888-765-5400Making Cents out of a Blue Options HSA
Many people choose a copayment plan because they want the predictability of knowing exactly how much they will pay out of pocket for doctor visits and prescriptions. However, many people who purchase these plans don’t realize they are paying hundreds of dollars extra each year for the convenience of copayments. In a traditional copayment health plan, you generally pay for health care like this:
+ You pay a relatively high monthly premium for coverage.
+ When you see an in-network doctor for an office visit, you pay a copayment.
+ When you fill a prescription, you pay a copayment.
+ When you go to the hospital, have a procedure, or have lab tests, you pay a fee that is applied toward your deductible.
+ When you meet your deductible, you begin paying coinsurance, until you meet your coinsurance maximum for the year.
Any copayments you pay for office visits and prescriptions are not applied to your deductible. Costs for services such as lab tests, procedures and hospitalizations are applied to your deductible.
The truth is 73% of customers with a traditional copayment plan don’t reach their annual deductible. This means you can end up paying high-dollar premiums, month after month, pay copayments visit after visit, and yet never reach your deductible. And even after you meet your deductible, you still must continue to pay copayments for office visits and prescriptions.
The High Deductible Health Plan
With a high-deductible health plan, you pay a much lower premium, but you pay your health expenses up front until you meet your deductible.
+ Instead of paying copayments for in-network office visits and prescriptions, you pay the negotiated discount rate for your medical care, until you meet your deductible.
+ After you’ve met your deductible, you pay coinsurance until you meet your out-of-pocket or coinsurance maximum (the deductible plus the coinsurance maximum).
+ With a high-deductible health plan, no matter how much care you need, you’ll never pay more than your out-of-pocket maximum for the plan year for in-network covered services.
+ High-deductible health plans always offer 100% coverage for preventive care, such as annual physicals, immunizations, mammograms etc., regardless of whether or not you’ve metyour deductible.
All qualified medical expenses are applied to your deductible — this includes prescriptions, office visits, emergency room visits, procedures, lab tests and more. For a list of qualified medical expenses visit www.irs.gov and reference Publication 502.
Information in this article is from a BCBSNC post and can be found at bcbsnc.com.
For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.