Like the co-pay plan, you still have co-insurance, so you will need to pay 20% of the remaining $8,500 or $1,700 or a total of $2,200 ($500 to reach your deductible that wasn’t in your HSA, plus the $1,700.) So now, you have $1,000 to help you reach your deductible, and you need $500 to reach your deductible. If this money is deposited into your HSA, you have $1,000 a year to pay for medical expenses. Remember, that you and your employer saved $1,000 a year by going to the HSA based plan. Yes, $1,500 is a lot of money, but this is where having a health savings account will help you cover the cost of your medical expenses and help reach your deductible. That means you have to pay $1,500 out of your own pocket before your insurance kicks in. On the other hand, er…wrist…consider an HSA-based plan with a $1,500 deductible. In this example, your out-of-pocket cost for this accident would be $2,500. Then the insurance company would pay the rest. Finally, you would need to pay your portion of co-insurance which is 20% of the remaining $9,500 or $1,900. In a traditional co-pay plan with a deductible of $500, you pay a co-pay for the ER (say $100), then you would need to pay $500 to meet your deductible. Let’s say you’re changing a lightbulb and take a nasty fall-It happens, and nobody plans on a painful, broken wrist! After a trip to the Emergency Room, surgery and perhaps some physical therapy, you are feeling a bit better.īut you now have a $10,000 medical bill to cover the services. Let’s consider an example of how these plans actually work side-by-side. $1,000 tax-free annual contribution into your HSA.If that $1,000 is put into your HSA, your HSA plan could look like this: Since your deductible is higher in an HSA based plan, you and your employer will save money….le’t say that by moving to a $1,500 deductible, you and your employer now pay $5,000 a year instead of the $6,000 a year in the co-pay plan. Just like a co-pay plan, in an HSA based plan, you would still have a deductible, co-insurance and an out of pocket maximum. And, remember, like any other insurance plan you pay nothing for preventative care like annual check-ups. Usage of your HSA funds may also count toward your deductible and coinsurance amounts.
Your HSA is a personal tax-free health savings account that can be used to pay for eligible medical expenses. The key difference is that an HSA-based plan has two parts: Insurance PLUS a health savings account. With an HSA based plan, you often pay a lower premium in return for having a higher deductible. Keep in mind, this number will vary based on several factors. To put a number out there, let’s say that you and your employer pay $6,000 a year, or $500 per month for this plan. Your deductible could be anywhere from $500 to $2,000, but for this example, let’s use $500 for the deductible.
$50 co-pay for brand name prescription drugs.$10 co-pay for generic prescription drugs.And, most all preventive services are typically covered 100%. Just check with your plan for those details.Ī typical co-pay plan look something like this: Once you’ve met your max out-of-pocket, insurance will then generally cover the balance. Once you’ve met your deductible you also have a co-insurance phase with cost-sharing between you and your provider on high-cost medical expenses before you meet your max out-of-pocket. Then, when you go to the doctor or pick up a prescription, you pay a fixed cost called a “co-pay” and the insurance company generally covers the rest. On a traditional “co-pay plan” you and your employer pay a monthly premium to cover the cost of your health insurance. So let’s examine their core distinctions, the advantages and disadvantages, and the cost over time. As Health Savings Accounts have become quite popular, many people are asking, “What’s the difference between a traditional insurance plan and an HSA-based plan?” Both plans offer valuable insurance coverage to protect you from high-cost medical expenses, and yet there are some key differences.
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