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I chose a HDHP through my employer only because it was the cheapest one: only $45.00 per paycheck. It's BlueCross BlueShield NC. I am 26 and I just got off my Dad's Insurance Plan. My HDHP has a $4,000 deductible. I realized I am paying more up front for treatments. With my Dad's plan, I only had to pay a $20.00 or $40.00 co-pay. There's this treatment that I've been approved for called Spravato for treatment-resistant depression. I'm being quoted over $300.00 per visit even with Insurance! If I had a copay plan, I probably would've only paid $20.00.
I think my plan is HSA eligible, but I had to sign up for the HSA during open enrollment. My job doesn't give it to us automatically. I'm so upset because I have medical care that I need that is unaffordable right now.
Can I look and see if my Insurance or the clinics I go to offer payment plans so I'm not paying so much up front? Should I look into financial assistance or discounts?
Check with Spravato, and see if they offer any discount or assistance programs. I'm willing to bet they do, especially if you are low to moderate income. Also, your service provider may also offer some type of assistance or forgiveness plan.
A high deductible plan works well for many people, as they save money if someone doesn't have a lot of medical needs. But for those with chronic conditions that are likely to require costly treatment for an indefinite period, a lower-deductible option would be better.
Your HR person at your workplace did a horrible job of education you.
The "high deductible" plan is for folks who rarely need the doctor. This mostly applies to young single people with no kids - but clearly, there are exceptions.
The "low deductible" plan, though, is quite a bit out of your paycheck. For us, here, the monthly "take out" is about the same as the deductible, when added up over the year, just might have better tax implications, so it's not the great savings you think it is. It's just spread out a little more tolerably - and if you don't need it - it's a huge savings, obviously.
I chose a HDHP through my employer only because it was the cheapest one: only $45.00 per paycheck. It's BlueCross BlueShield NC. I am 26 and I just got off my Dad's Insurance Plan. My HDHP has a $4,000 deductible. I realized I am paying more up front for treatments. With my Dad's plan, I only had to pay a $20.00 or $40.00 co-pay. There's this treatment that I've been approved for called Spravato for treatment-resistant depression. I'm being quoted over $300.00 per visit even with Insurance! If I had a copay plan, I probably would've only paid $20.00.
I think my plan is HSA eligible, but I had to sign up for the HSA during open enrollment. My job doesn't give it to us automatically. I'm so upset because I have medical care that I need that is unaffordable right now.
Can I look and see if my Insurance or the clinics I go to offer payment plans so I'm not paying so much up front? Should I look into financial assistance or discounts?
Welcome to the world of Adulting.
You are beginning to learn about taking care of yourself and your finances.
This is a learning year for you. You have learned that the "cheapest one" is not necessarily the most economical or best plan for you.
Location: East of Seattle since 1992, 615' Elevation, Zone 8b - originally from SF Bay Area
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The whole idea of a high deductible plan is that you have non-taxed salary money going into a health savings account, that you can use for those big deductibles. When I had one, my employer matched my contributions to the HSA up to $100/month. Sorry that you didn't understand that and sign up for it, now you probably have to wait until the next open enrollment period.
I chose a HDHP through my employer only because it was the cheapest one: only $45.00 per paycheck. It's BlueCross BlueShield NC. I am 26 and I just got off my Dad's Insurance Plan. My HDHP has a $4,000 deductible. I realized I am paying more up front for treatments. With my Dad's plan, I only had to pay a $20.00 or $40.00 co-pay. There's this treatment that I've been approved for called Spravato for treatment-resistant depression. I'm being quoted over $300.00 per visit even with Insurance! If I had a copay plan, I probably would've only paid $20.00.
I think my plan is HSA eligible, but I had to sign up for the HSA during open enrollment. My job doesn't give it to us automatically. I'm so upset because I have medical care that I need that is unaffordable right now.
Can I look and see if my Insurance or the clinics I go to offer payment plans so I'm not paying so much up front? Should I look into financial assistance or discounts?
First thing to do is go back to HR. Find out if & when you can change the plan. You may have to wait for October when new plans for 2025 are released. You chose the plan with the least premium but may have the highest deductible. Another plan may have higher premium and lower deductible. Also check to see what the HSA can cover. Maybe you need to get it to $4k or more.
Possible the clinic has a payment plan to split $300 into 2 or more payments. They may charge you something to do this. Depends how often you go for these treatments.
Next item you need is an emergency health fund. May take time to have HSA up to $4000. So you will need savings to cover the gap.
I'm being quoted over $300.00 per visit even with Insurance! If I had a copay plan, I probably would've only paid $20.00.
Not necessarily. Your insurance may cover the provider visit at the $20 co-pay, but the drug cost portion could have higher co-insurance or set individual treatment amounts, or even a yearly cap, so don't assume it would be covered at a lower rate from what your being quoted.
Many private/employer insurance plans won't always pay the full cost especially when the manufacture has a patient assistance program. If they know the manufacture will subsidize the cost, why pay the full amount when they can pay a much lower amount and force you to take manufacture financial assistance to pay the rest?
Also, to clarify, when you said you were "approved", was that by your provider to use the medciation or the insurance company to pay for the medication or both?
I agree about calling the drug manufacturer, many have low cost or free options, if you qualify. And definitely go to HR & find out when you next open enrollment is. Live & learn
I agree about calling the drug manufacturer, many have low cost or free options, if you qualify. And definitely go to HR & find out when you next open enrollment is. Live & learn
I'll second this as well. I took an extremely expensive heart drug after my heart attack (like, $500/Rx); however, after contacting the manufacturer I received a card that dropped the cost to $5/Rx. It was absolutely astounding and with all the other new meds I was taking saved my budget as well. it can't hurt to try.
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