If you have an HSA, you can only have a limited FSA, which is the dental/vision thing. It’s mostly use it or lose it, but depending on your employer’s plan you might get a grace period of a couple months into the next year to be allowed to spend it or be allowed to roll up to $500ish year-to year.
My employer has the rollover option and for me I can usually count on a couple hundred a year since I lost the genetic lottery when it comes to teeth and wear compressed bottlecaps for glasses, but generally I keep under the rollover amount in there just because it isn’t the easiest thing to use up. On the other hand, if you’ve got something planned (ex. a couple coworkers have used limited FSA funds for lasik) it’s an option.
One nice thing about FSA funds is that they’re available on day 1 of the year, though, even though pay deductions are spread throughout.
That is a huge premium difference!! Our is about $35/paycheck difference…so it’s never seemed worth it to me to get anything but the PPO. But I can see why you are trying to decide, that is a large difference in monthly income!
Buuuut that difference, at least in my plans, is balanced by the difference in deductible and coverage so for mine and the math Lily did for these plans it’s not really a straight $200+ difference
I get my health insurance from healthcare.gov and it is currently open enrollment time. Right now I’m on a bronze plan for which subsidies cover my entire monthly premium and the deductible is super high-- something like $8,000. I’m considering some changes for 2022.
Typically I use very little healthcare, so getting the lowest cost plan made sense. However, over the past year, the OTC medicine I used to treat allergies/hay fever seems to have stopped working and my allergies have been pretty bad. I switched to a different one but it hasn’t made much difference. I’m wondering if I may want to get allergy shots (it really sucks to frequently have sinus symptoms during a global pandemic for which sinus symptoms can be an indicator-- I’ve cancelled a lot of plans out of an abundance of caution). However, I haven’t ever broached this with a doctor, so I don’t know if they would be a good idea for me. I also don’t know what to expect with regards to cost in order to calculate which plans may make sense.
I’m also considering adding dental coverage. I needed a gum surgery this year and I paid 100% out of pocket. It was quite pricy. I looked into buying insurance at the time and all of them had one-year waiting periods for the procedure I needed. I figure it may be a good idea to have dental insurance in case I ever need a similar surgery at some point in the future.
Does anyone have any insights that could help me figure this out?
Re: dental insurance, I think it really depends on how often you are likely to need major work like the gum surgery or something else. When the SO needed deep periodontal cleaning a couple of years ago all the policies were similar-- had to be on the plan for 12 months before they would cover anything. And then the limits were way below what the actual cost was going to be. I think it worked out to being MORE expensive in the long run to carry the insurance for a year, get the procedure only partially covered (IIRC they had a limit of around $1000 for periodontal work and his was going to cost $1800 at the time, which would probably be $2000 if he waited over a year to get the insurance to cover it). So for us it made more sense at the time to self-insure.
If your income is low enough that you are getting a full subsidy for a bronze plan I would at least price out some of the silver options – for me if I can keep my on paper income low enough there are some good deals. For me and DD the sweet spot is between 24-26k annual income, then I have very low deductibles, copays and OOP limits If it were just me I think the sweet spot is around 18-20k.
It may be worth it for me to play around with lowering my “income” a bit-- I think the numbers I was using were a tad bit higher than the individual sweet spot you mentioned. I padded my numbers a bit because I have a small business that I may or may not try to earn income from.
Very illuminating to hear that dental insurance may not be worthwhile even when having work done. The admin at my dentist’s office always seems so surprised I don’t have dental insurance which was starting to make me think it was a mistake not to have it.
Today’s (11/7/2021) livestream at 5PM Pacific/8PM Eastern is going to break down how to pick a health care plan for you in the hellscape that is American health care. How do you predict how much you are going to spend? Should you risk a high deductible? How to check if your providers are covered? Open enrollment is NOW for healthcare.gov and for many employers -
We’ll conquer the alphabet soup: PPO, HMO, HDHP, HSA…
Plus two donuts and a floof!
If you have specific questions, please let me know!
I am confused.
I purchased a plan thru healthcare.gov in the middle of 2021.
Do i need to do November open enrollment??? Or is my current insurance good for 12 months?
I’m not an expert, but as I understand it all plans on healthcare.gov follow the calendar year. So yes, you need to do open enrollment for coverage starting Jan 2022. That said, I got a message from my current insurance provider that my existing plan will renew automatically if I don’t take any action.
Your current plan only goes til December 31. If your same plan is offered next year, then you will be auto-enrolled in it, but it’s worth checking to make sure there weren’t changes. If your same plan isn’t offered, you will need to choose a new plan by December 15th.
You may want to check to make sure that there aren’t better plans offered for your needs in 2022.
Not a question but (probably) a celebration: I seem to have won the battle with the insurance company and get to have an MRI tomorrow to see if I have a brain tumor.* Of course, the insurance company refuses to confirm or deny if I have pre-certification; they insist that they will only talk to the provider. Who is incompetent, so fingers crossed, but I’m gonna go climb in the giant donut tomorrow.
*I probably don’t have a brain tumor, but it has to be ruled out first before anybody can start trying to do anything else about my suddenly debilitating migraines.
I hope they figure out what’s wrong soon and I hope it’s not a tumor and is easily treatable!
We get to be MRI buddies this week. I’ll be getting one for abdominal pains that might be endometriosis. Surgeon wanted more imaging before making a recommendation.
Thanks, both of you. I’m really not worried- migraines exploded right as my hot flashes returned. This is hormonal but have to rule out a fast growing tumor since it came in so fast.
Ugh I thought I was sure what the best insurance was (each of us go on our respective HD plan + HSA) but turns out my insurance is really good? So good it might make sense for him to go on mine?
ohhh I like the alluding to the rules. I can’t remember your state, but here is the state laws on pre-authorization reponse times (individual insurance companies might have more restrictive patient bill of rights, even if your state doesn’t)
My “high deductible” plan has a deductible of $1500 and an OOP of $3000 and my biweekly payments are $32? Plus my company pays $750 towards my HSA. If I use no health care my expenses would be $30 (not counting HSA tax deductions). And when I add Mr Darling everything is doubled in price/contribution, not tripled or quadrupled like my grad school health insurance.
This is wildly good right? I never compared it to anything else since Mr Darling already had done his elections and its a startup that hadn’t sorted out the benefits documentation when I signed the offer letter.
If your high deductible plan is ACA compliant- it may be exempted if it is through the grad school, in which case you may not get the “essential health benefits” (oh wait, I think I misunderstand, this is through work, so it is likely to be approved)
if your drugs/providers are on the formulary and how much they cost and if deductible applies
But yea, that’s a pretty good plan - esp since they put $$ towards your HSA
My grad school plan was so terrible I got domestic partnered to Mr Darling through a notary at FedEx and went on his. This is from my job. Which is a startup that in February didn’t even have benefits.
