It is that time of year when companies and the government have open enrollment for health plan coverage. If you are lucky enough to still be working, and you company offers these benefits, you may have what is called a Cafeteria Plan. This is where you go down a long list of possible dishes and pick the ones you like. Those folks on who are retired or disabled will need to look at their Medicare, Medicaid, Supplement Plan A, B, or C and various other options that are available. If you watch TV this is presented as a easy and non threatening event. Just turn on your laptop and go to the government website and begin reading and choosing the best option for you. Right!!!!!!!!!
While sitting in my open enrollment session this year I reviewed the various forms that were sent for me to review in advance. The 2013 Insurance Rates, Dental Plan Summary, Dental Plan Enrollment Form, Vision Plan and Summary, and copies of the various Health Care Plans available, based on the contract that my company had signed. First of all there is the issue of what is a PPO, the HDHP (High Deductible Health Plans) both Standard and Enhanced, the HSA (Health Saving Account) and their various options, along with a Salary Redirection Form, so they can get the premiums taken out of my check.
I don't know when heath care became so complicated, but I image he probably occurred when the politicians and capitalist, decided that private industry could do a better job of providing it that the city, states, and federal government. If I got hurt or sick i went to the hospital, they took care of me , and then sent me the bill. Once all the hospitals became "for profit" establishments. insurance became almost mandatory for service, the cost sky rocketed, and the ability to take care of ourselves went down the tubes.
Now I have to figure out my contribution to pay for the insurance plans and also know what the company is kicking in. Some plans have co-pays (what does this really mean?) and deductibles like car insurance. Once I reach my deductible the insurance kicks in at some rate 70%,80%, or maybe even 100% of the cost of health care for the rest of the year. But wait there is a catch. I have to use a doctor or service "in network". So now I have another manual to go through to make sure I going to the right people or facilities that want to pay ball with the health care provider. Also, one must look at the prescription drug clauses, since you can get cut rate costs on some drugs, or generics, depending on which plan you take.
Now I can have one of these plans, but I also need to see if dental or vision coverage is included. If not I need a plan for these. I have to remember these have yearly caps on them, plus some have higher deductibles, may or may not cover the braces or frames fro the glasses I want. Timing is everything here in terms of when you get things done. There is also the HSA, which is like a saving/credit card account where you can save up money just pay medical bills. This is a way to get enough money saved up pre taxed to pay your deductibles with. Yeah, assuming you have the money. Anything that you don't use is yours to keep, but watch out for Uncle Sam, since there are a variety of tax implications. Since I am over 55 I can even add an additional $1,000 over what most people can have as a maximum contribution. Wow, they call that a "catch up" contribution.
Unfortunately I don't have the time or inclination to scour through all the pamphlets, brochures, and notebooks to learn all I need to know about the plans and health care. I'll pay the minimum amount for the medical premium, dental, and vision and hope this year that I don't reach my deductible. This year my wife has her own plans from her job so I don't have to pay for a couples plan which would be eight times as much as the single plan. Who would have thunk it.
And some of the people in our government want serior citizens to go out into these shark infested waters and negotiate for the best deal on health care with vouchers? Surely you jest.
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