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Traditional PPO versus High deductible PPO paired with HSA

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  • Traditional PPO versus High deductible PPO paired with HSA

    It's my open enrollment period at work and I'm a bit befuddled by the options. Is there a general rule as far as how to pick between the two options?

  • #2
    It really depends how often you utilize your health benefits. HSAs can save you a fair amount if you don't have many needs, as the money you'd put into a savings account remains yours vs. higher premiums that just get absorbed by the insurance companies.

    It's a numbers game.

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    • #3
      It is a numbers game. I was just trying to seek additional wisdom from my fellow SCI. I opted for the traditional PPO this year. Just adding up the monthly costs for hydrophilic catheter kits (pretty absurd) will run me through either the traditional insurance's deductible or the high deducible ppo.

      Do any of you opt for the HSA instead of the traditional insurance?

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      • #4
        If you can stay healthy (consistently) then a high deductible plan with an HSA can make a lot of sense for a SCI'd person. I utilized that option 7 out the last 10 years and was pleased.

        As Scott said earlier, you have to crunch the numbers for your situation. The numbers don't lie. As a rule of thumb if the savings is low (for me < $50/month) then I go with the traditional option.

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        • #5
          Thanks, Patton. The difference in premiums ends up being about $43 a month so I'm pretty confident the traditional is the best option this time around but with the changes in the heathcare system, I'm trying to better understand how chronic conditions factor into my future utilization.

          My biggest concern is not knowing how to estimate how much healthcare I'm going to use (aside from monthly medicine and catheters) and how much things cost (like surgeries or wound care).

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          • #6
            I was always the Chronically Overinsured. In my case it paid off when I broke my neck...
            Blog:
            Does This Wheelchair Make My Ass Look Fat?

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            • #7
              Our choice this year is the same but for family coverage the premium difference was a little over 2600 a year. We chose the traditional coverage as Ry sees numerous doctors, plus his supplies, plus DME (will need a bigger chair again soon), plus brother's MRI 2 x a year, plus my husband and I (who are not getting any younger).

              High deductible plans with a HSA work great for basically healthy people who have time on their side to build up the HSA.

              My eldest son and his family are covered that way and for them, it is great. They were able to build up their HSA so that when they got pregnant, they had no out of pocket expenses (HSA covered it all until the max). Routine baby visits are preventative and covered (not applicable to deductible) and they have been able to further build the HSA with only employer contributions. They have had it for three years and the account will cover at least two more years of maxing out without them contributing any more. Since they have no real issues, the employer contribution more than meets their needs.

              With that said, I agree with over-insuring. With a group health plan, Medicaid for 3 years for Ry and Medicare for the last year for him, we have had deductions that exceeded $100,000 in the last three years. I am expecting this year to be on the same track since we have made two trips this year to rehab out of state. Even with the massive increase in PPO coverage costs this year, we are maxing out the FSA and hoping that we will not qualify for a deduction for 2013.--eak
              Elizabeth A. Kephart, PHR
              mom/caregiver to Ryan-age 21
              Incomplete C-2 with TBI since 3/09

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