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Selecting your Health Insurance

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by Carolyn Burton on 3 November 2013

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Transcript of Selecting your Health Insurance

Medical Insurance Options
Selecting your Health Insurance
We offer 2 medical insurance plans:
Plan 4, a traditional PPO with higher premiums and co-payments/co-insurance to limit out-of-pocket expenses
Plan 6, a consumer-driven health plan (CDHP) with lower premiums and risk for higher out-of-pocket expenses
PPO: Plan 4
When you visit the doctor, you'll pay $20 or $40 for each visit
Regular check-ups are free (including annual physicals, well-women exams and well-child annual visits)
You'll pay for your first $500 of procedures, x-rays, lab fees, etc. and then you'll pay 20% of the rest of the bills up to $1500 (see plan details for info about dependents)
CDHP: Plan 6
"Consumer-Driven Health Plan" a.k.a.
"High Deductible Health Plan"
Instead of co-pays, you'll pay the first $1500 of expenses for doctor's visits, lab fees, procedures and prescriptions (your deductible)
Then, you'll pay 20% of the expenses after you've paid that first $1500
Your monthly premiums are cheaper and you get money from the College in an HSA (Health Savings Account) to help you pay for that first $1500
How do you decide which is right for you?
Why Choose a High Deductible Plan?
Your monthly premium is less.
You can put your premium savings in an HSA (Health Savings Account).
You can use unspent HSA funds in future plan years (they don't expire).
The College provides HSA funds to fill some of the deductible gap.
Pharmacy
Plan
Prescription drugs have their own deductible: $150 for individuals/$300 for a family
... so you'll pay the first $150 in Rx co-pays and it doesn't count towards your $500 medical deductible
Drugs are classified into Tier 1 (cheapest), Tier 2 and Tier 3(most expensive) and each tier has it's own co-pay.
Tier 1 = $10 co-pay ("generics")
Tier 2 = $35 co-pay
Tier 3 = $55 co-pay
Mail order is also available to help save money (typically 3 months for the price of 2)
Plan 4 Details:
http://www.sbc.edu/sites/default/files/Human_Resources/Benefits/Medical_Insurance/SBC%20Plan%204%20%28CICV%202013%29.pdf
Plan 6 Details:
http://www.sbc.edu/sites/default/files/Human_Resources/Benefits/Medical_Insurance/SBC%20Plan%206%20%28CICV%202013%29.pdf
These examples show how each plan might cover medical care in given situations. Use these examples to see, in general, how much financial protection a sample patient might get if they are covered under different plans. These are not cost estimators, just comparisons. (Just click on each one to get a closer look...)
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