Do you worry about your deductibles and coinsurance?
About this time every year millions of people go through the dreaded open enrollment period put on by their employers human resources department. I have been a public employee for over 15 years and have gone though several of these enrollments. I never enjoy them. This period usually causes people a great deal of anxiety over wondering if their benefits will remain the same and/or if they will have to pay more out of pocket for their medical and dental care. I have been lucky over the years because I have always had employers who offered good quality health insurance at a good price. Sure, the individual and total family deductibles have crept up over the years, but the core medical coverage has always been good.
I have detailed the basics of what my family coverage will be this year (2014) and based on what I have heard about people losing coverage nationwide due to the ACA (Affordable Care Act), I am very happy to have the coverage at the levels I do. Even though the employer mandate portion of the ACA has been delayed for a year, my employer has went ahead and enacted the provisions for this year. This means that even though costs might rise next year when it is implemented nationwide, the impact should be mitigated due to the fact that myself and my employer are already paying some of the cost for it.
Number of people in my family : 4
Individual deductible : $3,000
Total family deductible : $6,000
Total yearly out of pocket : $8,000
Coinsurance after deductible is met : 10%
Total bi-weekly cost : $131.00
Employer payment into HSA $1,000
As you can see, my employer makes a one-time payment of $1,000 into our family HSA (Health Savings Account) which reduces the total family deductible and total yearly out of pocket. However, I still worry about being able to meet the entire deductible should an accident or illness in my family happen. Luckily my employer has contracted with Allstate to provide group accident insurance at a very reasonable cost. In fact, it only costs me $15.00 dollars a check (bi-weekly) with my employer picking up some of the cost as a benefit. So, what benefits do I (and my family) get for $15 a check? We get accidental death insurance, common carrier death insurance, daily hospital confinement rates, and emergency room services benefits plus a litany of benefits for various types of injuries such as burns, lacerations, etc. The covered list is very extensive and includes most of the ways you could hurt yourself in an accident. The benefits that pay for these injuries are designed as a supplement to regular insurance to help meet out-of-pocket expenses, not pay the whole cost of the damage done by the injury.
The best part about this benefit is that it will pay $200 per day, per family member for a hospital stay of up to 90 days. In addition, it will pay $400 a day for up to 90 days in intensive care. These benefits would go a long way to meeting our total family deductible and out-of-pocket expenses should an accident occur. I would say that is a pretty good level of coverage for $15 a check and would encourage anyone who has an employer that offers this service to take advantage of it. There is one major drawback to this coverage though….the payments stop at 90 days for hospital stays. But, after the 90 day period you will probably have met your out-of-pocket max, unless your stay in the hospital bleeds over (pardon the pun) into the next year and a reset happens to your yearly out-of-pocket expenses.
The meat of the potatoes
Dealing with the yearly insurance game either by employer or private purchase kinda sucks, but it is a fact of life that has to be dealt with. I have never met anyone who was particularly happy with their yearly changing insurance, but in the end they always made an informed decision on which policy they would choose. If you remember to examine all of the benefits your employer might have open to you, you might find that purchasing some group accident insurance could really save you some money should you get in an accident. I hope my family never needs the coverage, but I take comfort knowing that it is there.