Those pesky deductibles - How do you choose?
08-24-2018, 06:45 AM
#1
Thread Starter
Those pesky deductibles - How do you choose?
On the hopes I may retire before age 65, on occasion I browse the offerings of various health insurance companies. Best case scenario I take my current plan under COBRA. My deductible isn't all that large, and no issue with any prescriptions, and the cost is cheaper than anything on the open market.
Last night I discovered, insurance companies have a new way to get the insured to pay their deductible meaning the insurance company doesn't pay out. In the past, certain tests procedures would be subject to the deductible, as would a hospital stay. Hospital stays for most of us aren't the "norm" in a typical policy year, but doctor visits may be. The plans I was looking at last night were getting "creative." One plan called for just about everything, except a few preventative visits, to be subject to deductible. Another plan showed co-pays for the higher end tests, and hospital stay, but it appeared doctor's visits would also be subject to the deductible and co-pay. Since one is more likely to have doctors visits vs a hospital stay, it would seem that the patient/insured would be digging in their pocket sooner.
So if you don't have the option of a portable plan from your employer, how does one decide how much to stick their neck out and where.....? Going to roll my dice to make a decision when the time comes.
Last night I discovered, insurance companies have a new way to get the insured to pay their deductible meaning the insurance company doesn't pay out. In the past, certain tests procedures would be subject to the deductible, as would a hospital stay. Hospital stays for most of us aren't the "norm" in a typical policy year, but doctor visits may be. The plans I was looking at last night were getting "creative." One plan called for just about everything, except a few preventative visits, to be subject to deductible. Another plan showed co-pays for the higher end tests, and hospital stay, but it appeared doctor's visits would also be subject to the deductible and co-pay. Since one is more likely to have doctors visits vs a hospital stay, it would seem that the patient/insured would be digging in their pocket sooner.
So if you don't have the option of a portable plan from your employer, how does one decide how much to stick their neck out and where.....? Going to roll my dice to make a decision when the time comes.
08-24-2018, 07:10 AM
#2
It's boring, but you need to list out all the medical "events" that you know you will experience in a given year. As oldies, there will be a lot of them. Then you need to figure out what your health care provider charges for these events and then you need to compare that to the plans under consideration. After you identify what is covered without impacting your deductible and what is billable to your deductible you can then compare the costs of the various deductible plans and the premiums. You may find you want a high deductible plan because your typical "events" will not exhaust any of the deductibles so now you are just gambling that the big-bad-unexpected thing won't happen and if it does, then the $5 or $10K deductible is the least of your worries. The plans I have analyzed have it figured out pretty close, but for me the high deductible plan is always the correct choice. Even if I have to pay the big deductible, the amount I save in premium usually covers it or comes very close.
08-24-2018, 08:01 AM
#3
Thread Starter
Hey Bill, maybe you can have a part time business helping people narrow down choices in the health insurance world.
I once tried to price out an MRI as it was subject to my deductible. Sure you can get codes for the procedure, but I kept hitting brick walls. I'd be charged whatever my insurance would pay IF the insurance was paying the bill. So how much will that be? They didn't know, it would depend on the contract they had with insurance companies, and contracts were not the same for all insurance companies. All I could get from the hospital or free standing Shields MRI facilities were ranges in price, not helpful. As far as medical events....except for an occasional asthma flare, I'm pretty darn healthy, and thankful for that, so listing out medical events isn't something I can really do. Bill, I didn't think the high (depending on what you call high) deductible plans meet the Mass Credible Coverage criteria. Most plans I look at are with deductibles of 2K or with total out of pocket of 4K or in that neck of the woods...still a lot of money in my world, but then again, so is the premium for plans with lesser deductible. I found Tufts (which I have now) has better offerings than Blue Cross Blue Shield. If, for some reason COBRA is not an option, I'm looking at around $150 or so/month more than my group coverage with a 2K deductible and 4k max out of pocket, both higher than my current coverage. All subject to change before I actually pull the retirement trigger....
I once tried to price out an MRI as it was subject to my deductible. Sure you can get codes for the procedure, but I kept hitting brick walls. I'd be charged whatever my insurance would pay IF the insurance was paying the bill. So how much will that be? They didn't know, it would depend on the contract they had with insurance companies, and contracts were not the same for all insurance companies. All I could get from the hospital or free standing Shields MRI facilities were ranges in price, not helpful. As far as medical events....except for an occasional asthma flare, I'm pretty darn healthy, and thankful for that, so listing out medical events isn't something I can really do. Bill, I didn't think the high (depending on what you call high) deductible plans meet the Mass Credible Coverage criteria. Most plans I look at are with deductibles of 2K or with total out of pocket of 4K or in that neck of the woods...still a lot of money in my world, but then again, so is the premium for plans with lesser deductible. I found Tufts (which I have now) has better offerings than Blue Cross Blue Shield. If, for some reason COBRA is not an option, I'm looking at around $150 or so/month more than my group coverage with a 2K deductible and 4k max out of pocket, both higher than my current coverage. All subject to change before I actually pull the retirement trigger....
08-24-2018, 08:22 AM
#4
Heck, I'm having a hard enough time picking a new delta plan! (Tricare dental disappears on New Years Day.)
If you're healthy the deductible doesn't matter, you'll never pay it. Co-pays are different and don't count toward your deductible (in most states). COBRA prices will shock you since you pay the whole expense. $10,000 a year is not unheard of for COBRA single -- that's what your employer has been paying all along. Look at that W2 you got earlier this year in Block 12, code DD. That's what your medical insurance cost -- and what COBRA will cost.
-- Chuck
If you're healthy the deductible doesn't matter, you'll never pay it. Co-pays are different and don't count toward your deductible (in most states). COBRA prices will shock you since you pay the whole expense. $10,000 a year is not unheard of for COBRA single -- that's what your employer has been paying all along. Look at that W2 you got earlier this year in Block 12, code DD. That's what your medical insurance cost -- and what COBRA will cost.
-- Chuck
08-24-2018, 08:34 AM
#5
Thread Starter
I'm aware of the cost of the employee health plan...I write out the check...it's not 10K, but not too far from it. I'm under a single plan.
You are right, generally speaking if you are healthy you won't have to deal with much if any of the deductible. However, I know people who were feeling just fine and visited the doc for what they thought was a minor issue, only to be told something big was going on. These were not people who didn't see a doc regularly either.
You are right, generally speaking if you are healthy you won't have to deal with much if any of the deductible. However, I know people who were feeling just fine and visited the doc for what they thought was a minor issue, only to be told something big was going on. These were not people who didn't see a doc regularly either.
08-24-2018, 04:27 PM
#6
Gee lainey I guess I've had it easy. I blow through my deductible every year as well as max out of pocket. 
08-24-2018, 07:42 PM
#7
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08-25-2018, 03:51 AM
#8
Fortunately they have been counting one of my meds towards my deductibles.
it was running $14k a year. I've heard the price is dropping to a measly $5k soon.
it was running $14k a year. I've heard the price is dropping to a measly $5k soon.
08-25-2018, 09:01 AM
#9
Thread Starter
Geesh, Jerry. You are one high maintenance guy!
08-25-2018, 12:30 PM
#10
High performance vehicles usually are. 