In my mind, I had anticipated paying up to the $1,000 deductible as dictated by my plan.
My health plan options, provided by my employer:
What I chose: Choice Plus Standard Plan
Rationale: Although the monthly premium was higher, the deductible was lower. Psychologically, I just figured if I ever needed to access my health insurance for anything other than an annual visit, I don’t want to have be worried about costs during my recovery. Additionally, the difference in monthly premiums was less than the difference in deductible per calendar year and the annual out of pocket maximum.
UHC Choice Plus Standard: $41 x 2 pay periods/ month = $82/mon x 12 months = $984/yr in premiums.
UHC Choice Plus Basic: $22 x 2 pay periods/ month = $44/mon x 12 months = $528/ yr in premiums.
Difference: $984 – $528 = $456/yr more for the plan I chose
Vs The Difference in Deductible per year: $1,000 ($2,000 – $1,000)
Vs The Difference in Annual Out of Pocket Maximum: $2,250 ($5,500 – $3,250)
What do all those words mean.
I recently did a little lesson on this for my math literacy class, so I thought I might as well share it here as well (source: uhc.com).
Premium – The amount that must be paid for your health insurance or plan. You and/or your employer usually pay it monthly, quarterly or yearly.
Copayment – A fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service. Also known as: co-payment, copay, co-pay
Out of Pocket Maximum – The most you could pay during a coverage period (usually one year) for your share of the costs of covered services. After you meet this limit, the plan will usually pay 100% of the allowed amount. This limit helps you plan for health care costs. This limit never includes your premium, balance-billed charges or health care your health insurance or plan doesn’t cover.
- Health Savings Account (HSA) – A bank account that lets people put money aside, tax-free, to save and pay for health care expenses. The Internal Revenue Service (IRS) limits who can open and put money into an HSA.
- Flex Spending Accounts (FSAs) – Flexible Spending Accounts (FSAs) are a provision of the IRS Section 125 tax law that allows you to deposit a tax-free portion of your gross income into a savings-like account which is then used to reimburse you for certain out-of-pocket expenses.
|Jointed Pneumatic Leg Device $1,490|
|The Actual Surgery $3,000|
|The Pathology Report $485|
Total Billed: $6273
Total Patient Responsibility: $986 (15.7%)
Did I choose the right plan? Since I haven’t reached either deductible ($1,000 or $2,000), there’s not much comparison. I knew I would be spending more yearly with the plan I chose, but in case of emergency, it’s a choice I would not regret.
Final thoughts: Thank you Lord for health insurance!
July 17, 2018 Update:
So I received a letter dated 27Jun2018 that the surgery center actually submitted a claim of $22,000 for the surgery. That’s $19,000 more than the surgery number above ($3,000). Additionally, to date I have not received a bill for the pneumatic leg device ($239.12). For the sake of transparency and completeness, I updated the numbers below.
Total Billed: $6273 + $19,000 = $25, 273
Total Patient Responsibility: $986- $747.40 (3%)