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Easy to get appointments I can choose my doctor I’m part of the decision free to focus on my patients test results online excellent prenatal care great.

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Presentation on theme: "Easy to get appointments I can choose my doctor I’m part of the decision free to focus on my patients test results online excellent prenatal care great."— Presentation transcript:

1 easy to get appointments I can choose my doctor I’m part of the decision free to focus on my patients test results online excellent prenatal care great specialists BETTER INFORMED. BETTER TOGETHER. Open Enrollment presentation for Englewood Schools

2 2| © Kaiser Permanente. All Rights Reserved. Kaiser Permanente HDHP-HSA Understanding the Kaiser Permanente High Deductible Plan with a Health Savings Account (HSA)

3 | © Kaiser Permanente. All Rights Reserved.3 A different way to pay for your care Same great doctors Same personalized attention Same convenient locations Same health resources Your Kaiser Permanente High Deductible Plan with HSA

4 | © Kaiser Permanente. All Rights Reserved.4  A deductible is the set amount you’ll need to reach each calendar year before services are covered by your plan.  You’ll pay full charges for all services (except prevention) until you reach your deductible.  If you have Employee +1 or family coverage (2 or more people on your plan), you must meet the full family deductible before you’ll be covered by the plan What’s a deductible?

5 | © Kaiser Permanente. All Rights Reserved.5  For 2014, you will have a choice of two different HDHP- HSA plans:  Option 1 (current plan offered)  Your individual deductible is $4,000  Your family deductible is $8,000  Option 2 (new plan with lower deductibles)  Your individual deductible is $2,000  Your family deductible is $4,000 What are the deductibles?

6 6| © Kaiser Permanente. All Rights Reserved. How does this work? Option 1 ($4,000/$8000) You pay Kaiser Permanente pays After you reach your deductible 0% for any additional covered services during the calendar year The full cost of covered services Before you reach your deductible You pay Kaiser Permanente pays Full charges for all covered services (except prevention), up to your deductible amount $4,000 (Indiv) $8,000 (Family) $0 No charge only for preventive care services Full cost of covered preventative services

7 7| © Kaiser Permanente. All Rights Reserved. How does this work? Option 2 ($2,000/$4,000) You pay Kaiser Permanente pays After you reach your deductible 0% for any additional covered services during the calendar year The full cost of covered services Before you reach your deductible You pay Kaiser Permanente pays Full charges for all covered services (except prevention), up to your deductible amount $2,000 (Indiv) $4,000 (Family) $0 No charge only for preventive care services Full cost of covered preventative services

8 8| © Kaiser Permanente. All Rights Reserved. How does this work? CONTINUED Note: These are estimated costs only. Before you reach your deductible Office visit $195 You pay $195 Kaiser Permanente pays $0 After you reach your deductible $195 $0.00 $195.00

9 9| © Kaiser Permanente. All Rights Reserved. Examples of services that count toward my calendar year deductible?  Emergency room visits  Hospital care through Kaiser network facilities  Imaging, laboratory, and special procedures through Kaiser  Office visits, including primary care, specialty care, dialysis and therapy obtained at Kaiser clinics  Outpatient therapy through Kaiser facilities  Prescriptions obtained at Kaiser

10 10| © Kaiser Permanente. All Rights Reserved. Preventive care services Preventive care is about staying healthy and preventing illness. Preventive services are covered at little or no cost to you, even before you reach your deductible. Examples include:  preventive annual exams  well-child visits  well-woman exam  preventive lab tests and X-rays  breast cancer mammography screening (every one to two years for women over 40)  colorectal cancer screenings for adults over 50  cervical cancer screening for women 21 to 65

11 11| © Kaiser Permanente. All Rights Reserved. Out-of-pocket maximum  Your out-of-pocket maximum offers peace of mind by limiting the total amount you’ll pay for most covered services each year.  All your deductible payments count towards your out-of-pocket maximum.  After you reach your out-of-pocket maximum, Kaiser Permanente will pay the full amount for covered services for the rest of the calendar year. IndividualFamily Annual out-of- pocket maximum Option 1: $4,000 Option 2: $2,000 Option 1: $8,000 Option 2: $4,000

12 12| © Kaiser Permanente. All Rights Reserved. What ’ s a Health Savings Account (HSA)?  You can use HSA funds to cover your out-of-pocket costs for deductibles, and other qualified medical expenses  Your HSA belongs to you, so whatever you don’t spend rolls over to the next plan year. And if you change jobs or health plans, you can take your money with you.  Englewood Schools contributes $136.23/month (Option 1) or $65.97/month (Option 2) to your HSA. You can contribute more to your HAS on a tax-free basis up to the annual IRS limits.  The funds in your HSA are not considered part of your wages, so they’re not subject to federal income taxes.

13 13| © Kaiser Permanente. All Rights Reserved. More About Health Savings Accounts (HSAs)  Your contributions to the HSA do NOT negatively impact your PERA Highest Average Salary  The 2014 annual contribution limits (set by the IRS) are: – Single: $3,300 – Family: $6,550  Note: this is the TOTAL amount that both you and Englewood Schools together can contribute in calendar year 2014  If you are age 55 or older, you may contribute an additional $1,000 to your Health Savings Account

14 14| © Kaiser Permanente. All Rights Reserved. Paying for care When you check in for your visit, you will be asked to make a payment or you can ask to be billed for any services rendered. You can use funds in your HSA to make this payment for yourself or your dependents. You will get a bill after your visit if:  Your payment at check-in didn’t cover the full amount you owe for the services you received during your visit.  You received additional services during your visit. Before you reach your deductible Payment is based on full charges and will count toward your deductible and out-of-pocket maximum. After you reach your deductible Kaiser Permanente will pay for all covered services under the plan for the remainder of the calendar year.

15 15| © Kaiser Permanente. All Rights Reserved. Tools and resources to help you plan and budget At Kaiser Permanente, we think you should be in charge of your health and your budget. You’ll find helpful information, tools, and resources at kp.org/deductibleplans. Some resources are:  Financial Counselors to provide cost estimates for services  Preventive care services list  Estimates and Out-of-Pocket Summary tools  Sample fee list

16 16| © Kaiser Permanente. All Rights Reserved. Better Informed. Better Together. Questions? Questions about plan benefits, call member services at / Medical cost estimates, call our Financial Counselors /

17 | © Kaiser Permanente. All Rights Reserved.17


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