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Medicare and Health Care


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Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age person with End-Stage Renal Disease (ESRD). There are many different parts to Medicare; with all of these options, it can be confusing.

This forum will allow members to share their experience with medicare and seek advice* on certain medicare-related situations.

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ryee925  
#1 Posted : Tuesday, November 30, 2010 2:52:20 AM(UTC)
ryee925

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Joined: 11/14/2009(UTC)
Posts: 456

I just wanted some opinions on Aetna HDHP. I really don't know too much about health insurance or how to really use it since I never go to the doctor. I go to the dentist twice a year and the eye doctor for my annual boxes of lenses, but that's pretty much it. I'm just a normal 24 year old kid that doesn't really get sick or go in for yearly checkups or anything.

I chose Aetna HDHP mainly because it was the least expensive. I'm a GS 7 not making much and since I never go to the doctor, I thought it would make sense to choose the lease expensive plan. But can those with any experience with it tell me about it? I've read the plan on the OPM website and all of it just goes over my head. Can someone just break it down for me in layman's terms?
upandup  
#2 Posted : Tuesday, November 30, 2010 3:23:54 AM(UTC)
upandup

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It sounds like a solid choice for you.

These links on Aetna's site break down the plan in simpler terms:
http://custom.aetna.com/fehbp/medhdhp_how.php
http://custom.aetna.com/fehbp/medhdhp_highlights.php

You will need to open up an HSA (Health Savings Account) with Aetna's partner, Chase Bank. There are no fees for the basic account. Each month, Aetna will deposit $62.50 in that account (single enrollment). You may make additional contributions should you desire--either by payroll deduction (pre-tax) or direct contribution (tax-deductible). There's a yearly limit of $3050 for a single enrollment so you could make $2300 in additional contributions on top of the pass-through.

The HSA money is yours forever (until you spend it). You can keep it even if you change to a non-high deductible plan. You can make tax-free withdrawals to pay for medical, dental, or vision expenses that are incurred after you have established the HSA. If you withdraw the money for other reasons, you will pay tax on the withdrawal; if you are under 65, you will also pay a 20% penalty (as of 2011). That's to be avoided if possible.

As for the plan itself:
If you stay in Aetna's PPO network, you get 100% coverage for dental cleanings and x-rays. Other dental work in Aetna's dental PPO network is not covered, but you get the network rate. You get 100% coverage for a routine eye exam. You get some vision network discounts on glasses and can get a $100 eyeglass/contacts reimbursement every two years. You get 100% coverage for routine physicals and some preventive tests.

All other services are subject to a $1500 annual deductible (single coverage). To meet this deductible, you can use your HSA money (remember, Aetna contributes $750 per year). Because of the deductible, you should consider making the above-mentioned additional HSA contributions as your finances permit.  $31.25 per pay period would mean that you'd have the deductible set aside in your HSA after one year (accounting for the plan pass-through contribution on top of that).

After you meet the annual deductible, then you pay 10% of the negotiated expenses in the Aetna network. For prescriptions, you pay a copayment amount. Once your copayments, 10% coinsurance, and deductible costs reach $4000 for the calendar year, Aetna pays 100% of all in-network medical and prescription drug covered expenses.

ryee925  
#3 Posted : Tuesday, November 30, 2010 5:02:29 AM(UTC)
ryee925

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Thanks for the information.
 
So I have to pay all the doctor fees up to $1500...that's not as good of a deal as I thought. So just to go in for a checkup, there isn't a copay, I actually have to pay the amount in full until I reach my limit?
 
Say I have this plan for 2 years and never go to the doctor or spend any of my HSA. That $750 is still in my account correct? So I'd have $1500 saved up in my HSA to use and I can just go ahead and use that all towards the deductable?
 
Also, it says 100% of preventative care is covered if it's in-network. What constitutes as preventative care?
 
Also, there is a $2.50 per month fee for Chase's HSA as an Investment Account Maintainance Fee. Unless I'm using the wrong HSA...
ryee9252010-11-30 13:59:41
upandup  
#4 Posted : Tuesday, November 30, 2010 6:15:07 AM(UTC)
upandup

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The $1500 isn't as bad as it seems.
Accounting for the $750 pass-through, that leaves only $750.
Accounting then for the the premium savings each pay period, the deductible compared to some other plans might even be negative! Take the premiums savings and make HSA contributions.
http://federalsoup.com/forum_posts.asp?TID=28841&FID=14&title=hdhps-the-deductible-seems-much-worse-than-it-is

As for preventive care, that is described beginning on page 84 of the brochure: http://custom.aetna.com/.../2011FedBrochure-AHF.pdf
ryee925  
#5 Posted : Sunday, January 02, 2011 11:21:12 PM(UTC)
ryee925

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Alright, after doing some more research, the brochure says they will establish an HSA with JP Morgan/Chase for me. I have yet to receive any notification. Do I have to open one up myself and then link it to Aetna? Or do I have to open an HSA directly with Aetna?
 
I'm on the Aetna members site and there is a link to my HSA that allows me to enroll in one, but it asks for a enrollment identification number (a 15 digit number) and a verifiation code (3 digit number) that should be provided by either my employer or insurer. I have no idea where to find these numbers
ryee9252011-01-03 07:29:47
kg78  
#6 Posted : Sunday, January 02, 2011 11:57:41 PM(UTC)
kg78

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If I recall correctly, Aetna set up the account for us, and started depositing money into it all on their own.  We didn't need to ask for them to do that.  It surprised my husband (who handles most of this type of stuff for me, but isn't actually a federal employee....I'm the fed in our household), because we knew we wanted an HDHP, and our choices were Aetna and another company we had never heard of, so other than looking at the costs, and basically what was covered, he didn't look into it too deeply.  We had had a high deductible health plan when we were self employed and liked it a lot.  We had an HSA account already set up through another bank for the BCBS high deductible health plan we had prior to me starting federal service.  So the fact that they started depositing money into an HSA account he didn't know about was a pleasant surprise to us.  The enrollment for the HSA is probably the enrollment for their online website.  The HSA gets set up for you automatically regardless of what you do.  You can contact Aetna and/or Chase for help getting it all set up.  I've found their phone customer service to be fantastic and friendly.  As for the HSA and out of pocket costs, etc...you can actually use the money in the HSA to pay for any out of pocket health care costs before you meet your deductible.  So if you don't go over that initial $750 in a year, you're actually incurring no cost except the cost of the plan itself.

Also, keep in mind that HSA accounts are a little different from FSA accounts.  While flexible spending accounts go away at the end of the year if you don't use the money, HSA accounts don't.  You can roll that balance from year to year to year.  So if the only cost you incur all year is for your yearly physical, because you're fit and healthy, the money remaining in your HSA at the end of the year is rolled over to the next year (assuming you stay on an HDHP plan).  You can also use your HSA money to pay for anything FSA money would as well, not just limited to expenses your health plan covers (for example, you can use HSA money to pay for prescription glasses, contact lenses, non-covered dental work, etc).

ryee925  
#7 Posted : Monday, January 03, 2011 2:53:32 AM(UTC)
ryee925

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How do I access those funds then if they're doing it all on their own?
spence  
#8 Posted : Monday, January 03, 2011 3:05:40 AM(UTC)
spence

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Was thanked: 2 time(s) in 2 post(s)

You can probably get the most accurate answer by calling Aetna customer service.  This FAQ mentions the HSA will not be funded until February, so that may be why you haven't gotten anything in the mail about it yet: http://custom.aetna.com/fehbp/medhdhp_faq.php

"16. I joined
the Plan during Open Season and my coverage is effective on January 2,
2011. Why didn't the contributions to my HSA from Aetna start until February?



The law states that the HSA is effective on the first day of the
month following the effective date of the health plan coverage; unless
the effective date of the health plan coverage is the first day of the
month. For most federal employees who enroll during Open Season, the
effective date of the health plan is the first day of the first pay
period, which in 2011 is January 2, 2011 for many people. With a January
2, 2011 health plan effective date, the HSA is effective February 1,
2011. The first Plan contribution would be made in February. Employees
whose effective date is January 1, 2011 will have an HSA effective date
of January 1, 2011. "


spence2011-01-03 11:19:25
kg78  
#9 Posted : Monday, January 03, 2011 3:22:13 AM(UTC)
kg78

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Posts: 612

I agree with spence.  You need to call Aetna.  Aetna can confirm that an HSA is being set up for you, and when you should expect to see contributions to it.  For any other info (such as getting a debit card for your HSA, balance info in your HSA, setting up online access to your HSA), they'll give you the customer service number to Chase.
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