Two years ago when I first joined my new company, I was planning on laser eye surgery so I stuck with the Flexible Spending Account option with a PPO health plan. I was familiar with saving all year for my health expenses so it was easy to do and a no-brainer.
Then open enrollment came around and I thought I should try out this High Deductible (HD) Plan with Health Savings Account. It seemed pretty reasonable for me since I’d been pretty healthy the last 5 years and I wasn’t planning on having kids in the near future. I was able to save enough money to pay for my final crown out of pocket and still have some money left in my account for savings. I was too busy to see any doctor all year. Thus I didn’t really get what it meant to have this plan.
Fast forward to January 2010 and I’m deathly ill. I’ve made friends with a woman at work who also has the same insurance carrier, but through her husband’s insurance plan, i.e. not our company HD Plan. That’s ok, I’m just happy to find an in-network General Practioner that’s not a pediatrician. (For some reason all the DC GP’s in the plan are pedes.)
First problem with the HD Plan is that the doctor’s office has no idea what my co-pay is. They charged me a cursory $15 but they actually won’t know what I owe until they submit my expenses for reimbursement. I have this fear that it will be a crazy amount of money for that fancy spirometer test they ran.
Second problem is that my pharmacy benefit is really lousy under the HD Plan. How lousy? I was prescribed 2 drugs.
Drug A without prescription is ~$174.00.
Drug B without prescription is ~$47.00.
Drug A with prescription is $130.46. (25.0% discount)
Drug B with prescription is $37.71. (19.8% discount)
Crazy huh? I *knew* I should have asked for samples or different medications. Maybe I should have gone with the PPO with a $10 pharmacy benefit. Or maybe I should have driven over to the Wal-Mart out near the doctor’s office and crushed every last personal integrity crumb I have and made the Walton family richer for a $4 generic on Drug B.
The only saving grace in this financially is that my company throws fee money at me for having the HSA and it’s enough to cover the drugs and the $15 co-pay.
So far so good. I guess it’s true what they say, “DON’T GET SICK!!” LOL
(For what it’s worth, I never did see a “doctor”. I saw a pretty awesome LNP. I am a big believer in Nurse Practioners so I’ll probably stick with her since my friend’s doctor isn’t taking any new patients.)
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I’ve had this sort of plan for a couple of years (although my prescription drugs are only subject to a small co-pay, rather than going toward the deductible).
The upside is the thousands I save in premiums each year. Last year, for example, I was fully responsible for a few hundred bucks at the end of the year. Not a big deal – it was peanuts compared to what I saved in premiums over the past year.
Being able to roll over unused HSA money is great, too.
I really would check out Walmart. You can go on their website to view their list of $4 or $9 meds. Plus they often have lower prices on medications not on the list. I just wrote a post praising their pharmacy but it’s not scheduled for later this week! I think when it comes to health and medication, it’s okay to go to Walmart. They have saved me hundreds.
No. I really won’t check out Wal-Mart. I dislike they way the strong arm their suppliers into bankruptcy. It’s a disgusting business practice.
FWIW, I went and looked at the $4 medications for asthma and they would do me very little good. I need an inhaler, not tablet or liquid form. And the other drug is not on there because it’s not a generic. If it was, I am sure I would have paid a lot less with my coverage.
$4 prescriptions are great for people who are really poor and can only afford $4. I made $17K one year and was glad to get $5 meds at a local university hospital, but the point of being middle-class and having a good job with health insurance is that I shouldn’t have to think if I can pay for my meds or turn the heat on this month, savings or not. $200 was a really huge amount of money to pay and I wonder what will my HD Plan actually cover.
I have buyer’s remorse. I do not think that suppressing my use of health insurance till I overuse it is a good idea. It’s crazy, but that is the point of an HD Plan at the core.
I think there are a few other pharmacies that having pricing similar to WM on the cheaper generics. I’m almost certain Walgreens does.
Don’t lose track of the money you’re saving on premiums. It might be hard to pay a $500 bill when you run out of the employer-funded money in the HSA, but if you’re saving a few grand on premiums, you still come out ahead.
The point of the HSA plans are to avoid a lot of visits for really minor things that don’t necessarily need professional medical attention. But if your visit resulted in two prescriptions, this was probably a necessary visit
Are you going to change to a regular PPO when open enrollment comes again? I’ve never had a HSA before but I feel like it’d deter me from going to the doctors too much. I hope you get better soon. Those prescription drug prices are crazy!
I’m on my first year with an HSA plan. I have two prescriptions, both which were astonomical. My doctor was able to procure a discount card from the manufacturer on one prescription and the other I’ve accepted that I’ll pay a ton for. It’ll definitely be a year to save receipts and pencil it all out before open enrollment season.