Originally Posted by MichaelB
The net cost is $150 but it is an HSA, so you will pay out of pocket for all care until the deductible has been met. Still sounds like a pretty good deal.
As long as Guy A has continued coverage under Guy B's policy and that policy meets Medicare requirements, it sounds like a good plan. Guaranteed issue for Medicare B, along with D and MediGap, begins when B's policy coverage ends.
One things to keep in mind is the total out of pocket expense. An HSA policy means Guy A pays a high deductible. If he were to develop a chronic condition that requires expensive, ongoing care, it might make more sense to leave the high deductible spousal coverage and enroll in a Medicare / MediGap / PlanD, which might have a lower total out of pocket cost. For now, though, it sounds like the spousal coverage option is more price effective.
Thank you for bringing up deductible amounts.
Currently they are $3800 for in-network family coverage, with max in-network OOP of $11,000.
Also, "If an employee covers more than one individual under the Health Savings Medical Plan option, and one individual reaches $7150 in eligible in-network out-of-pocket expenses, all remaining eligible in-network expenses will be paid at 100% for that individual only."
I like your suggestion a lot. It will be worth monitoring the switching point.
Best value Medicare Advantage plans in the area are about $1300 in annual premiums + Part B premiums of about $1300 with a $3400 out of pocket max. But the cost sharing curve starts with $20 office copay etc. So it takes a while to reach $3400 max unless a hospital stay or surgery are involved.
There is a zero cost Medicare Advantage plan plus Part B premiums of $1300 but it has $5700 out of pocket max. The cost sharing curve starts with $20 office copay etc. So it takes a while to reach $5700 max unless a hospital stay or surgery are involved.
There is a high deductible Medigap plan F that is about $400 in annual premiums plus similar Part D cost. I believe the deductible portion is about $2200 (?). Also, medical underwriting may be involved
So many options to weigh. How do people do it? I am amazed at folks that can figure this out.
Scenarios for max annual medical cost for Guy A not including nursing care:
Scenario # 1: Guy B's health insurance: $7150+ $150 - a bit of HSA tax savings
Scenario # 2: Best value Medicare Advantage $1300 + Part B premiums $1300 + $3400
Scenario # 3: Zero-cost Medicare Advantage plan + Part B premiums $1300 + $5700
Scenario # 4: High deductible Medigap F + Part D premiums (about $800) + Part B premiums $1300 + $2200 + Part D cost sharing