Make It Simple At Open Enrollment!

#002 – Open Enrollment is coming up soon

Get 100% Covered

What you need to gather:

Health Insurance enrollment kit from your employer or insurance company – should include the plan options available, in some detail

Pencil/Pen/Paper/Spreadsheet – whatever works best for you

In the plan outline, you will want to locate and identify the following:

Premium amount – generally expressed as the amount you will contribute per pay period

Deductible amount – the amount that you will be responsible for first before any eligible medical claim expenses are paid by the insurance plan

Coinsurance rate – generally expressed as a percentage that you are responsible for while sharing the eligible medical claim expenses with the insurance plan and only after your eligible medical claim expenses have exceeded your deductible in the calendar year.

Create a table such as this:

Health Insurance Plan Comparison

Option 1Option 2Option 3Option 4
Premium $600$500$400$300
Deductible$1,000$2,000$3,000$5,000
Coinsurance80%80%80%100%

Out of Pocket Maximum

Some plan documents will state:

Out of Pocket Maximum is [stated amount] after deductible met

For example:

Out of Pocket Maximum is $2,500 after deductible has been met.

Alternatively, other plan documents will state:

Out of Pocket Maximum is reached when eligible claims expenses exceed [stated amount]

For example:

Out of Pocket Maximum is reached when eligible claims expenses exceed $12,500

In each of the above examples, with a Coinsurance Rate of 80% to the insurance plan and 20% to you the insured, you will have an Out of Pocket Maximum of $2,500 after your deductible has been met.  (20% x $12,500 = $2,500)

As always, thanks for listening. Be sure to check out upcoming episodes for more on Health Savings Accounts and lots more. Find all Doxcost episodes on Apple Podcasts or wherever you get your podcasts.

If you have questions, contact me directly:

https://scottwdowling.com/contact/

Listen to my pal, Morgan Fingleton, by visiting:

https://morganfingleton.com

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