Choosing the Right Medical Plan

Choosing the Right Medical Plan

During Annual Open Enrollment you can choose your plan for the upcoming year. New hires will have 30 days from your hire date to choose your medical plan. You’ll be able to go to WatersBenefitsNow.com to start the enrollment process and walk through some questions with me to help make your decision. Here’s some things you should keep in mind to make the most of it.

To pick the right plan, the first thing you’ll need to consider is just what health care services you’ll need in the upcoming year. Obviously, there are a lot of unknowns, but if you have any specialists you visit, routine expensive prescriptions you take, or any significant, planned medical events — like a surgery, or having a baby — they can give you a baseline.

Your next two big considerations are per-paycheck costs (the  premium ), and then your out-of-pocket costs (the  deductible ,  coinsurance , and the out-of-pocket maximums ).

As a reminder, you have a choice between three Aetna health plans:

• The Deductible $2,500/$6,250 Plan with an HSA or HRA

• The Deductible $1,600/$3,700 Plan with an HSA or HRA

• The Copay and Deductible Plan

You can choose between three medical plans.

You should evaluate each plan to determine which one is best for you and your family for the upcoming year. The goal is to choose the plan that will cost you the least throughout the entire year, both pay check premium deduction, plus out of pocket costs throughout the year. Use the tools found in the medical enrollment section of the enrollment site on WatersBenefitsNow.com.

The Copay and Deductible Plan:

• This plan is designed to have a higher premium cost, but a lower out-of-pocket cost at the point of service. This plan may be a good choice if you expect to have high health care needs in the plan year. Most employees and their families would still be better off in one of the other two medical plans. Plus, if you elect this Copay and Deductible Plan, you cannot contribute to a Health Savings Account (HSA).

The two Deductible plans eligible for a Health Savings Account (HSA) or Health Reimbursement Account (HRA):

• Both allow you to be eligible to contribute to an HSA, or have an HRA. The premiums are lower than those of the Copay and Deductible Plan. Between the two Deductible Plans, the premiums, deductibles, and out of pocket maximums are different. Depending on your health care needs in the upcoming year, one will be better for you and your family. Use the tools and resources included in the Medical Enrollment section of Open Enrollment to compare the plans.   One out-of-pocket expense you should consider when deciding between these two Deductible Plans is your prescription drugs. Both the Deductible $1,600/$3,700 Plan and the Deductible $2,500/$6,250 Plan will cover eligible preventive prescription drugs (see the Aetna Preventive Drug lists under Quick Links on the home page) at no cost to you (not even a copay nor a deductible). All other drugs are subject to the deductible. The Deductible $1,600/$3,700 Plan and the Deductible $2,500/$6,250 Plan are the same to this point. The big difference is what happens after you reach your deductible for the year. This Deductible $1,600/$3,700 Plan will then cover all drugs at 100% for the remainder of the calendar year. This is valuable if you have expensive prescription drugs. The other plan’s prescription drug costs would be subject to the plan’s coinsurance, meaning you would be sharing in some of the costs, capped at the plan’s out-of-pocket maximum.

And once you’re enrolled in a plan, you’ll have access to even more tools and resources to help make the most of your plan – including Aetna’s concierge team, Medical Experts by Teladoc, and the Aetna website, and Aetna Health App.

Both the Deductible $1,600/$3,700 Plan and the Deductible $2,500/$6,250 Plan allow you to set money aside from your paycheck (and money from Waters) in a Health Savings Account (HSA account)

• It’s your account for life, and the money is never forfeited.

• The money earns interest.

• The money can be invested.

• The money can be withdrawn at any time, tax-free, for eligible health expenses.

• The money can be withdrawn at any time for non-eligible health expenses (penalty and taxes will apply).

• The money can be withdrawn in retirement for health-related expenses, tax free; or non-health-related reasons, which would be taxable.

One thing you’ll want to note though, is that if you enroll in the Copay and Deductible Plan, you are not eligible for an HSA or HRA. But, you will be eligible for an FSA. To learn more about how that account works, follow the link below.