3 ms·

When I was looking (a few years ago, in California) I had trouble finding HSA plans that included prescription-drug coverage (even with a very high deductible)

by mjn 13y ago

When I was looking (a few years ago, in California) I had trouble finding HSA plans that included prescription-drug coverage (even with a very high deductible) for less than ~$400-500/mo. There were plans cheaper than that with no drug coverage (starting around $200), but that leaves you on the hook for unlimited liability if you end up needing an expensive prescription (and some can be very expensive). I was looking for something where I self-insure the first $10k in an HSA, and then the plan covers hospitalization+drugs past that. And those exist, but not at the lowest end.

mgkimsal 13y ago
It seems it's a bit of a shell game... $500/month with some prescription coverage is a guaranteed $6k/year. $200/month without prescription coverage is a guaranteed $2400/year - $3600 savings. If you know you'll have more than $3600/year in prescription costs, then this plan doesn't necessarily make sense, but unless you know you'll have that much in costs, it doesn't matter. I was looking for something where I self-insure the first $10k in an HSA, and then the plan covers hospitalization+drugs past that. And those exist, but not at the lowest end. Not sure what you mean. Those are the only HD/HSA plans I see - you self insure up the first $2k/$5k/$10k, and the insurance plan covers stuff after that. Most I've seen, deductibles under $10k carry a co-insurance split between you and the insurer up to a certain amount. In our case, if we just took the $10k deductible, we'd get everything covered after our initial $10k, and that is the 'lowest' end (I'm thinking you're meaning cost - maybe you mean something else?)
- mjn 13y ago
  My worry is coverage of prescription drugs above $10k/yr. I'm perfectly fine paying for normal prescription drugs, but when I was looking for high-deductible insurance, all the cheaper plans explicitly said "no prescription drug coverage", even above the high deductible, which I didn't feel comfortable with. To me the idea of the high-deductible plans was that I cover regular costs in return for coverage in the event of a catastrophic illness. For example, in the unlikely event I'm diagnosed with MS and need a Copaxone prescription ($40k/yr), I can't self-insure that amount.
  - mgkimsal 13y ago
    Maybe mine's different - any medical cost over the deductible is covered - prescriptions or hospital visit or whatever??

by mjn 13y ago

mgkimsal 13y ago

It seems it's a bit of a shell game... $500/month with some prescription coverage is a guaranteed $6k/year. $200/month without prescription coverage is a guaranteed $2400/year - $3600 savings. If you know you'll have more than $3600/year in prescription costs, then this plan doesn't necessarily make sense, but unless you know you'll have that much in costs, it doesn't matter. I was looking for something where I self-insure the first $10k in an HSA, and then the plan covers hospitalization+drugs past that. And those exist, but not at the lowest end. Not sure what you mean. Those are the only HD/HSA plans I see - you self insure up the first $2k/$5k/$10k, and the insurance plan covers stuff after that. Most I've seen, deductibles under $10k carry a co-insurance split between you and the insurer up to a certain amount. In our case, if we just took the $10k deductible, we'd get everything covered after our initial $10k, and that is the 'lowest' end (I'm thinking you're meaning cost - maybe you mean something else?)

mjn 13y ago
My worry is coverage of prescription drugs above $10k/yr. I'm perfectly fine paying for normal prescription drugs, but when I was looking for high-deductible insurance, all the cheaper plans explicitly said "no prescription drug coverage", even above the high deductible, which I didn't feel comfortable with. To me the idea of the high-deductible plans was that I cover regular costs in return for coverage in the event of a catastrophic illness. For example, in the unlikely event I'm diagnosed with MS and need a Copaxone prescription ($40k/yr), I can't self-insure that amount.
- mgkimsal 13y ago
  Maybe mine's different - any medical cost over the deductible is covered - prescriptions or hospital visit or whatever??