Log in

View Full Version : Benefits/Insurance packages, open enrollment time.


Pages : [1] 2

turbotalon1g
11-18-2010, 01:19 PM
So I just scored an on-call/casual position with Summit Ortho. and it got me thinking about benefits and such.

Now this is the start of my career and I've never really needed this because I've been in the military, just not had any coverage, or had a job that actually had coverage and i just left if because 1. I was covered and 2. didn't care because it was a job.

Because I am in teh military i get to have TRIcare, medical/dental thru the military and what I believe is a good rate.

http://www.tricare.mil/mybenefit/home/Medical/Costs

Costs

Monthly Premiums
TRICARE Reserve Select premium rates are established annually on an calendar year basis. You are required to pay the monthly premiums if you decide to enroll in TRICARE Reserve Select.

Type of Coverage 2010 Rates
Member Only $49.62 per month
Member-and-Family $197.65 per month

Other Health Care Costs
The chart below outlines the costs for covered services for TRICARE Reserve Select.

* Cost sharing begins after the annual deductible is met
o Sponsor's rank is E-4 and below: $50 (Single)/$100 (Family)
o Sponsor's rank is E-5 and above: $150 (Single)/$300 (Family)

* Costs are determined by the type of provider you see, network or non-network

The costs shown in this chart are for care received outside of a military treatment facility (MTF). While MTF care is usually free of charge, there may be minimal charges applied for inpatient care. Please check with your local MTF for details.

All costs listed below are effective October 1, 2010.
Ambulance Services

Network providers:
15% of negotiated rate

Non-network providers:
20% of allowable charges
Ambulatory Surgery
(Same Day) $25
Behavioral Health (Inpatient) $20 per day ($25 minimum charge)
Behavioral Health
(Outpatient)

Network providers:
15% of negotiated rate

Non-network providers:
20% of allowable charges
Clinical Preventive Services

$0 for colorectal, breast, cervical and prostate cancer screenings; immunizations; and well-child visits for children under age 6.

For all other preventive services:

Network providers:
15% of negotiated rate

Non-network providers:
20% of allowable charges
Durable Medical Equipment, Prosthetic Devices and Medical Supplies

Network providers:
15% of negotiated rate

Non-network providers:
20% of allowable charges
Emergency Services

Network providers:
15% of negotiated rate

Non-network providers:
20% of allowable charges
Family Health Services

Network providers:
15% of negotiated rate

Non-network providers:
20% of allowable charges
Home Health Care $0
Hospice Care $0
Hospitalization (Inpatient) $16.30 per day ($25 minimum charge)
Immunizations

$0
Laboratory and X-Ray Services

Network providers:
15% of negotiated rate

Non-network providers:
20% of allowable charges
Maternity Care (Office visits and hospitalization for delivery planned in a hospital in an inpatient setting) $16.85 per day ($25 minimum charge)

Note: This is one global fee for all of the maternity care and delivery.
Maternity Care (Office visits for delivery planned in a TRICARE-authorized birthing center) $25
Maternity Care (Office visits for delivery planned at home or another setting)

Network providers:
15% of negotiated rate

Non-network providers:
20% of allowable charges
Newborn Care $16.85 per day ($25 minimum charge)

Outpatient Visits


Network providers:
15% of negotiated rate

Non-network providers:
20% of allowable charges

Routine Pap Smears
Network providers:
15% of negotiated rate

Non-network providers:
20% of allowable charges

Skilled Nursing (Inpatient)
$16.85 per day ($25 minimum charge)

Prescription costs:
http://www.tricare.mil/mybenefit/home/Prescriptions/Costs

Dental:
http://www.tricaredentalprogram.com/tdptws/enrollees/premiums/reserveguard_premiums.jsp

Matt D.
11-18-2010, 01:24 PM
What do you want to know?

turbotalon1g
11-18-2010, 01:34 PM
Is that a good deal?

polishmafia
11-18-2010, 01:46 PM
Whats the annual deductible?

49 bucks a month, with 85/15 after the deductible isn't a bad deal, depending on what the actual deductible is.

turbotalon1g
11-18-2010, 01:57 PM
I think its: Family $460.

I'll be honest, I really have no clue what any of this means = suckfest.

Matt D.
11-18-2010, 02:06 PM
You will typically have a copay that you pay out of pocket any time you go to the doctor, like $15 for an office visit, $50 for xray, $100 for emergency room, etc. Beyond that any costs you incur are covered are covered by the deductible like Pete said, the insurance company will pay something like 85% and the other 15% is your responsibility. Usually there is also a maximum out of pocket cap per year as well, like if you end up hitting that cap, let's say $2000 for example, before the end of the year, the insurance company will pay all costs beyond that for the rest of the year.

Also be sure to stick with in-network doctors and hospitals otherwise you will get killed with costs. Otherwise the monthly costs don't look too bad.

turbotalon1g
11-18-2010, 02:16 PM
The nice thing is/would be if i use a VA hospital/treatment center like the one they are putting in ramsey it there would be little to no cost.

I was thinking of using my military benefits and then bargaining for more pay since the company wouldn't be paying for my benefits.

polishmafia
11-18-2010, 02:28 PM
Now this is the start of my career

bargaining for more pay since the company wouldn't be paying for my benefits.

Just starting out, and already begging for more money. ;)

asshanson
11-18-2010, 03:43 PM
I dont know your rank, but here is the deductible information you listed:
* Cost sharing begins after the annual deductible is met
o Sponsor's rank is E-4 and below: $50 (Single)/$100 (Family)
o Sponsor's rank is E-5 and above: $150 (Single)/$300 (Family)

That is a pretty low deductible, I'd say it seems like a decent deal. $50 for you isn't bad, does your wife already have her own insurance or would you be paying the $197 for both of you?

I doubt you could bargain for more pay because you dont use their benefits.

Speedfreak
11-18-2010, 04:20 PM
You can sometimes bargain for a pay adjustment when not taking their insurance. However it usually isn't a huge amount added.. My coworker gets an extra $100 a month.

From the looks of it(skimmed it), your current policy/deductible looks to be the best deal you are likely to get.

Just as information, insurance for a married couple per month through BCBS on their best plan with a 80/20 and a $1500 or $2000 deductible is about $400/month.