Just in case you are thinking about switching to an HSA qualified High Deductible Health Plan to save money on premiums and put that money into premiums, you should know about the wellness option offered on many plans. We have such a plan and are getting this years results on wellness visits. While the main appointment, and tests that are submitted as “routine” by the doctors office or coming back with no costs, other items run by the primary care provider that are not covered by the insurer.
When we had a copay plan, everything was covered that occurred during an office visit for an in-network primary care provider. Now that we’ve moved to a high deductible health plan coupled to an HSA, we’ve seen that not everything is covered in the wellness component. Specific tests that may be somewhat routine for the doctor are not routine nor covered by the insurer. The good news is that with the network discount, the additional costs of these tests are negligible when compared to the savings in monthly premiums.
For example, we had a wellness visit that covered the office visit and a few labs. Four more labs were ordered for additional screening. These four labs would have cost several hundred dollars if we didn’t have a network discount. With the network discount we paid around $40 for the labs. This is fine with us, and to be expected. The full-featured plan for our healthy family would have been up to double what we pay for the high deductible plan. And the COBRA continuation coverage that we had is four times as expensive as the HDHP/HSA plan. So the $40 additional cost of the office visit (once a year), and the $55-$65 we pay for a sick visit, with labs on top of that, still show a great savings in our out of pocket costs.
Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.