Author Topic: Minimizing prescriptions for HSA Based Health Insurance Plan  (Read 2479 times)

lexde

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Minimizing prescriptions for HSA Based Health Insurance Plan
« on: October 24, 2017, 11:56:23 AM »
I was given an option to pick either a traditional health insurance plan or a high deductible HSA based plan. I'm a generally healthy person but as a female I have a regular monthly prescription for birth control.

I am looking at my plan and it looks like even generic prescriptions will end up costing me $30+ per month, up to $80 since I pay 100% until my deductible is met.

Are there any better alternatives to this? I am trying to shop around, look at genetics, and price match pharmacies but it still seems so expensive. I'd like to get the HSA and use it as a health buffer and tax shelter but it seems so much more expensive short term even with long term value. $175/mo premium, then $2800 HSA contribution and $600 employer contribution.

If anyone has experience with any of this I'd really appreciate some input!

terran

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #1 on: October 24, 2017, 12:05:45 PM »
I believe birth control has to be covered 100% even on high deductible plans unless your employer has claimed a religious exemption. You should look into that. Also note that preventative medicine (including an annual visit to the gynecologist) should be covered 100%.

We were between insurance plans for a month this summer (could have signed up through COBRA retroactively, but it wasn't necessary) and my wife was able to purchase her (generic) birth control for around $30 using a coupon printed off https://www.goodrx.com/.

We did very well with the HSA plan at my wife's previous employer, but the premiums were significantly lower than the copay plan (saving about $160/month). Her new employer is introducing an HSA plan this year, but we're waiting to see what the premiums are.

dcozad999

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #2 on: October 24, 2017, 12:48:40 PM »
Unless you work for Hobby Lobby (or some other company with a religious waiver), birth control is currently covered at 100%.

Until the GOP finds a way to get rid of it anyway.

lexde

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #3 on: October 24, 2017, 02:02:09 PM »
Unless you work for Hobby Lobby (or some other company with a religious waiver), birth control is currently covered at 100%.

Until the GOP finds a way to get rid of it anyway.
I'll have to go back and see what is going on then since I'm paying a copay on my RX. Thanks for the heads up!

jamesbond007

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #4 on: October 24, 2017, 02:45:52 PM »
Unless you work for Hobby Lobby (or some other company with a religious waiver), birth control is currently covered at 100%.

Until the GOP finds a way to get rid of it anyway.
I'll have to go back and see what is going on then since I'm paying a copay on my RX. Thanks for the heads up!

You are probably getting a prescription that your insurance company does not "support". I mean it's not their preferred brand? It happened to my wife. So she called the doctor and the doctor figured out which one is preferred and changed the prescription. She doesn't pay the copay anymore.

EricEng

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #5 on: October 24, 2017, 04:12:31 PM »
Some insurers also require you to get it through the mail after the first couple or you pay it yourself.  It should be paid for though before deductible per current law.

frugal rph

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #6 on: October 24, 2017, 04:41:31 PM »
Wal-Mart has 2 types of birth control for $9 without insurance, Sprintec and Tri-Sprintec

thingamabobs

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #7 on: October 24, 2017, 06:03:52 PM »
Price check on goodrx.com

etselec

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #8 on: October 25, 2017, 07:03:27 AM »
There are tons of factors other than money that can come into play here, but I'll just say really quick: IUDs are $*^@&#)* magic. They don't end up working for everyone, but if you're a good candidate, I can't recommend 'em highly enough. If you decide to go that route, get one before the end of the year/before your plan switches over. Problem solved for 3 to 12 years (depending on the brand/type you go with).

lexde

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #9 on: October 25, 2017, 07:23:01 AM »
There are tons of factors other than money that can come into play here, but I'll just say really quick: IUDs are $*^@&#)* magic. They don't end up working for everyone, but if you're a good candidate, I can't recommend 'em highly enough. If you decide to go that route, get one before the end of the year/before your plan switches over. Problem solved for 3 to 12 years (depending on the brand/type you go with).
I have bought about this and would love to go this route but unfortunately it is not compatible with my partner so I am stuck with pills, shots, or rings. Pills have the least serious side effects for me in my experience so I'm stuck with that for now. I wish I could just set it and forget it though!

rubybeth

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #10 on: October 25, 2017, 08:00:54 AM »
Your insurance plan likely has a formulary/covered Rx list somewhere--sometimes this is online and searchable. Look up your bc options there, and see if one of the ones they cover would be comparable to what you're on, and have your doctor switch you to one that's covered 100%.

Need2Save

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #11 on: October 25, 2017, 08:03:57 AM »
For a healthy young woman with no other immediate/anticipated healthcare needs other than preventive and birth control, a high-deductible with HSA plan has strong incentives.  You did not post the difference in payroll contributions for the 2 choices of medical plans.  But if you take that difference (you presumable pay much less for the HDHP option), plus the $600 that your employer is giving you in your HSA - I don't see how you could not come out ahead with the HDHP/HSA option.  The choice to put in extra money of your own to fill out the HSA is wise so that you do have enough saved should something come up.  Plus you reduce your taxable income by the amount you fund your HSA (and presumably your pretax payroll contributions for the premiums as well).

With regard to your specific Rx for BC - the above posters are correct.  Generic birth control is covered 100% by all non-grandfathered health plans (this is a requirement of ACA) unless the company has claimed a religious exception (only recently, so unlikely that is your company).  If you are paying $30/month - you must be getting a special brand name that is not preferred and could discuss with your doctor switching to another type/manufacturer that would be zero-copay. Also, if your company requires mail-order or 90 day refills and you are not doing that, that is another reason you may be paying out of pocket unnecessarily.  Take your Rx id card out of your wallet and call the number on the back and ask the question of your pharmacy benefit provider.  Or else - login to their online account if they have one and I bet they'll show you alternatives for the one you are taking that would be zero copay.

lexde

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #12 on: October 25, 2017, 01:58:56 PM »
For a healthy young woman with no other immediate/anticipated healthcare needs other than preventive and birth control, a high-deductible with HSA plan has strong incentives.  You did not post the difference in payroll contributions for the 2 choices of medical plans.  But if you take that difference (you presumable pay much less for the HDHP option), plus the $600 that your employer is giving you in your HSA - I don't see how you could not come out ahead with the HDHP/HSA option.  The choice to put in extra money of your own to fill out the HSA is wise so that you do have enough saved should something come up.  Plus you reduce your taxable income by the amount you fund your HSA (and presumably your pretax payroll contributions for the premiums as well).

With regard to your specific Rx for BC - the above posters are correct.  Generic birth control is covered 100% by all non-grandfathered health plans (this is a requirement of ACA) unless the company has claimed a religious exception (only recently, so unlikely that is your company).  If you are paying $30/month - you must be getting a special brand name that is not preferred and could discuss with your doctor switching to another type/manufacturer that would be zero-copay. Also, if your company requires mail-order or 90 day refills and you are not doing that, that is another reason you may be paying out of pocket unnecessarily.  Take your Rx id card out of your wallet and call the number on the back and ask the question of your pharmacy benefit provider.  Or else - login to their online account if they have one and I bet they'll show you alternatives for the one you are taking that would be zero copay.
Thank you for such a detailed answer! I will be calling tonight to nail down a Rx and will have my doctor call it in tomorrow so I make sure everything works out before I switch plans on 11/3.

Interestingly... the HSA plan premium is identical to the regular POS plan. $178/mo. I'm assuming that the employer is making money on it and that's why they're contributing $600/yr. That said, it's probably still worth it due to the tax savings.

Need2Save

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #13 on: October 29, 2017, 05:56:43 AM »
Thank you for such a detailed answer! I will be calling tonight to nail down a Rx and will have my doctor call it in tomorrow so I make sure everything works out before I switch plans on 11/3.

Interestingly... the HSA plan premium is identical to the regular POS plan. $178/mo. I'm assuming that the employer is making money on it and that's why they're contributing $600/yr. That said, it's probably still worth it due to the tax savings.

Yes, that is interesting.  Bizarre strategy by your employer for sure.  There is usually more of an incentive to take on the additional risk of the high deductible by way of lower payroll premiums by the employee.  How big of a company do you work for? 

Rubyvroom

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #14 on: October 29, 2017, 08:52:52 AM »
I would assume this is fairly common practice, but maybe not, so I'll mention it. I asked that my prescription be written in such a way that I could pick up 3 months at a time, so I was only paying $35 every quarter for 3 months of a generic brand. I see from a previous poster that Wally World may have been even cheaper. You might consider doing the same to save yourself some money and time.

kpd905

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #15 on: October 29, 2017, 09:01:29 AM »
IUDs are $*^@&#)* magic.

Definitely not always.  I work in pathology and have seen an IUD embedded in a placenta after the mother gave birth, I'm sure she wasn't expecting that.  I also received an IUD that a surgeon found in the abdomen while removing the gallbladder, so the IUD just perforated through the uterine wall into the abdominal cavity.

rubybeth

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Re: Minimizing prescriptions for HSA Based Health Insurance Plan
« Reply #16 on: October 29, 2017, 09:23:32 AM »
IUDs are $*^@&#)* magic.

Definitely not always.  I work in pathology and have seen an IUD embedded in a placenta after the mother gave birth, I'm sure she wasn't expecting that.  I also received an IUD that a surgeon found in the abdomen while removing the gallbladder, so the IUD just perforated through the uterine wall into the abdominal cavity.

I also know at least one person who got pregnant on an IUD, wanted to keep the baby so had the IUD removed, then lost the baby tragically. These are outliers, but stuff can happen and women should know the risks.