, and about $6k max annual out of pocket.

Company provides this for free as of halfway through this year, and gives a $1k bung for the HSA. They also offer a traditional copay plan for about $250 per bi-weekly pay check, but that makes no financial sense at all now even if you're a heavy medical user who'd be maxing out the HD plan. Perhaps it's a new criterion for carrying out RIF exercises: 'inability to do basic math'. I shall be very surprised if this is even an option in 2018.

The company also introduced an interesting variant this year - a waiver, whereby if you opt out of their employer healthcare, you get $1.5k. I assume this is aimed at getting people to jump ship onto a spouse's plan instead.

Noorah101

Yeah, my company made the PPO so financially unattractive that almost no one is choosing it. My guess is that in the next year or two they will get rid of it, justifying it by saying "look, no one is using it! "

Rene

Pulaski

Unless you expect to exceed the $2.2k deductible, I wouldn't be so sure that the HD plan might not make sense. If you're not hitting a $2,200 deductible anyway then taking a higher deductible means that the $60/mth is a free gift. .... Then you can put almost $1,000 in an HSA with the $60/mth you've saved because you've saved the tax ($1,000 before tax will only cost you around $750 after tax) and then use that $1,000 to pay your medical expenses, and if you stay fairly healthy (don't have medical bills exceeding $1,000) you will have paid for your medical expenses with the savings on the lower insurance premium plus the tax benefit.

Of course if you have any other money you could save the tax by putting that into your HSA, but at very least you could put your Flex-spending money into the HSA instead, then you wouldn't face the "spend it or lose it" problem.

Bob

Well it's not quite that simple because the in network on the PPO is nationwide, whilst all the other plans aren't, it's the greater metro area only. This was the main decider for us, considering family up in Maine and well, winters just suck.

Also, the missus deals with the public and they're a sick bunch of people that spread sickness...that and same for the kids. The winters are brutal for eye/ear/nose infections.

That and the deductible on the HD plan is about $6K and some odd change.

Oh, the other stuff, dental went up a couple of bucks a month, so it's about $35 a month, which isn't bad, considering the eldest is doing a run with Myobrace palette expander which is about $3K a year and the insurance is picking up half of that so it's paid for it's self on the one kid.

No change to the eyeballs, which we dont' have the kids on as it was cheaper to sort the eldest at Target and pay with the AAA discount than have insurance on them, but it worked well for me.

Pulaski

Yeah, if the HD plan doesn't mirror the PPO then that does suck, and isn't what Mrs P and I both experience - we get a choice of traditional insurance plans, and then each traditional has an HD variant, that pretty much mirrors the traditional plan with a much higher deductible.

RICH

I did not know there was an option for it to get "better"!
We are changing from blue cross to united healthcare, but overall it looks like a little bit worse coverage and a little more expensive. As every year in my 10 years experience.

Bob

Yes, it's a little odd but then they didn't offer a HD option previously.

The PPO, is probably simpler for the company as it's the same nationwide, whilst the other plans are more localised, I think, so they're probably getting a better deal out of it but that might change now that they're offering a HD plan.

HD plan is great if you're young and single and don't plan to go out of state or the metro region though! It costs peanuts then, about the same for the really cheap, localised plan they used to offer but dropped this year, which was basically covering you in-network for your local hospital only.

Pulaski

Anyhow, my open enrollment doesn't kick off until next week, so at the moment I don't know, but I am not expecting any huge changes, based on prior years probably around another $7/mth for the family's medical insurance and a few tweaks of a few cents here and there for dental and eye coverage.

MidAtlantic

My HD plan has gone up $2.50 a month, with no changes in the coverage. MY HSA, funded by the savings I am making by not using a PPO plan, is more than sufficient to cover my deductible and that is money in my pocket, not the insurer's.

Pulaski

That is how it works for us too - the savings on premiums fund our HSAs, so the HSAs are full of "free money", and already hold enough for at least six years of maximum OoPs on our HD policies.

Olly_

We're switching from a regular policy to a high deductible plan for 2017, it's about $80 a month cheaper and my husband's company will pay $1000 per year into a HSA at no cost to us so it's a win win all round.

I wish we'd done it for 2016, we've not claimed at all (so far!) in 2016 so would have saved the premiums and had $1000 in the HSA by now. Oh well!

Pulaski

Yeah, we wished we'd switched to HD years earlier. We've been on HD for seven years, 2017 will be our eighth, and we have rolled up very tidy balances into our HSAs.

kodokan

Are most people's HSA plans not PPOs? Most of the posts above are referring to the two terms as if they're mutually exclusive. All three of my HSA plans, across two employers and through the Exchange, have also been PPOs, with reciprocal in-network coverage in other states and, certainly for the Exchange plan (I chose it specially with a planned trip in mind), including coverage overseas.