Obolacare Open EnROLOLment

Obolacare

Here it is again, that time of year that used to be a simple tradition that’s turned, in the past couple of years, into a week of anxiety and trepidation: Open Enrollment.

I am really grateful that my husband’s employer provides healthcare, and we haven’t been thrown onto the Obamacare Exchange. And looking at the choices we have this year, I can tell that the company worked really hard to come up with plans that both the company & the employee can afford. But there have been changes, and a bigger squeeze on both. I call it the Obolacare Effect.

In our case we get a choice of two traditional health insurance plans, one better and more expensive than the other, and “the new trend in healthcare benefits” – a High Deductible Health Plan (HDHP).

Since I was looking at family coverage, I’ll talk about family rates here.

HDHP is where you pay all the costs until your deductible is met, then insurance kicks in and pays their part (80% in network, 60% out of network). How much is the deductible? It depends. In network it’s $3,000, out of network it’s $6,000. There is an out-of pocket maximum, again with different levels: $12,000 in-network, and $15,000 out of network.

To sweeten the deal, the HDHP comes with some incentives – a tax-free Health Savings Account that you can rollover yearly, anyone in your family can contribute to, goes with you if you change jobs, and can be bequeathed if you die. Also you get free preventive care: annual physical, well-woman & well-child care visits, immunizations, and mammograms & colonoscopies.

So if a family were to pick the HDHP, they can expect to contribute monthly premiums slightly lower than the cheaper traditional health plan (for us it would be around $30 cheaper per month) and sock away a bunch of money in an HSA. How much money? The family would have to budget to spend a minimum of $3,000 (in-network deductible) plus the 20% above that, up to a maximum of $12,000, if they were careful and lucky enough to be able to stay in-network. Otherwise they could be on the hook for up to $15,000.

Who would this plan work for? At a guess, healthy young individuals who hardly ever go to see the doctor because they are sick and are careful about not getting into accidents. They can use the HSA to save for when they get older & sicker. I don’t see how this would work for us as a fairly typical family, specially with lab tests for chronic conditions. For us we will go with the lower end traditional health care plan. Even with higher co-pays, it still will work out for less money, fingers crossed and the skies don’t fall.

On the bright side, at least we get the “tobacco-free” rates on our premiums. Heaven help us if they ever start a “chocolate-free” rate.

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