Deductible Health
April 20th, 2008
Question: how do i compare high deductible health plans to traditional PPO?
Answer: PPO means “Preferred Provider Organization”, in the USA many types of PPO plans are offered, meaning most offer different Deductible amounts, along with Co-insurance. I operate in Ca. so I will give you some examples of what is available, as an example.
In Ca. “NO Deductible plans are very popular PPO”
They typically offer:
No Deductible
Copayments for Office Consultations
Co-insurance 30-40% is typical (meaning that you as the consumer would pay up to 40% of the negotiated fee “if you see a participating physician) of the cost.
RX usually has copays for Generic and Deductibles of 500 to 1000. then copays for Brand name RX
Annual out of pocket max. on these plans vary from 6000 to 7500 “this means that if you stay within the participating network dr. and hospitals your billed amount in most cases should not exceed 7500 or the annual out of pocket max. “very important to find out when buying a policy”.
Compared to: High Deductible plans.
High Deductible plans are very popular, especially when HSA eligible plan.
HSA High Deductible plans normally offer:
2400-4000 Deductibles for Individuals
4800-9600 Deductibles for couples or Families
typically these types of plans do not offer copays for Dr. Visits, or RX until you have reached the Ded. then services are paid for in full, “again just so you stay within the participating physician list”. Annual out of pockets are these plan can be much lower than “no deductible plans”, but remember you will pay for all services up to the deductible. Big advantage on these type of plans, lower premiums, tax. advantages when opening HSA are incredible!,
Hope this helps, if not contact me directly
www.HSAInside.com President
Rudy Rivas
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High Deductible Health Plans
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