Trying to Choose a Plan (Details inside, in Minnesota)
Hi all. I'm trying to decide between my company's PPO and HDHP. I've been beyond lucky to be on Medicaid during the COVID-19 freeze, but I'm losing coverage on 6/30. I have a lot of medical expenses/appointments (5+ monthly) and expensive prescriptions (Vyvanse is $1800 for 30 days, Emgality, and ~10 more reasonably priced ones.) Under my current plan, my "Total cost of service" would have been $26,177 for 2023 and cash value of prescriptions is between $8-10k. Any help or advice would be greatly appreciated. I'm in Minnesota and will be the only person on the plan. If there is any information that would be helpful, I can probably track it down. Just let me know. 🙂
Plan Details:
Medica Open Access Network/PPO ($155.44/mo)
• Overall deductible: $1750 (in-net); $2625 (out-of-net)
• Out-of-pocket limit: $6000 (in-net); $8400 (out-of-net)
• Co-insurance: 20% (in-net); 35% (out-of-net)
• Prescriptions (deductible does not apply):
o Generic $15; Preferred $45
o Non-preferred $60
o Specialty 20% (Preferred) or 40% (Non-preferred)
OR
Medica Open Access Network/HDHP with RX Plus ($1750-20%) ($107.06)
-$750 annual employer HSA contribution
– Overall deductible: $3000 (in-net); $6000 (out-of-net) – Out-of-pocket limit: $3500 (in-net); $8400 (out-of-net) – Co-insurance: 20% (in-net); 45% (out-of-net)
Prescriptions drugs:
-Generic: 20% co-in after deduct.
-Preferred: 20% co-in after deduct.
-Non-preferred 40% co-in after decuct.
-Specialty 20% co-in after deduct.
submitted by /u/whisperedmayhem
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