First Person: When Lower Health Insurance Premiums Aren’t a Benefit

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I receive my health insurance benefits through my spouse's place of employment. For the first six years that I was on the plan we paid a set amount of one hundred and fifty dollars bi-weekly for our insurance and then we had to pay a co-pay every time we would go do a doctor. We paid thirty dollars for a family doctor visit, forty dollars for a specialist and fifty dollars for either an emergency room visit or a trip to urgent care. Once we paid the co-pay everything else related to the visit was paid for through our insurance company.

This past year, however, our benefits were changed from a co-pay system to a health savings account system. Under this new system we are now paying approximately seventy eight dollars bi-weekly, which is almost half of what we had previously paid for our premiums. In addition we were given one thousand two hundred dollars to start off our health savings account, money which we could use any way that we saw fit for any health expense. While this sounded like a really good money saving deal at the onset, just over three months into the new system we are learning the true cost of this new plan.

There is no longer a co-pay for this new insurance plan. Now, each time we go to the doctor we simply go to the appointment and wait for everything to be processed through our insurance. We then receive quite lengthy and complicated explanations of benefits which you almost have to be an insurance specialist to understand with itemized charges, broken down over several pages, for everything that was involved and billed for in the previous doctor visit. The only thing that is easy to understand is that the insurance company covers none of the bill and we are responsible to pay the full amount until we reach our deductible of three thousand dollars for the year. After this deductible has been met the insurance company will pay for eighty percent of any doctor visit, still leaving us to pay the remaining twenty percent.

To pay these incoming bills we are supposed to use the funds from our health savings account since all money in this account comes from pre-tax dollars. To maintain our health savings account we were advised by my spouse's employer that we should add to this account bi-weekly through a set pre-tax payroll deduction. The amount we added bi-weekly was up to us and we could adjust our deduction at any time. Not knowing how much we would need to add each month we decided to start conservatively by adding twenty five dollars bi-weekly to this account until we had a better understanding of how this new plan would work. However, after just three months we are considering the reality that we will have to significantly increase our bi-weekly contribution since we have already used almost three quarters of our original twelve hundred dollar account for both doctors bills and monthly prescriptions.

If the first three months of this plan are an indication of what the next three quarters will bring then we will be paying approximately the same amount or more for our health care this year as we paid last year. This just goes to show that paying a lower premium price for health insurance is not always a benefit.

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