“Which health insurance plan do you have?” That is the question I’m asked about every few weeks. And I certainly understand why clients want to know. I can choose any plan with any Ohio carrier. And there are a lot of great choices here in Ohio. Anthem. UnitedHealthcare (they market Golden Rule plans). Aetna. And don’t forget Medical Mutual, which is a non-profit company, and features very competitive pricing.
Well…here’s our situation. I’m 54, my wife is 39 (I thought she’s 51, but she claims she’s 39) and we have two children (both teenagers). Fortunately, we are a very healthy family with no existing conditions or ongoing medications. We live in Springboro, which is located between Dayton and Cincinnati. Most of the carriers offer a wide variety of plans with several deductible and copay options.
The perfect fit for us is the Anthem Lumenos Health Savings Account (HSA). An HSA works best when family members are not being treated with many (or any) office visits or prescriptions, and insuring against the catastrophic loss is the most important objective. Preventative coverage (Routine annual physicals, OBGYN visits, mammograms and pap tests) are not subject to our $6,000 family deductible.
Also, with an Ohio HSA, covered out of pocket expenses that we pay (such as non-preventative office visits) receive a “negotiated discount” since Anthem enjoys exceptional leverage in negotiating fees with Network providers. Lab and X-ray fees receive substantial discounts. For example, if one of us needed an x-ray, and the retail charge was $150, our out of pocket cost would be about $25-$40. That’s not too bad! The cost of an MRI can be discounted from a retail price of $1,200 to about $700-$800.
We also contribute tax-deductible funds into the account that are used to pay for qualified medical, dental and vision expenses. Because we have enjoyed good health, the fund balance in our HSA continues to grow each year. And generally, premiums don’t increases as rapidly as a typical copay plan. Yearly increases the last few years have been very low and I assume this health insurance trend will continue through 2014.
What Is Your Best Plan Option?
An Anthem HSA is not the best policy for everyone. For us, it is, although Medical Mutual was strongly considered.Many other carriers offer excellent PPO and HMO copay plans, but they are not the most cost-effective policy for our household.
What about you? Every family and individual situation is different. Your needs and budget are unique, and may change each year. You may only need coverage for a few months. If you are eligible for Group benefits through your employer, the rate may be lower than purchasing a private plan.
2021 Update: We still have an HSA, but it is an Aetna HSA. It’s a grandfathered plan with a $3,000 deductible and a very low rate. Aetna offers Senior Medicare and Group plans in Ohio, but not private medical coverage.