The Anthem HSA works just as others Kentucky health plans would work, except without the copays and with an excellent preventative benefit included in it. Why are there not any copays you may ask? Well, for two reasons mainly. Including copays in a plan takes away your control over where your health care dollars are being spent. With a plan such as an HSA you, the consumer, is fully in control of where each of your health care dollars is going. Also, all of the money you spend is applied directly to your deductible, whereas copays are not. Therefore, you are able to start chipping away at your deductible from day 1 of your plan. The second reason that it is good to have a plan without copays is that it will save you between 30 and 60% on your premiums. Why is this? When a plan includes copays the premiums must be raised to account for the extra money that the health insurance company will pay to a doctor each time a copay is paid by the consumer. For example, if you had cold symptoms and decided to go see the doctor with a typical copay plan you would just pay $30 to see the physician and then go on your way. Meanwhile, the health insurance carrier is paying close to $100 on the back end to take care of the actual cost of that visit. Keep in mind, your copay is not applied toward your deductible. Now, take this same scenario and apply it to a consumer who has an HSA plan. If his cold was bad enough to possibly need a prescription antibiotic and he went to see his physician he would pay the Anthem pre-negotiated rate and that amount would also be applied toward his deductible. If, in fact, he did receive a prescription he would pay for that in the same way as his office visit (that amount too would be applied to his deductible).
The benefit that sets the Anthem HSA aside from all others is the unlimited preventive benefit. This covers all well-child visits, immunizations deemed necessary by the state, yearly physical for adults, mammogram, pap test, colonoscopy, etc. This benefit is unlimited, there is no dollar cap on the amount that will be covered in preventive services. There is no charge or copay for any of these services. They are free to the consumer who pays their premiums for their HSA plan. This could save an individual hundreds of dollars a year in medical expenses, and even thousands for a family plan. What a great opportunity for savings!
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I recently had blood in my stool, and my doctor recommends that I have a colonoscopy (I'm 67 and have not had one yet).
ReplyDeleteI have Medicare as my primary and an Anthem Group PPO policy as my secondary.
What would this procedure cost; and how much out of pocket will I be looking at?
Hi Pete,
ReplyDeleteThat is actually a very difficult question to answer. I would need to see your Medicare benefits as well as your Anthem benefits and it will vary by doctor. I would contact your physician to ask what they charge. Then you would need to ask them what their Medicare pre-negotiated rate is for that. Sorry I can't be of more assistance, it just really varies by physician and plan benefits.
To Your Health,
One Source Benefits
Good
ReplyDelete