Copays vs. HSA's....LEt's Get it ON!!!!!!!!!

May 9, 2007

  1. salpro22
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    salpro22 Guru

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    Ok guys I am curious to know what your personal viewpoint is on selling a copay versus a HSA. Here is my jist on the fight.

    Copays
    1) Great for people/families who go to the doctor more than 120 times a year :)
    2) Great for people who do not fully comprehend how to maximize their health care cashflow.
    3) People who are used to making copays and do not like, nor do they want to change.
    4) When it is to cost prohibitive to finance a HSA (e.g., people who will get rated or ridered and have an excessive amount of costs to pay and want a simple co payment on drugs).
    5) A specific plan does not allow VARIOUS charges (e.g., lab work, preventive, wellness, etc.) to apply towards the deductible.

    HSA
    1) Great for people who go to the doctor 119 times a year.
    2) Understand ROI, and more specifically, can understand how cashflow operates and ways to increase it exponentially with HSA's.
    3) Despise not knowing what they are going to pay and are confused about how things are paid.
    4) Take pride in the fact that they have more control over their health care.
    5) Understand the give and take of copays versus paying out of pocket.

    I would love to hear your thoughs on when it is acceptable to offer an HSA versus copay plan. For example, do you have a number of doctor visits, prescription cost cap (in one year), etc. that you base your decision on?

    The J.R.
     
  2. CHUMPS FROM OXFORD
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    CHUMPS FROM OXFORD Guru

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    On a side note...invariably, in family situations, I notice that the male wants the HSA and the female wants the copay policy.

    This is not meant to be a sexist comment in any way...just an


    observation.

    Will the Brewers ever lose again?
     
  3. salpro22
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    salpro22 Guru

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    What do you think the reason is for that? i have noticed the same thing sometimes.
     
    salpro22, May 10, 2007
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  4. David C
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    David C Guru

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    Women want security, men want opportunity.

    I quoted a case today with Assurant. Adding the copay adds 98 and change to the monthly, then they still have to pay the 35 copay. It does not make financial sense.
     
    David C, May 10, 2007
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  5. salpro22
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    salpro22 Guru

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    HaHa, women do want security and that is one reason why we love them. That doesn't address my question though. What specifically causes women to want copays vs, men being comfortable with HSA's? I believe that once I have a good idea about how a person thinks by having a nice qualification phone call and I find out what drives them, it is highly possible to find out the type of personality they have and cater a presentation to meet those needs/personality type.

    Alpha's love HSA's because it puts them in control and they LOVE THAT. Women love copays because they are SIMPLE and EASY to use. Start talking about keeping track of expenses, researching prescription/procedures costs, etc. and you are now dealing with the women from Orange County.

    This is in no way to say that women are simple-minded, but i do think that some TYPES do prefer to keep things simple. However, talk about all the money they can save and paint a picture of a closet full of nothing but shoes.......They may not not buy the HSA, but you should at least get a nice laugh, while providing quality education and that is the fun part :)
     
    Last edited: May 10, 2007
    salpro22, May 10, 2007
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  6. djs
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    djs Super Moderator Moderator

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    People who want copays like the predictibility. I'm going to the doctor, I have $35, everything is good. No questions, I know what it is.
    :v_SPIN: ;)

    People who like HSA's like the power trip. I can control when I go to the doctor. I don't have $200? I don't get sick enough to go to the doctor. After all, I'm in control, I can control when I get sick.
    :D :D

    My experience is people who have been on large group and are used to paying a small copay to see the doctor have a hard time ever changing.

    Dan
     
    djs, May 10, 2007
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  7. newmindfashion
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    The Brewers are this year's Tigers it seems.

    HSAs are a no brainer. If you compare them to the more reasonably priced PPO copay plans with Assurant or whoever, the maximum out of pocket (OOP henceforth) on an HSA blows away the standard PPO plans.

    The standard PPO plans are laced with extra OOP in the form of multiple deductibles which have to be met by at least two (usually 3) family members. After those deductibles are met, guess what, there's coinsurance on top of that (Assurant LOVES to price those 80/20s out of oblivion) which is often 50/50 until a few more grand are out of pocket.

    And, the copays don't count to the deductible. And, medical expenses are not likely to be pre-tax. And Rx drugs have a separate per person deductible on brand Rx adding even more OOP.

    When the agent adequately explains the amount of OOP on the reasonably priced PPOs and compares it to the HSA-compatible plan, far less people will go with the copay PPO than they usually would when the agents focus only on the copays and not the MULTIPLE deductibles (which many agents don't go out of their way to clarify).

    Now, when you compare the HSA against the higher cost comprehensive HMOs which don't have as much OOP laced into the plan in the form of testing going toward deductible and lower overall hospital fees, then its STILL A NO BRAINER because the premium difference literally pays the whole family HSA deductible right there. So even if they get hit with 5K plus, their guaranteed to be no worse off plus the expenses are pre-tax.

    Case closed. Fat lady is wailing not singing.
     
  8. newmindfashion
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    BTW, I'm out of the office until late afternoon so I look forwad to reading Petrowski, STI and Somarco's comments (and the rest of you too)

    ;)
     
  9. Crabcake Johnny
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    Crabcake Johnny Guru

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    Anyone who's not selling HSAs is also not selling their clients what the family OOP is. When you go over the fact that it's $3,000 to $5,000 of liability for one person, then the clock resets for another family member most people don't like that. It's just something most agents who sell copay plans fail to discuss with clients.

    And you know who you are. If you sell copay plans ask yourself when the last time you went over family liability. I know the answer - so do you.

    If you want a line to use here it is:

    Me: "Tim, does your family abuse the healthcare system by running off to the doctor 20 times a year?"

    Tim: "Absolutely not."

    Me: "Would you like to pay for people who do?"
     
  10. somarco
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    somarco That Medicare Expert Guy

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    A defective gene.

    And this works with your wife?

    Stop lying. No one is going to believe you understand women.

    For that matter, no one is going to believe ANY man understands women. Even Dr. Phil can't figure them out.

    Nope. Wrong again.

    The answer can be found here.
     
    somarco, May 10, 2007
    #10
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