starky

It’s the opposite way round in Ireland, we only see out side a few months of the year!

Bob

Depends where you live for what's best, I stick with a tracfone pay as you go as I hardly ever use the thing, but most phones without credit history, chuck in a $500 deposit and they won't care.

Saff_London_Girl

Congratulations on the job offer. How is the preparation for the move going?

starky

That’s what I was banking on! I spend half my life on the phone, although the amount of people that I will be calling at first will be limited. I will just make life way easier to have a contract phone.

Thanks! Not too bad, I had to change my flight from DC to Boston (€35) and re organise my shipping. Looking at booking temporary accommodation at the moment. Thankfully I can hire a car under the company fleet policy which means it will be cheaper as I can wave the CWD. Just two weeks now till I go. I have managed to get three weeks of unpaid leave to organise my self when I get there so that will give me time to do all my running around when I get there.

I got my “new hire” pack yesterday, an my god do the Americans know how to complicate things. I have spent ages reading it and I still have not got a clue what to make of it all. There are so many choices and decisions to be made.
I have the option of two Blue cross medical insurance plans, one specifically for new England employees its a HMO one ($88 p/m) and another one for all US employees its a PPO ($128 p/m). The only really difference that I can see so far is that the HMO one is cheaper and there are slightly more benefits with it, but I suppose not all employees are eligible for the HMO one as it is specifically for New England employees.
So what would be the general idea here do some people prefer HMO over PPO schemes? And vice versa? Are the advantages of one over the other? Then are three related booklets about prescription schemes.
And don’t get me started on the 401K, I think I will have to get a finical adviser to help me making my mind up about what to do with that. The company will match the first 3% of what ever I put in, is that good?
Then there is something called flexible spending, still trying to figure out what the hell that’s all about. I think the gist is that I put away X amount of pre tax income and then use it for medical expanses, but I have to guess how much I will need??
Its all a but confusing.
Medical and dental seem straightforward both about $10 a month each. I have pre warned the HR people in Boston that I am going to have a list of questions as long as my arm :-)
Anyway I suppose loads of benefits that I am trying to figure out are better then having none at all!

Here are the summary of the two medical plans is any one has any feedback on what one looks like the best, I am single with no family by the way:


PPO Medical Plan –
National BCBS

* ALL employees eligible*


Cost per pay period

• Individual: $64.18
• Employee + One $128.52
• Family: $192.76

In-Network Benefits
• Inpatient stays covered at 100%, after $250 deductible
• $15 office visit co-pay

Out-of-Network Benefits
• Annual deductible: $250 per single member; $500 per family.
• 80% coverage after the annual deductible.

• Prescription Drug: $10/$20/$35 for generic/brand/non-formulary


HMO Medical Plan –
HMO Blue New England

*New England employees eligible* Cost per pay period

• Individual: $44.40
• Employee + One: $88.80
• Family: $133.20

In-Network Benefits
• No deductible.
• Inpatient stay covered 100%, after $250 deductible
• $10 office visit co-pay
• No out-of-network benefits
• Prescription Drug: $10/$20/$35 for generic/brand/non-formulary

Michael

It is actually not all that complicated. I'll try to describe everything.

Medical Plan Differences

HMO

Generally pays slightly better benefits at a lower price.
Generally does not pay medical bills if services are not provided by the network. If you are out of the service provider area (eg. on vacation), the services may not be paid for when you see a doctor. Check with you plan admistrator to see if at least emergency care at a minimum is paid for when out of the service provider area (on vacation or business trip). If it is not, I would not get this plan.
A primary care physican will be choosen and you must always see him first and he will send you to a specialist.

An HMO is similar to the NHS. If you leave the plan area (UK or New England) or see a private doctor (non-NHS doctor or out-of-network doctor), you are probably not covered.

PPO

Generally cost more and benefits are slightly less.
You do not have a primary care physican. You can go to a different doctor every day and you can see a specialist of your choosing whenever you want. As long as the doctors are in the network, you will have the lower in network co-pay. If any of the doctors are not in the network (eg. you are on vacation), usually there is a higher coinsurance payment.

You are allowed to see any specialist whether in or out of network. This allows you to see a world renouned specialist.

Most Americans desire PPO plans because you are always covered.

http://www.insurance.com/faqs/health...l.aspx/index/7

401K

This is an employee directed retirement plan. Usually the employee can decide how to invest any payments into the plan. The plan has investment options and for simplicity purposes we will assume it has the choice of 5 mutual funds (bond fund, large cap fund, value fund, growth fund, and high growth fund). Usually the employee decides what is his/her risk tollerance. If it is low, the employee may indicate that 50% should be invested in the bond fund and 50% in the large cap fund. If the risk tollerance is high, the employee may decide to indicate that 50% should be invested in high growth fund and 50% in growth fund. Once the employee indicates his/her investment options, he/she usually does not readjust the options unless in the future he decides he wants to change his risk tollerance.

The employer may provide matching funds to the employee (3% of your salary in your case) to invest in the plan. Any money you invest will be tax free (example: If you invest $5,000, you will be taxed on salary -$5,000 as if you did not receive the $5,000). Any money matched by the employer is also tax free and is not included in your salary. Since your employer has a maximum 3% match, you should invest a minimum of 3% of your salary otherwise you are thowing away money from the employer contribution.

Any withdrawls from the plan at retirement will be taxed for that year which is usually at a lower rate than would have occured if it was taxed immediately.

Flexible Spending Account (FSA)

The government gives you a tax advantage if you correctly use a flexible spending account. If you think you will have unreimbursed medical, dental, or vision expenses for that year, you can tell your employer to deduct money from your salary for the FSA so that you can pay for those expenses. However, the notification must occur at the beginning of the plan year and all funds must be drawn out of the account by the end of the plan year or else the money in the account will be lost. Any money contributed to the account is tax deductable (reduced from your income).

Example: Your going to have major dental work done that year (braces, caps, etc.). You are going to have an outpocket expense of $5,200. At the beginning of the plan year you notify the administrator that you want $5,200 put into the FSA for that year. The company will withdraw $200 every two weeks ($200*26=$5,200) and when you have unreimbursed bills from your dentist, you request funds from the FSA and pay the dentist. The $5,200 can be withdrawn any time during the year even if the FSA has not yet been funded. Your income will be reduced by $5,200 for tax purposes.

starky

Thanks for that. Its starting to make more sense bit by bit.

So It seems as though I should try and go for the PPO plan then? Its only slightly more expensive in my case $64 vs $44. I don’t mind paying more if it means I will have better coverage out side of MA, as I definitely intend to do as much exploring over there as my vacation allowance will permit, so I will most likely be out of my “network” quite a bit I would hope.

What things should I be looking when comparing the two schemes?

Michael

It is primarily the out-of-network capability that is the most important thing. However if you are considering the HMO plan, determine under what conditions they will pay for out-of-network. Possibly they will pay expenses for out-of-network if you are out of area always, maybe only if you are out of area and for emergency only, or possibly never. Until you know that, you can't determine how good the HMO is. I also like the idea that I can see a specialist under a PPO plan whenever and whoever I want and don't have to see a GP first.

I have always chosen the best PPO plan even though some of my employers offered many different plans (serveral HMOs, PPOs, and EPO plans).

Usually there are a very large number of doctors and facilities that are in-network for most good plans. If your plan is good, there could be as many as 10,000 or more doctors in New England that are in-network as well as most hospitals and clinics.

Bob

In a gist, HMO, you have to see your doctor who refers you and you can only see doctors/hospitals on your network, or get the vasline for the cost.

PPO, see who and where you like...it's more handy for people who might have certain issues or family history of cancer etc, and for people who travel around a lot...you end up in California and break a leg sort of thing, the doc will have to be in-network, but it won't be as restricted.

What you really need to worry about is the small print, what the co-pay is everytime you see a doctor, ER, get a prescription, and also what the coverage is for length of stay for emergencies, are ambulances covered, do they cover MRI's for non life threatening issues etc.