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Author Topic: it's benefit enrollment time again...  (Read 1105 times)

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Offline KaelynsMom

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it's benefit enrollment time again...
« on: October 26, 2015, 11:13:49 AM »
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  • I seriously hate this time of year. I don't think I have ever had so much trouble deciding before. We will now have a new RX deductible on top of our regular deductible and beyond that I feel like I am still suffering with the "brain fog" that accompanies the adrenal fatigue so trying to make heads or tails of this is crazy. My husband is clueless. Anyone have a tried a true method of figuring out what is best?
    -Stephanie  Mom to Kaelyn, age 7 DX 10/31/10




    Offline stefaniemsmith1

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    • Discovering Our New Normal
      • Life With My Giggly Girls
    Re: it's benefit enrollment time again...
    « Reply #1 on: October 26, 2015, 01:08:03 PM »
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  •  :-\  Wish I had some advice for you but I have no experience with this.  Praying that you find exactly what you need for the best price.

    Wife to my hero, Kevin
    Mom to Mackenzie (14, T1, DX 9/17/12, Pinging Green)
    & Kayleigh (7, T1, DX 11/20/12, Podding)
    www.prncsstefy.blogspot.com
    http://www.facebook.com/GigglyGirls

    Offline SarahMay

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    Re: it's benefit enrollment time again...
    « Reply #2 on: October 26, 2015, 03:35:37 PM »
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  • Ooh I feel ya. Our method involves spreadsheets, random scribbled notes, and usually tears. I try not to think about benefit enrollment season until it's upon us because otherwise I get anxious in advance. (And we have decent insurance!)

    Okay but seriously. The others here are much better/more experienced, but I would start with:
    1. Do you have to decide between different plans/deductible levels? (I assume there's a choice to make, otherwise there's no debate.)
    2. Do you have a general idea of how much your monthly supplies cost? (So you can estimate which plan ends up being more beneficial.)
    3. Do you have state aid, and do you know how much they pick up?

    In general, the T1Ps have taught me that a low-deductible plan *usually* ends up better in the long run because we'll hit the deductible so quickly and only pay the co-insurance from there forward. (The exception would be if the monthly premiums for a low-deductible plan are astronomically high.)

    Sending hugs. I'll need them back in February when it's time for us to re-up.  <hug>
    Sarah - wife to Aaron, mom to
    Matthew (9) non-D
    Jonah (8) DX 02/05/14 (Animas Ping, Dexcom)
    Isaiah (8) DX 01/10/13 (Animas Ping, Dexcom)
    Gideon (5) non-D


    Offline oddangela

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    Re: it's benefit enrollment time again...
    « Reply #3 on: October 26, 2015, 04:53:45 PM »
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  • We make spreadsheets.  We include the cost of premiums, deductible, supply costs, oop max.

    For us the past 2 years the best choice has been the cheapest premium with the highest deductible.  Given our costs it was several hundred cheaper over the whole year to get the cheapest plan.  The most expensive (and lowest deductible) would have cost us several thousand more over the year due to more expensive premiums.  On the cheap plan we know exactly how much we will spend (total premiums plus total out of pocket- which we know we will hit) and that's that.  Just sucks how much of it we have to come up with in Jan/Feb.
    Angela- Mom to S- 8/9/04 (dx 5/4/11)  G- 6/4/08 and L- 4/3/12 and W- 3/18/15

    Offline Mich*09

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    Re: it's benefit enrollment time again...
    « Reply #4 on: November 01, 2015, 07:29:06 AM »
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  • Yes, our experience is just like Angela's.  Highest deductible is the best for us too because the lowest deductible plan costs so much more in monthly premiums.

    We also have benefit of a secondary insurance through the state that he qualifies for based on his dx.  That has been a wonderful thing the past 6 years.  Unfortunately, it will only cover him until he is 21 which will be this coming June.  I sure wish it carried him until 26 like health insurance plans do now.
    Michelle
    Mom to - Jordan 22, Grant (19 dx 9/17/09 MM Revel 6/1/10), Brett 16

    Offline SarahMay

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    Re: it's benefit enrollment time again...
    « Reply #5 on: November 01, 2015, 09:38:53 PM »
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  • Okay, maybe I misspoke. Will know better when we re-up again. But for us a "high" deductible plan is something like $8,000/person, which even with T1D supplies takes a long time to reach. Is that normal? Or are other people's high deductible plans lower than ours?
    Sarah - wife to Aaron, mom to
    Matthew (9) non-D
    Jonah (8) DX 02/05/14 (Animas Ping, Dexcom)
    Isaiah (8) DX 01/10/13 (Animas Ping, Dexcom)
    Gideon (5) non-D


    Offline oddangela

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    Re: it's benefit enrollment time again...
    « Reply #6 on: November 01, 2015, 11:40:23 PM »
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  • Okay, maybe I misspoke. Will know better when we re-up again. But for us a "high" deductible plan is something like $8,000/person, which even with T1D supplies takes a long time to reach. Is that normal? Or are other people's high deductible plans lower than ours?

    Okay- from what I'm reading $8000 per person is higher than the individual oop max allowed under aca... maybe I'm missing something?

    Our current plan has a $3500 deductible (it's complicated though...  actually 2 plans, a basic higher deductible plan and then a "wrap")   And that was the highest deductible on our choices last year.

    Here are some links where I'm seeing the highest deductible allowed.  There are more rules going into effect this year too...

    http://www.shrm.org/hrdisciplines/benefits/articles/pages/embedded-oop-limits.aspx

    last year, but
    https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/

    http://groupservicesinc.com/blog/aca-copayment-deductible-limits

    Angela- Mom to S- 8/9/04 (dx 5/4/11)  G- 6/4/08 and L- 4/3/12 and W- 3/18/15

    Offline Mich*09

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    Re: it's benefit enrollment time again...
    « Reply #7 on: November 03, 2015, 10:21:27 PM »
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  • Our high deductible is $3000.  Or I should say, was.  I haven't done a nose dive into the changes for the upcoming year yet.  But they have said our expenses will be higher.
    Michelle
    Mom to - Jordan 22, Grant (19 dx 9/17/09 MM Revel 6/1/10), Brett 16

    Offline SarahMay

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    Re: it's benefit enrollment time again...
    « Reply #8 on: November 04, 2015, 11:13:32 AM »
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  • Now I'm second-guessing my numbers. But I'm too busy (lazy?) to look them up.

    So just ignore everything I said and listen to the true experts.  :D

    ETA: $2500/individual, $5000 family deductible
            $10,000 OOP max
    « Last Edit: December 17, 2015, 01:01:05 PM by SarahMay »
    Sarah - wife to Aaron, mom to
    Matthew (9) non-D
    Jonah (8) DX 02/05/14 (Animas Ping, Dexcom)
    Isaiah (8) DX 01/10/13 (Animas Ping, Dexcom)
    Gideon (5) non-D




     


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