2018 AMIkids

HOW DO I DETERMINE WHICH PLAN IS BEST FOR ME AND MY FAMILY?

SCENARIO 1: EMPLOYEE AND CHILD(REN) EARNING LESS THAN $35,000

Karl with EE + Ch <$35k

Base HDHP H.S.A. Plan

Copay H.R.A. Plan

Copay Premium Plan

Notes

Annual Plan Deductible AMIkids deposits $500 (prorated) into Karl’s H.S.A. Karl goes to his in-network Dr for his annual physical, blood work, etc. Karl’s son gets the flu! Karl takes him to the Dr and the office visit charge is $145 but the BCBS negotiated rate is $73, so Karl pays:

$3,000

$4,500

$1,500

$500

n/a

n/a

Only the Base Plan is eligible for the H.S.A. Preventative covered at 100% on all 3 plans! The $73 goes towards meeting Karl’s deductible and out of pocket (OOP) max, but the $50 or $35 copay would only go towards his OOP max. On the Base Plan, Karl can use his H.S.A. funds to cover his son’s office visit

$0

$0

$0

$73

$50 Copay

$35 Copay

HSA Balance

n/a

n/a

$427 ($500 - $73)

At his son’s office visit, the Dr prescribes Flu medication (generic):

$47

$20 Copay

$10 Copay

H.S.A. Balance

On the Base Plan, Karl can use his H.S.A. funds to cover his son’s prescription.

$380 ($427-$47)

n/a

n/a

Late one night, Karl’s son is ill and is running a bad fever so he takes him to the E.R. H.S.A Balance & Out of Pocket Expense (deductible) Total Annual Medical Premiums Karl paid Karl’s total health care expenses for the year in the scenario above

$600

$500 Copay

$350 Copay

$0 H.S.A. Balance $220 Out of Pocket ($600 – $380 = $220)

n/a

n/a

On the Base Plan, Karl uses up his H.S.A. funds to pay for part of the ER visit, but still has to pay the remainder out of pocket.

$3,077.04

$4,615.44

$7,051.20

$3,297.04 ($3,077.04 + $220) This plan is Karl’s best option!

Even though Karl used all of his H.S.A. funds & paid $220 out of pocket, the Base Plan is still best for him!

$5,185.44 ($4,615.44+$50+$20+$500)

$7,446.20 ($7,051.20+$35+$10+$350)

Treatment Cost Estimator Login to www.MyHealthToolKitFL.com , plug in your zip code and name of a medical procedure to find real-time cost estimates for nearby hospitals, surgery centers and physician offices.

Lower Your Costs When necessary, compare costs before you schedule treatments. Try to price out fees with doctors or health care facilities before you receive services in order to help lower your out- of-pocket costs.

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