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NWR: Health Insurance Plans
Open enrollment is going on right now at our jobs and we are kind of overwhelmed by options. Admittedly, insurance has always confused me anyway, just doubly so now.
H currently has a high deductible plan- his company actually gives them a decent chunk of money toward the plan. I have the choice of a high deductible but I have heard they are not great for pregnancy (we plan to start trying in the next month or 2). When I look at total out of pocket, I think it kind of makes sense for us to stay each on our own policies (the cost for adding a spouse is more than double a single person).
What do y'all do?
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Re: NWR: Health Insurance Plans
High deductibles are only good for a large family with super high medical bills. I would find out what's important to you: a low deductible? Medication coverage? And choose your plan that aligns with what is important to you. For me it was durable medical supplies and medication coverage.
We have a fairly low in-network deductible ($650 I think?) and max out of pocket of $2500. You can imagine that I hit my deductible and max out of pocket in one day this year. When all is said and done, I believe my medical bills will be close to $1M for the year.
I'm the fuck out.
FWIW, I would not do high deductible if you're TTC - that's a LOT of prenatal visits to pay out of pocket. I have no copay for any prenatal care beyond the first $25 visit to determine pregnancy, then it's a 550 copay plus an additional like 1300 in labs and whatnot. High deductible plans are more beneficial for people who are willing to risk not needing a doctor at all.
My plan also offers tremendous support while pregnant/trying to get pregnant. We're trying right now, but if things don't go well, I've got great coverage for infertility testing/fertility treatments should we decide to go that route. It's part of the reason I chose the plan I did - the maternal health coverage is more than other plans.
It depends on how it's set up. Do you have a benefits card (like a debit card) for the account? If you do, and there's a pin where you can withdraw the cash, you certainly can take the money out and use it for whatever and just pay the penalty on it. You'd have to pay back the amount that you spent plus a 20% penalty (I believe that's the current penalty percentage).
That's the shitty thing about FSAs. You can only use the funds on expenses that occured within the plan year that you elect the FSA. So if you have an FSA in 2013, you can only use it for service dates within 2013. So even if you don't get the bill until the next plan year, you can't use the FSA to pay it since you didn't incur the service within that plan year. I HATE FSA accounts, unless you have planned monthly expenses like prescriptions or you know you need glasses or your kid needs braces.
I'm a little rusty on the penalties so I would double check with your HR office or you can google it, but I do believe there is a 20% penalty that you have to pay on any expenses that aren't deemed eligible (someone correct me if I'm wrong!).
If it's set up to mail in your receipts, you won't get anything through that isn't an approved item. Also, if you have a card attached to your account, unless you can swipe it as debit and withdraw cash, you'll most likely be required to send in receipts to substantiate the purchase. If it's deemed not eligible, you just have to pay that amount back and there's no penalty. It's only if you get audited that you would incur that penalty.