Feb 23, 2011

Health Insurance (Janssen)

We feel fortunate to have health insurance through my husband's job. In the past, we've always done a regular coverage plan, but when we moved back to Texas, we switched to a high-deductible plan.

What this means is that instead of paying a large monthly amount to our health insurance company and then having them pay for the majority of most health care expenses, we pay a very small amount monthly to the insurance company and then the rest of the money goes into an account that we can use to pay for medical expenses.

We have a debit card attached to that account that we can use to pay for any medical expenses. Plus my husband's company put a large chunk of money into the account when we switched.

The high-deductible part means that our insurance doesn't pay for any care (except for regular preventive care like annual exams or routine checkups for children) until we've paid up to the deductible amount (which is about $6000). But we can pay for that $6000 out of the fund we pay into each month.

For us, it's worked out really well - we haven't paid any co-pays for our daughter's regular check-ups or my post-pregnancy visits and by the time we have our next baby, we anticipate there will be enough in our account to cover the entire deductible.

We spend considerably less each month on health insurance and with an infant who has to go in for check-ups and immunizations regularly, we've saved a bundle on co-pays ($30 a visit adds up fast). Plus, even if we did have to pay something out of pocket, the difference between the monthly cost of this plan and our former plans means that we would still come out ahead.

Of course, if you're about to have a baby or are currently having some expensive health problems, this might not be a good choice for you at the moment. But if you have some time to let your monthly contributions accumulate, you might consider looking into this type of coverage.


Linda said...

From what I've been told, and experienced, no insurance requires copays for preventative care like well-baby check ups anymore (thanks to health care reform). Another great option when you're on high deductible (or any time you're expecting a hospital stay) is a hospital indemnity plan. Women planning on having a baby should consider one. You have to be on the plan 10 months before the baby is born, but I signed up 2 months before I got pregnant, will pay about $40/month and then when I get admitted to the hospital to have the baby (or for any other reason) I will get at least $2200, more with each day I stay!

Melanie said...

Is this something that has to be offered by an employer? I currently have the least expensive plan, but the deductible is set (and there aren't any high deductible options in the three plans that are offered). I go to the doctor once a year for a preventative health visit, so I'm basically paying hundreds of dollars for the "just in case" peace of mind.

Stacy said...

My husband's work offers these types of plans as well. I've been reluctant to sign up for it though. I guess I have too many questions about it and the literature that his HR department provided about the plans was poor to say the least.

Does your account balance carry over into the next year if you don't use it?

Lisa C said...

I did a lot of research on HSAs like this once for a class. Seems like a great program. According to the info at the time I think it was available without an employer and the nontaxable contributions did rollover (although you cannot withdraw them tax free for nonmedical expenses until after a certain age). Does that sound right? My question is if being a part of the high deductible insurance plan gets you the negotiated rate for the services you pay for out of pocket (with your debit card) or if you have to pay the uninsured rate.

Nathan Pralle said...

The key to this is having the time to build up the reserve fund to handle the deductible. If you don't have that time or initial funding, you risk exposing yourself to big problems down the road.

We've never had the option for an HSA plan and even if we did, we've never had a moment in between medical needs to build it up. Thus, I pay for the 100% coverage plan from my employer. It costs a lot more than any other plan per month, but at the same time, I have zero worry that a medical issue will give us huge debts or wipe out savings/reserves. In this case, the insurance helps me manage my debt by giving me the peace of mind that it won't be an issue. I like that, and it's totally worth it in my book.

Jodi said...

maybe I don't fully understand, but what if something major were to happen before you have saved up your $6,000?

Also, I thought I would ask your experience since you had your baby in Massachusetts and then immediately quit your job/moved. I'm due the very end of April, and am worried about my insurance not going through with everything because I am quitting my job (of course I have to talk to my boss still, but he is out of town for a month). What was your experience with this? you can email me if you'd rather- jodisparks9@hotmail.com

Janssen said...

Jodi, if you don't have the money in your account, you are personally responsible for the deductible up to the limit of $6000 (or whatever your deductible is set at). So if you have major medical costs frequently (like Nathan mentioned) or don't have the funds to pay the deductible if you are diagnosed with something horrible a week after you switch plans, it's probably not a good plan for you.

If you are young and in good health and have the emergency funds to pay the deductible if you absolutely had to, it's a much less expensive way to go.

Janssen said...

And yes, the funds do rollover - they don't expire at the end of the year like a flexible spending account.

I believe you are charged the insurance discount prices (I'm basing this on the fact that all of my daughter's immunizations and well-child checks have been billed at the insurance discount rate and paid for in full by the insurance company).

Corbett Family said...

We just switched to this type of plan when Jim switched jobs and so far it has been great. I haven't paid a dime for any health coverage (well checks and a couple of sick visits for my kids, plus some tests for me) and next month our remaining funds from this year (still quite a bit) will rollover into next year giving us a nice cushion for our high deductible. I believe our deductible is only $1800 for our whole family, but we are paying substantially less each month out of my husband's salary for health insurance than we were before. I have definitely become a fan of this type of plan.