Friday, October 14, 2016
Medical insurance: phase one deductible met
My new medical insurance "year" took effect 9/1/16. As of this week, we have met the first of a 2 tier deductible system as part of my High deductible/Heath Savings Account (HSA) plan. We pay all costs, luckily at a discounted rate if "in plan" with a provider, until we incur $4000 worth of expenses. I am calling this phase one. Yeah, it only took us about 5 weeks.
From this week on, all expenses, while in plan (rare for us to go out of network with the exception of one MD) whether for medical or RX, there is another phase with a co-pay system where we are responsible for 10% of costs. This continues until we have met the second deductible of an additional $2000.
$6000, if in plan, is a LOT of medical costs to absorb. How do I address this? I make sure that $6000 of pre-tax monies are deposited into my HSA account, from which I pay out on the aforementioned costs. I know that $6000 is the maximum that we would incur, so I plan accordingly. My monthly budget doesn't include this cost as it is based on take home pay(prorated for 12 months, and now at the retirement level).
Knowing how this system works, we plan accordingly. For example, DS #1 needs to return to the eye MD, but is making a low salary. Although his in network provider visit will be covered as it's a medical and not just an eye aka vision screening appointment (another insurance loophole), even if charged $200, he'd only be incurring a $20 co-pay fee. Very do-able, even on his wages. One of my maintenance RX's costs over $800 for a 3 month supply. I refill based upon the status of our deductible. The aforementioned RX is ready to be refilled (I had stockpiled a bit last year as a stopgap measure on all of our RX's whenever possible) as of Oct. I will refill in Oct, Jan, April and July during this current insurance plan year, which will expire come the end of August, 2017. In the interim, I am guessing within 5 months, we will meet this second deductible, at which point all medical costs, if remaining with in plan providers, will be covered at 100%.
It's a bit of a game, but I am very familiar with it. We've got this.