Kaiser Permanente- Understanding group health insurance |
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Here is a summary of Kaiser's most popular plans.
Kaiser Plan 30: A $30 doctor co-pay. You pay $ 400 per night in the hospital to a maximum financial exposure of $3,500. $10 co-pay for generic prescriptions. Brand name prescriptions are covered after a $250 calendar year deductible at a $35 co-pay.
Kaiser HSA $0/1,500 TWO PARTS This plan has a $1,500 deductible for individual subscribers and a $3,000 deductible for family subscribers. Like all plans, the deductible is calendar year. If you enroll September 1st, you have a short year to accumulate your deductible. Nothing is covered (except certain wellness benefits, Pap, Mammograms) until you reach your deductible. You meet your deductible by paying in cash for services at Kaiser Permanente. You will pay the "MEMBER" discount rate for services.
For example: Kaiser provides the enclosed EXPENSE LIST for Southern California. It is an estimate of what you will pay for services while working toward meeting your deductible. The estimated charge for a primary care office visit is $65. A specialist visit is $110. An intensive ER visit may cost $220. A CAT SCAN of the chest is estimated at $500. If you are admitted to the hospital, you can expect to meet your deductible (be responsible for) immediately. Blue Cross just showed that a typical day in the hospital is estimated at over $9,000 a day.
The SECOND part of this plan is an optional Health Savings Account. This allows you to set aside additional money on a pre-tax basis. The goal is to set aside enough money to be able to meet your health plan deductible. Like an IRA, (individual retirement account) you set this money aside pre-tax. At tax time, you tell your accountant you set aside XXXX amount. If you are in the 25% tax bracket, you saved 25% of the amount you set aside.
Understanding group health insurance and HSA accounts takes patients and educations. The learning curve is step but worth it if you want the best solution
I look forward to meeting your insurance needs. Please call anytime.
Sincerely, Patrick D. Reaume, CFP, RHU |
