HSA Silver plan with cost sharing = Big trouble!

[bingybear]

I currently have BCBS multi state plan and when talking to a BC customer service representative yesterday she said that multi-state is a marketing tool that may not mean what it says. What??

So the conclusion at the end of the conversation was like this. Yes, I have coverage in other states 1. IF they offer the BCBS Blue Network at the dr. office, hospital or facility. 2. IF they are in the Blue Network services are covered under my plan in network.

I don't know if all states offer BCBS but if you rv travel it is something to consider and research. Of course, emergencies out of state should be covered under the plan.

From what I've talked about with my insurance company, "emergencies" are "life threatening". A simple broken bone or stitches would not count. Compound fracture likely would.
Yes, for multi-state coverage, the medical care would need to be done in network facilities excepting emergencies as defined by the plan. With a non-multi state plan... this is no in network out of state.
And the insurance companies have been shrinking the networks both in and out of state, so follow your plan rules and networks. If you have to have a pcp referral as part of your plan, do so even when you are out of state.

 

[MBSC]

I currently have BCBS multi state plan and when talking to a BC customer service representative yesterday she said that multi-state is a marketing tool that may not mean what it says. What??

Multi-State Plan refers to selling plans across state lines in multiple states. It does not refer to the size or scope of the provider network your policy is connected to. This means out of state non-emergency care may be out-of-network unless the BCBS policy participates in the BlueCard Program.

An ongoing source of consumer confusion is the name: Multi-state plans don’t necessarily offer a national network of providers or in-network coverage away from home, except in emergencies. Some plans do, but consumers need to check the plan documents for network coverage just as they would with any plan.

Average premiums at the bronze, silver and gold levels for the Blues’ multi-state plans were all higher than average premiums for regular individual Blues plans at those metal levels.

“Because the multi-state plans are always priced higher, they’re not really increasing competition,” says Caroline Pearson, a senior vice president at Avalere. “They’re potentially providing a modicum of consumer choice. But they’re not injecting competition into the market.”

Reference: Despite Hopes Of Health Law Advocates, ‘Multi-State’ Health Plans Unavailable In Many States | Kaiser Health News

Blue Cross Association agreement to sell across state lines: https://www.opm.gov/healthcare-insu...gram/opm-multi-state-plan-program-fact-sheet/

BCBS BlueCard Program: Manage Healthcare Coverage for Travelers and Students | BCBS.com

 

[Youngster]

I am confused here.

If a couple with a family policy has a Bronze HDHP that has a deductible of $5,000.00 per person, and the state exchange is paying (subsidizing) about 80% of the premium to the insurer, can one contribute to an HSA when the policy qualifies for HSA?

 

[bingybear]

I am confused here.

If a couple with a family policy has a Bronze HDHP that has a deductible of $5,000.00 per person, and the state exchange is paying (subsidizing) about 80% of the premium to the insurer, can one contribute to an HSA when the policy qualifies for HSA?

yes. The PTC does not change the plan's parameters. Cost sharing with a silver plan can change deductibles and max out of pocket in addition to providing help paying the premiums.
The bronze HDHP plan does not change deductible or max out of pocket.

 

[Youngster]

Thank you very much, bingybear. Your explanation made the light finally go on in my head. I guess I was confused with the term "cost sharing".