that’s awesome. I mean, not the grad school plan, but yes, awesome!
I’m about to join SSO’s plan and I’ve never been on someone else’s health insurance (I barely like being on employer insurance after being used to getting to pick off the exchange) and I’m mildly terrified to have my health insurance in the hands of someone else’s employer.
Particularly because I can’t tax-deduct it even though I’ll be self-employed. So who knows how much the premium might be.
This is even better than my plan, which is so great that even though my employer excludes spouses who have access to a comparable plan at their employer, my spouse was able to be on my insurance despite working at a company known for excellent insurance coverage.
The only other catch I could think of would be if the network were not great and didn’t include your preferred doctors.
Okay, I’m playing around some more with my ACA health insurance options for next year. The website has a feature where you can estimate your total annual costs assuming you have Low, Medium, or High use. I compared three plans this way.
Basically, the plan I have now (bronze, with $8,700 deductible and the premium completely covered by my subsidy) is by far the cheapest compared to any of the silver plans if I am at low or medium use. The only way one of the other plans becomes cheaper is if I’m at high use and then the difference is very significant.
If I were to get allergy shots, I’m not sure what category that would put me in. Maybe still low, or maybe medium? I don’t know. I am curious if anyone here has gotten them and what the experience was like and whether they were worth the effort of all the necessary visits.
Also, I guess I don’t really understand what out of pocket max really means as the silver plans at high use all have total annual costs higher than the OOP max listed for the plan. Is this because OOP max isn’t including what you pay for the premium?
So currently leaning towards sticking with the bronze plan but feeling FOMO on the cost sharing reductions, etc that are getting so much hype with the silver plans…
Allergy shots would usually be considered medium or high-use, and many high deductible plans wouldn’t cover them, or will cover them at high cost. Usually you will have to pay a provider charge (a few hundred dollars) and a drug charge (around $400 per shot). Places to check:
Everyone I know who has gotten allergy shots has said it is worth it.
Out of pocket max is just your stop-loss. It means you won’t pay more than that amount out of your own pocket (co-pays, co-insurance, etc). Your premium costs do not count towards it.
This livestream may be helpful, I broke down the terms. (relevant part starts at 40:09)
Reviving this for help understanding what my potential costs will be if I take a job I have an offer for versus what I’m currently paying.
Currently I have great coverage with a $1000 family deductible and $6000 OOP max. So far we’re at $0 towards our deductible because all of our costs are co-pays and prescriptions, and we’re at $654 towards our OOP max. So if we continue to use care at the same rate we’ll pay about $1600 OOP over the whole year.
The plan at the potential job is a HDHP with a $6000 family deductible and a $7700 family OOP max. They will contribute $1250 to an HSA. So that means that I will pay the full cost for office visits, therapy, and prescriptions until we meet the OOP max? So we’ll probably end up paying the full $6450 (7700-1250), if we estimate 36 therapy visits total per year at roughly $150 per session = $5400, and then assume 7 Drs visits that aren’t annual physicals, and then prescription costs on top of that? UGH
I’m confused about this. Do you have a two deductible plan? Generally your copays and prescriptions count towards deductible.
Until you meet the deductible, and prescription costs would be included in that total (as long as you bought them with insurance - with a high deductible plan, you might end up wanting to use goodrx or something similar and save money overall, depending on the prescriptions.)
Also… Unless you have a two-tier deductible plan where there is an Rx deductible that is separate.
I’ve always been confused about this too. The only things that I have that ever seem to count towards the deductible are lab tests. In the detailed plan booklet, most of the types of visits that have copays and preferred generic drugs also say deductible waived? So I guess that also means they don’t count towards the deductible?
Also, thank you for clarifying!
Yup, this is a deductible waived thing. That’s the case in which it won’t count.
That won’t happen on an HSA-eligible HDHP because by legal definition, they cannot cover anything before deductible and be HSA eligible EXCEPT essential health benefits (ACA required preventative things, like certain screenings and annual primary care visits).
Is there a non HDHP option for you at the new job? because it sounds like you are a pretty high user of your health insurance, and therefore an HDHP is not the best option for you.
Nope, that’s the only one they offer, so it might become a deal breaker. I’ve never even considered a HDHP before because for two essentially healthy humans we sure do have a lot of medical costs.
You can also mention to them that your health care costs would increase by X,XXX per year and therefore you would like that factored into your salary offer.
