So, my university is changing its entire health plan around and we all have to do open enrollment next month. To be honest, as I did a little research (primarily asking friends how much their premiums are) my major conclusion so far is that I’m really lucky to work here. By the standards of American health care, all the plans are a very reasonable cost, especially for single people like me (premium costs go up significantly for families or even for just a spouse.)
I have two options (there’s another one, but these are the two I’m considering). One is a “high-deductible” plan, and one is the same PPO I have now.
In both cases, I continue to have access to the faculty-staff health center at the university, which is a small but full-service clinic that does general health stuff and has a great doctor in residence that I really like, plus an on-site pharmacy. It’s an amazing benefit. In the 15 months I’ve worked here, I’ve only been anywhere but the clinic twice: once for an eye infection, and once for a gynecology exam. There’s a $15 co-pay for each visit to the clinic, regardless of what insurance plan I choose. Also, I’m generally very healthy and am only 36. So we’re really talking about situations where I break my leg or get cancer, not about managing ongoing chronic health issues.
OK, I know you were waiting for the numbers. Here they are [each premium is reduced because I already completed a health screening to get a discount]:
- High-deductible plan:
- $11/month premium (!!)
- $1500 deductible
- out-of-pocket max of $5000
- university will put $500 in an account to help cover the deductible; this will roll over year to year if I stay with the university, but it’s not a HSA; I lose it if I leave the job. Functionally though this means it’s really a $1000 deductible.
- If I go anywhere but the health center, I have to pay the full cost of the visit until I meet my deductible, so if anything does go wrong and I need to see off-campus doctors, this could get expensive fast.
- PPO plan
- $55/month premium
- $400 deductible
- out-of-pocket max $1950
- All visits to off-campus doctors (if they’re in network) covered except for $30 co-pay.
I was leaning towards the high-deductible plan when I first looked through the info, because hot damn, just look at that monthly premium. And the out of pocket max is just not all that high, in the grand scheme of things, so if disaster did strike I’d survive, financially. But now that I look at it more, hmm. I’d take home about $450 more over the course of the entire year (after taxes.) If I stuck to visiting the health center all year, that would work out just great. But if I had to start seeing off-campus doctors for whatever reason, that $450 savings would vanish quickly as I’d have to pay the full cost of the visits up until the deductible is met. Is it enough of a take-home bonus to make it worth the risk?
What questions am I not asking? What would you do? Is it worth doing the high deductible plan if I don’t get an HSA to go with it? (I can still contribute to an FSA, but that’s a use-it-or-lose-it account so I’ll only put enough into it to cover the cost of contact lenses and a few clinic visits.)