high deductible HSA healtcare plans? Our church is switching to that as of 1/1/09 and I'm trying to figure it out. We had a meeting with the rep today to answer a lot of questions, and Igot all the ones I could think of answered. But... what are the questions I didn't think to ask??
The one unanswered Q that I had was whether after the "20 visits of PT allowed" the other 84 appointments are then out of pocket? Even with a prescription? Same with ST, which would be only 32 more (once a week all year). And honestly we'll miss a week here and there- but still... that's a LOT to miss if we don't.
So... what didn't I ask that I should??
PS- I have no choice in this move :( But I will say that Mike's employer is VERY generous in their provisions for each family in putting in to the HSA as well as paying the premiums, but still, ICK! I don't want to do this! LOL Any help with the switch would be greatly appreciated tho.
After the 20 visits it is our understanding that the other visits are then paid with your HSA. Would you email me and let me know who the Health Care rep was? What company is he with? We need to switch to an HSA after Ian is born.
ReplyDeleteI'm guessing if they say 20 visits, then the rest is out of pocket or from your flexible spending account. You should ask if PT/ST/OT are COMBINED with their limit or if those each get 20 or whatever number visits. I'd also ask if diagnosis makes a difference, sometimes they list those visits as if they are rehabilitation after an injury, and your coverage might be different.
ReplyDeleteI had a 20 visit limit when I had a knee replacement a year ago. 20 visits was all I got per year and anything above that would have been out of pocket.
ReplyDeleteI'd say that move to an HSA/High Deductible plan was not great for your family. If you're healthy and can build up some funds with the lower premiums in the HSA they're great - and ultimately will probably be what most people go to, but they aren't great for people with a lot of medical expenses.
Can't you get medicaid for the children with SN? In NY we can get an income waiver so that Jonathan and Anah can get it even though we "make too much", ;o)
ReplyDeleteAlso, won't the school district pay for services?
Yes, we are the same with June. We have a medical waiver so Curtis is covered completely. Maybe you could take a look and see if that is a possibility. I am so grateful or we would have thousands in bills for him.
ReplyDeleteNot sure how our therapies work, to be honest. We only have OT right now. This is our first year with the HSA. It is not as good but it beats nothing by a long shot. We had medicaid for Sawyer but are in the process of getting it back because it got screwed up. I think it was paying for some of the OT. So we may be out of therapy all together for a while. When there are so many children in the house, (we have 4 6 years and under), it is hard to build up extra money but it is ez to meet that deductible early. It did pay all the well visits without a deductible, including immunizations and blood work.
ReplyDeleteLooks like many many places are going to the HSA.
Jan
my former employer offered the HSA/high deductible. not trying to sound down but this is a bad choice for your family. you will have a high amount out of pocket expenses. they are trying to get you not to use insurance unless an absolute emergency. since mikes employer is small, last year or this year he must have had alot of employees using the insurance which has in turn cost the employer. this is his way of not paying that amount, you will be. i know i worked in insurance for years.
ReplyDeleteI agree with everyone else that an HSA is not the best health care plan for families who need a lot of medical visits, but it doesn't sound like you really have a choice. The HSA will also pay for anything else medical, including over the counter meds and stuff that a regular insurance company will not...however, with a high deductible (I've seen some as high as $5000+), you're responsible for all the money up to that deductible, which is a rough transition. Usually when they limit you to 20 PT/OT/ST visits, the rest are considered out of pocket. Definitely check if these visits are combined or if you have 20 visits each for OT, PT, ST, etc. Good luck!
ReplyDeleteI don't know anything about it. I hope you figure it out and it won't mean too much hardship for your family dealing with the new insurance.
ReplyDeleteBtw, I nominated you for a blog award. :)
you have an award...on my blog. Love ya.
ReplyDelete