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We do analyze the options from the perspective of individuals as well. The most basic insurance plan available caps out of pocket expenses at $6350, which whil

by xiaosun 13y ago

We do analyze the options from the perspective of individuals as well. The most basic insurance plan available caps out of pocket expenses at $6350, which while is still significant but likely won't cause medical bankruptcy. Even the most "premium" plan only caps out of pocket expenses at ~$3000, yet would cost $3000-5000 more in premiums. A premium plan would provide a nice sense of security, but might be the best option to minimize expenses for an employee.

philsnow 13y ago
> The most basic insurance plan available caps out of pocket expenses at $6350, which while is still significant but likely won't cause medical bankruptcy. Even the most "premium" plan only caps out of pocket expenses at ~$3000, yet would cost $3000-5000 more in premiums. are those caps per year ? per incident ? even if they are per year, that doesn't make sense. you're asking me to believe that people have been paying $3000 more to cap their risk for the year at a number $3000 lower. It can't be that simple, or else people have been leaving money on the table.
- hamburglar 13y ago
  It's not quite this simple, but I can tell you that people have been leaving money on the table. This year I finally sat down and worked out the spreadsheets and last year my family paid nearly $12k in premiums + out of pocket and yet we had only $6k in actual costs. We are now on an HDHP that costs $1500/year and pays for hardly anything initially, but caps our annual out-of-pocket at around $12k. The upshot is that we save $5-6k in a typical/easy year and in a worst case year we pay an additional thousand or two. Seems like a pretty good trade-off to me. The part I don't like about it is I've been raised in a world where you DO NOT ask the cost of a service when your health is on the line -- you just do what the doc says -- but now it's sensible for me to concern myself with the cost since they are coming out of my pocket directly (until I hit the cap). Doctors in the US are not typically prepared to discuss specific costs with you. This patient attitude and doctor attitude are each partially responsible for our health costs bring so out of control, in my opinion, and it is going to be a while before I can ask, "how much is this procedure for my child going to cost, and just how necessary is it?" without getting a dumbfounded stare in response and feeling like a crazy penny pincher.

by xiaosun 13y ago

philsnow 13y ago

> The most basic insurance plan available caps out of pocket expenses at $6350, which while is still significant but likely won't cause medical bankruptcy. Even the most "premium" plan only caps out of pocket expenses at ~$3000, yet would cost $3000-5000 more in premiums. are those caps per year ? per incident ? even if they are per year, that doesn't make sense. you're asking me to believe that people have been paying $3000 more to cap their risk for the year at a number $3000 lower. It can't be that simple, or else people have been leaving money on the table.

hamburglar 13y ago
It's not quite this simple, but I can tell you that people have been leaving money on the table. This year I finally sat down and worked out the spreadsheets and last year my family paid nearly $12k in premiums + out of pocket and yet we had only $6k in actual costs. We are now on an HDHP that costs $1500/year and pays for hardly anything initially, but caps our annual out-of-pocket at around $12k. The upshot is that we save $5-6k in a typical/easy year and in a worst case year we pay an additional thousand or two. Seems like a pretty good trade-off to me. The part I don't like about it is I've been raised in a world where you DO NOT ask the cost of a service when your health is on the line -- you just do what the doc says -- but now it's sensible for me to concern myself with the cost since they are coming out of my pocket directly (until I hit the cap). Doctors in the US are not typically prepared to discuss specific costs with you. This patient attitude and doctor attitude are each partially responsible for our health costs bring so out of control, in my opinion, and it is going to be a while before I can ask, "how much is this procedure for my child going to cost, and just how necessary is it?" without getting a dumbfounded stare in response and feeling like a crazy penny pincher.