L8Z8

Just curious if anyone has been using this plan and how your experience has been with it? I'd like to get an HSA going so it's between this and the "Healthy Savings" plan. At first glance and for an HDHP it's a pretty expensive premium for a family, but 95% coinsurance is great. Anyone with a family been using this and how have the real costs for medical care been? Our plan is to not use the HSA funds until we retire, but between the hefty premium + maxing the HSA contribution + out of pocket medical expenses I'm wondering if this makes sense.

Myfingershurt

is it the premium that’s hefty or the deductible? I thought the purpose of the HDHPs were to keep premiums low and deductibles high. I believe the irs actually sets the minimum deductible you have to pay to even have a qualified HSA.

glassnpowder98

It’s a great option if you and your family are healthy and don’t make many trips to the doctor. My wife and I are on it and have fortunately been pretty healthy. I do feel like the 95% covered claim is a bit misleading though. I’m not going to claim to have much knowledge of how the black magic of insurance works, but in our experience, my wife’s two trips to the doctor this year amounted to $1800 “billed”. Through “discounts and reductions” the total we paid out of pocket was just under $500 which goes towards the deductible and max out of pocket. When you hit those thresholds then insurance starts paying the bills. It’s basically impossible to figure out how much each trip is going to cost, but in my experience in years past (under a different plan) an overnight stay in the ER will get you pretty close to maxing out your out of pocket.

So depending on how old your kids are and if they’re constantly getting sick or breaking limbs, it might not be the best option or you’ll be hitting the max out of pocket every year. My plan is to stick with the Core HDHP until I can put enough money away that will hopefully grow to pay for someone to change my diapers when I’m old, but switch to something with less out of pocket exposure when I’m a little older and more susceptible to health issues.

L8Z8

Compared to our peers I feel our premiums are some of the highest on most plans. So yes the HDHPs available to us have higher deductibles, but the premiums are (in my opinion) high. For instance the employee share of our Core HDHP covering a family is $584/month. The Core PPO (no HSA, low deductible and max OOP) is $622/month. Not a significant difference. I imagine by the time our next UPA is rolling around most of the group will wish we had visited this section for our recent UPA as premiums rise every year.

L8Z8

Thanks for the info. I think most of our doctor visits are typical for a family. Kids get sick. Stuff happens. I’m thinking even if we are in a worst case scenario and hit the max OOP due to unforeseen medical care we’ll still come out in the longterm. It’s just a matter of if we want to cashflow what could get expensive to gain the triple tax benefit of the HSA and use of it in retirement. Annually (and worst case) it’s $7,008 premium + $6,000 max OOP + $6,300 HSA contribution = $19,808.

Brickfire

Deductible = you pay it all.
$500 bill and $1000 deductible you pay $500

Coinsurance = cost share AFTER meeting deductible

$1500 bill, $1000 deductible and 5% coinsurance
You pay $1000 plus 5% of the amount over

At some point coinsurance caps out. A million dollar bill may only cost you $3k or something

The IRS restrictions are on deductibles. I suspect the core hdhp is a “high” deductible (by IRS standards), high premium, generous co-insurance plan aimed at high income pilots who want a tax shelter

L8Z8

Good general info for anyone cruising this thread, but I'm clear on how coinsurance, deductibles, and OOP limits work; moreover, what plans qualify to utilize an HSA. The Core HDHP is the union-vetted plan only available to pilots here so it's built specific for us. The alternative is our United Healthy Rewards PPO which is also an HDHP with an HSA. It's a bit more gambling on this one to me because while the premium is a bit lower at $462/month the total costs are more expensive in a situation where out of pocket limits are reached. A very similar plan at some competing carriers is low to mid $300s/month for a family which is why I feel overall our premiums are on the high side. I could be missing some key info though.

Brickfire

Usually it’s something along the lines of you just had cardiac surgery and need to spend a week in rehab. The well known, well regarded rehab hospital doesn’t take xyz plan but does take the costs more/“same” coverage plan

L8Z8

Yeah that's a good example. Another is when insurance dictates your care instead of the doctor. No shortage of instances where a doctor recommends a particular medicince or procedure only for insurance to say, "Hm no you have to try this older less effective generic or archaeic procedure first. I think the "core" plans generally stop that nonense.

RustyShacklferd

I am a new hire and will be starting soon and am starting to look at health plans. Does anyone have any experience with the Core HDHP and having an autistic child? Just wondering if it is good at covering ABA therapy, speech, OT etc. Any info would be great. Thanks