| Author | Message | ||
     Time_pass Side Hero Username: Time_pass Post Number: 5784 Registered: 06-2008 Posted From: 173.78.151.42 Rating: N/A |
// HSA is high deductable plan. So Insurance company covers all prevetive care 100%. But for others it does very min negotiations untill all the family dedutable is reached. One 20% kick in it starts agrresive negotiations So expect to pay more till it hits Family dd. Ofcourse from your HSA monthyl savings account with pre-tax dollars // your information is incorrect the negotiated price is same irrespective of plan, it is by procedure so you will be billed the same dicounted price when it is under deductible or you are in 80 20 split | ||
| Rudraksha Side Hero Username: Rudraksha Post Number: 4082 Registered: 07-2012 Posted From: 32.214.184.26 Rating: N/A |
thank u all: time_pass, sonyvaio, last_avatar | ||
| Last_avataar Side Hero Username: Last_avataar Post Number: 4770 Registered: 09-2012 Posted From: 12.10.219.223 Rating: N/A |
Compared to Traditional PPO, where insurance company agreesivey negotiates with provider as 20% - 80% starts from beginning along with copay HSA is high deductable plan. So Insurance company covers all prevetive care 100%. But for others it does very min negotiations untill all the family dedutable is reached. One 20% kick in it starts agrresive negotiations So expect to pay more till it hits Family dd. Ofcourse from your HSA monthyl savings account with pre-tax dollars | ||
| Rudraksha Side Hero Username: Rudraksha Post Number: 4081 Registered: 07-2012 Posted From: 32.214.184.26 Rating: N/A |
so final question, in PPO most of the times provider bills more than what he gets paid from both the insurance + and from the member (copay) + member responsibility(if any). this is because of the negotiated prices. so HSA/HRA lo kooda ante kada? member will be paying only negotiated price but not the full billed amount? | ||
| Time_pass Side Hero Username: Time_pass Post Number: 5783 Registered: 06-2008 Posted From: 216.52.207.121 Rating: N/A |
// so once we have family plan, no matter who is getting services we still need to meet the total family deductible 2400 to get 80%-20% benefit? // YES. kaakapothe you can set aside money pre tax in an HSA account to pay for these. Max contribution including employer will be 65oo for family this year this money rolls over and can be used for any medical expenses. | ||
| Last_avataar Side Hero Username: Last_avataar Post Number: 4769 Registered: 09-2012 Posted From: 12.10.219.223 Rating: N/A |
Yes that is true. Order of precedence for any person 1. if it is not met take it from Individual deductable, if it is crosses 2. if it is not met take it from Family Deductable , if it is crosses 3. if still with in max out o pocket , start applying 20%, if it exceeds 4. insurance has to pay all upto some limit and constraints any year our liabilty is limited to Max family deductable + 20% of bill amount exceeding the family dd which should be <= max oop. | ||
| Rudraksha Side Hero Username: Rudraksha Post Number: 4080 Registered: 07-2012 Posted From: 32.214.184.26 Rating: N/A |
so once we have family plan, no matter who is getting services we still need to meet the total family deductible 2400 to get 80%-20% benefit? | ||
| Last_avataar Side Hero Username: Last_avataar Post Number: 4768 Registered: 09-2012 Posted From: 12.10.219.223 Rating: N/A |
Individual anedi - Insurance holder ki appy avvadu - Any individual in family ani So any expense that cross this individula limit, starts consuming resources from family deductable till it completes Then 20% kicks off till the 20% reaches the max limit of Family out of pocket expenses. Suppose oka person ke mee family deductable fill avute, all other people get 20% from the beginning till the end of year, till that 20% hits sax out of pocket | ||
| Rudraksha Side Hero Username: Rudraksha Post Number: 4078 Registered: 07-2012 Posted From: 32.214.184.26 Rating: N/A |
member+dependent+kids (family) plan lo unte total deductible 2400. but individual deductible 1200. let us say member and dependent never visit doctor and only kids need, so in this case deductible individual 1200 applicable for kids or we still need to meet family deductible 2400? | ||
| Sonyvaio Hero Username: Sonyvaio Post Number: 16907 Registered: 12-2006 Posted From: 170.48.19.254 Rating: N/A |
yes, 2400 deductible, i saw it wrong, i was thinking 6000 was deductible, but 6000 is your max out of pocket, so if you reach max out of pocket 6000, anything beyond it will be contributed by the company | ||
| Last_avataar Side Hero Username: Last_avataar Post Number: 4766 Registered: 09-2012 Posted From: 12.10.219.223 Rating: N/A |
Sorry for te typo The 20% = 20*(total negotiated bill - family max deductable)/100 if and if the family max deductable + 20% <= Max family out of pocket any amount over and aboe should be ment by insurance upto a limit defined by them | ||
| Last_avataar Side Hero Username: Last_avataar Post Number: 4765 Registered: 09-2012 Posted From: 12.10.219.223 Rating: N/A |
HSA is operated under is a high deductable plan. The money gets accumulated and tolled over next , if one won't use it - Except for preventive care which is 100% covered - all expenses should be met with initail individual / family max limits before 20% kicks off. The 20% = 20*(total negotiated bill - family max out of pocket)/100 if and if the family max deductable + 20% <= Max family out of pocket any amount over and aboe should be ment by insurance upto a limit defined by them. ex : mee total bill 4000 anukondi - Insurance nails it down to say 3000 anukondi - you need to pay all 2400 as it is your family max deductable out of HSA account or what ever source - remaning 20% $600 meeru kattali along with other amount - there are no copays for HSA | ||
| Rudraksha Side Hero Username: Rudraksha Post Number: 4077 Registered: 07-2012 Posted From: 32.214.184.26 Rating: N/A |
total family deductible is 2400, so I think 80%-20% comes after we meet 2400 and then we continue paying 20% deductible until we reach OOP which is 6000? The question is in the plan, if only one member availing the plan.... can the total HRA/HSA funds be given to them and also will Individual Deductible/OOP applicable or we have to satisfy family deductible/oop (even when only one member is availing) | ||
| Sonyvaio Hero Username: Sonyvaio Post Number: 16905 Registered: 12-2006 Posted From: 170.48.19.254 Rating: N/A |
first 1200 varaku, 100% employer chestadu aa taravata 100% manam pay chestam aaa taravata 80-20 start avtundi these are called value plans | ||
| Rudraksha Side Hero Username: Rudraksha Post Number: 4076 Registered: 07-2012 Posted From: 32.214.184.26 Rating: N/A |
also, bill lo 100% charged amount manamu pay chestama (or deducted from HRA/HSA funds) leka discounted price pay chestama? (usually ppo lo 400 charge cheste insurance vaadu ee 60 leka 100 discounted price kadataadu and we get no charges...so HRA/HSA lo kooda discounted prices untaya leka full prices pay cheyala?) | ||
| Sonyvaio Hero Username: Sonyvaio Post Number: 16903 Registered: 12-2006 Posted From: 170.48.19.254 Rating: N/A |
atla kaadu annai, your total deductible actually is 1200(from employer) + 6000(from you) makes it 7200 family. So basically this 1200 is coming from company, aa next 6000 comes from you before 80-20 can start in individual ki 500 vestaru, total family cannot go beyond 1200 | ||
| Rudraksha Side Hero Username: Rudraksha Post Number: 4075 Registered: 07-2012 Posted From: 32.214.184.26 Rating: N/A |
Can we use the total HRA/HSA fund to one member deductible? let us say only member needs care most of the times (usually with the kids), can we use that total HRA money 1200 to meet individual deductible or we must meet the family deductible and then only the 80-20 comes into picture? | ||
| Sonyvaio Hero Username: Sonyvaio Post Number: 16902 Registered: 12-2006 Posted From: 170.48.19.254 Rating: N/A |
Yes No Copay, Insurance Provider is CIGNA? so basically you will first use 1200 from Employer fund, 1200 ayye varaku whole bill goes from that fund aa taravata your deductible kicks in, once you reach deductible then 80-20 will start | ||
| Rudraksha Side Hero Username: Rudraksha Post Number: 4074 Registered: 07-2012 Posted From: 32.214.184.26 Rating: N/A |
here is plan details: 80% plan pays, 20% our responsibility. employer provides 500 per individual and 1200 per family for HRA/HSA. individual deductible 1200, family deductible 2400. OOP individual 3000, family OOP 6000. I guess there is no copay?? (1) If the member/dependents visit provider, the total (100%) bill will be paid (assuming that bill less than 1200) from HRA/HSA or only 20% of the bill deducted from HRA/HSA? | ||
| Last_avataar Side Hero Username: Last_avataar Post Number: 4758 Registered: 09-2012 Posted From: 12.10.219.223 Rating: N/A |
HSA here cheppandi, what is the question | ||
| Sonyvaio Hero Username: Sonyvaio Post Number: 16901 Registered: 12-2006 Posted From: 170.48.19.254 Rating: N/A |
I have HRA | ||
| Time_pass Side Hero Username: Time_pass Post Number: 5782 Registered: 06-2008 Posted From: 216.52.207.75 Rating: N/A |
ask, will help if I can | ||
| Rudraksha Side Hero Username: Rudraksha Post Number: 4073 Registered: 07-2012 Posted From: 32.214.184.26 Rating: N/A |
any one in the DB? Konni questions unnay |
