Help with Work Insurance

[jhodges58]

Hi:

I've been on dialysis for four years and I'm still working full time. My company has always offered a POS II plan from Aetna (your traditional full insurance/copay/deductible setup).

This year, they're still offering it but they significantly increased the premiums in a move to drive most of the employees to their High Deductible plan. For Employee+1 it's a $3,000 deductible with a $5,000 out-of-pocket maximum.

What I'm trying to figure out is with Medicare as my primary, will this plan work okay as a secondary/supplemental or would I be better off finding a Plan F that will take me and have my wife enroll for her own insurance at work.

Any  one else using one of these high deductible plans to backstop Medicare? My company does do a $800 funding of the HSA which is nice and the cost per paycheck (2x a month) would be on $67 (as opposed to the POS II which is moving from $195 a paycheck to a whopping $273). Even if I fully funded my HSA to the tune of $4,200 (which, with the $800 the company kicks in, would give me my $5,000 max) that works out to $242 per paycheck and I wouldn't have the additional deductibles and copays I have now.

Any thoughts would be appreciated.

-- Jon

[Michael Murphy]

Check with the insurance coordinator at your dialysis center.  But high premiums for you are a rip off.  Since you are on Medicare for your primary your treatments are substantially lower than the rates your private insurance would pay. In my case my insurance is billed Around 1450 per session with drugs extra the Medicare rates are around 270.  Since medicare pays 80% that leaves only around 50 to 60 dollars for your company insurance.  But the company insurance doesn't  cut you a price break.  I am retiring and moving to New York the coordinator knew that blue cross Medicare advantage for New York does not exclude esrd from coverage.  So the coordinator should be able to crunch the numbers with you and find your best options.