A Quick and Easy Guide to Choice Account Plans

Picking an insurance plan might seem intimidating. But buying a lawnmower? Well that’s easy: just think about what your yard needs.

When it comes to signing up for health insurance for 2017, the process is similar. You have four plans to choose from: Option 1, Option 2, Choice Account, and Choice Account Plus.

 

 

 

Options 1 and 2:

  • Generally have higher premiums. Premiums are the money that comes out of each paycheck — and you pay premiums whether you use your insurance or not.
  • With Options 1 and 2, each time you use your insurance (like when you go to the doctor or fill a prescription), you’ll usually pay less out of pocket.
  • With these plans, you’re usually paying a copay for visits and prescriptions. A copay is a set dollar amount. You’re responsible for the copay, and, in most cases, insurance pays the rest.

But what if you don’t use your insurance very much? You can still choose Option 1 or 2, but you might be paying for more insurance than you need right now. The money you spend on Option 1 and Option 2 only pays for benefits this year (it’s not an investment).

Choice Account and Choice Account Plus:

  • Generally have lower premiums, which means less money comes out of each paycheck.
  • If you do go to the doctor or fill a prescription, you’ll probably be paying more out of pocket.
  • Choice Account plans don’t have copays. Instead, you pay the full dollar amount for doctor visits, hospital stays, and most prescriptions until you meet your deductible. Once you’ve paid your deductible, coinsurance kicks in. That means you pay a percentage of full price, and, in most cases, insurance pays for the rest.
  • But Choice Accounts give you a way to save for the future. Read more about HSAs.

 

Whichever plan you choose, basic medical needs (like annual checkups, routine screenings, and standard vaccinations) are 100% covered. Which means if you’re in-network, you usually pay nothing out of pocket.

 


 

Example 1

 

 

    Employee only* (Employee only coverage)

 

2017 HEALTH EVENTS:

  • Sprained ankle
  • 2 in-network visits to primary care physician
  • 1 urgent care visit
  • 1 generic medication filled at local in-network pharmacy (10 day supply)

 

Medical Option 1 Option 2
Out-of-pocket costs$800$830
Premiums$1,863$1,421
Total yearly cost$2,663$2,251

 

Medical Choice Account Plus Choice Account
Out-of-pocket costs$1,087$1,087
Premiums$1,263$1,092
Lowe's HSA contribution -$260$0
Total yearly cost$2,090$2,179

 

*Non-tobacco user

 

Example 2

 

 

Icon_Couple    Employee + spouse* (Family coverage)

 

2017 HEALTH EVENTS:

  • Heart surgery
  • Surgery for appendix
  • 4 in-network visits to primary care physician
  • 8 specialist visits
  • $500 for prescription medication copays

 

Medical Option 1 Option 2
Out-of-pocket costs$12,000$13,100
Premiums$6,015$4,586
Total yearly cost$18,015$17,686

 

Medical Choice Account Plus Choice Account
Out-of-pocket costs$13,100$13,100
Premiums$4,077$3,525
Lowe's HSA contribution-$520$0
Total yearly cost$16,657$16,625

 

*Non-tobacco users

 

Example 3

 

 

Icon_family    Employee + spouse + 2 children* (Family coverage)

 

2017 HEALTH EVENTS:

  • Broken arm
  • 9 in-network visits to primary care physician
  • 4 in-network visits to specialist
  • 2 urgent care visits
  • 1 ER visit copay $250
  • $200 for family prescription medications

 

Medical Option 1 Option 2
Out-of-pocket costs$3,220$3,920
Premiums$6,015$4,586
Total yearly cost$9,235$8,506

 

Medical Choice Account Plus Choice Account
Out-of-pocket costs$4,990$5,767
Premiums$4,077$3,525
Lowe's HSA contribution-$520$0
Total yearly cost$8,547$9,292

 

*Non-tobacco users

 

Example 4

 

 

    Employee only* (Employee only coverage)

 

2017 HEALTH EVENTS:

  • 1 PCP Visit for the flu
  • 1 generic medication filled at local in-network pharmacy (10 day supply)
  • 1 Preventive Care Visit
Medical Option 1 Option 2
Out-of-pocket costs$40$50
Premiums$1,863$1,421
Total yearly cost$1,903$1,471

 

Medical Choice Account Plus Choice Account
Out-of-pocket costs$102$102
Premiums$1,263$1,092
HSA contribution used$102$0
HSA remaining balance$158$0
Total yearly cost$1,263$1,194

 

*Non-tobacco user

 

Get more information about:

Cost per paycheck (2017 information coming in October)

Expected costs when using your insurance (2017 information coming in October)

Prescription drug costs (2017 information coming in October)

 

FSA vs. HSA

 

You’re probably already familiar with a Flexible Spending Account, or FSA. During annual enrollment, you estimate how much money you think you’ll spend on medical expenses in the coming year: glasses, doctor’s visits, bandaids, medication, etc.

That money is deducted from your paycheck before taxes, and goes into a special account that you can use for medical expenses. But if you don’t spend the money by the end of the year, you lose it — it’s not an investment.

You can only put money into an FSA if you have Option 1 or Option 2 insurance.

A Health Savings Account, or HSA, works kind of like an FSA. During annual enrollment, you decide how much you want to contribute to your HSA. Like the FSA, your contribution is not taxed. Like the FSA, this money is available for medical expenses.

But the money in an HSA is yours, even if you retire or leave the company. Whatever you don’t spend will roll over year-to-year-to-year — until you need it. So if, one day, you do have an unforeseen medical emergency, you have funds to pay for it.

You can only put money into an HSA if you have a Choice Account or Choice Account Plus plan.

FSA/HSA Details

 

Check out our FAQ below, but if you have any questions — medical questions, benefits questions, FSA or HSA questions — call your navigator. (It’s the phone number on your insurance card.)

Accolade: 888-926-2404

Quantum: 888-560-6466

Optum: 800-926-7426

 

 

FAQs

  • What’s the difference between Option 1/Option 2 and Choice Account/Choice Account Plus?

    Options 1 and 2 might be good choices for someone who expects to use their insurance a lot this year. Choice Account and Choice Account Plus might be better choices for someone who is more likely to need insurance someday in the future.

    Options 1 and 2 usually cost more upfront, but often cost less out-of-pocket as you use your insurance — and they don’t help you save money for the future.

    Choice Account and Choice Account Plus generally cost a little less upfront, and often cost more out-of-pocket for medical expenses and prescriptions, but they do help you save money for the future.

  • What’s the average savings per paycheck of Choice Account plans vs. Options 1 or 2?

  • Does my insurance affect how much I pay for prescriptions?

    It does. If you’re covered by Option 1 or Option 2, you’ll probably pay a set dollar amount (a copay) for your prescriptions. If you have Choice Account or Choice Account Plus, then you’ll usually pay the full price of the medication — until you meet your deductible. After that, you’ll pay coinsurance (which is a percentage of full price).

  • Can I cover my spouse and/or dependents with Choice Account and Choice Account Plus plans?

    Yes, spouse and dependents are generally eligible for coverage under all four plan types: Option 1, Option 2, Choice Account, and Choice Account Plus.

  • Can I switch between types of plans if I change my mind during the year?

    No, you can only change your plan during annual enrollment (October 17 – November 4, 2016). But if you have a qualified life event (like having a baby, getting married or divorced, or if your spouse gains or loses insurance coverage), you can make the corresponding change to your insurance: adding or removing family members from your plan.

  • What happens if I have Choice Account or Choice Account Plus and I have a major medical incident?

    You would be responsible for 100% of costs until you have met your deductible. After that, you pay a percentage of the costs, and insurance usually pays the rest. Once you hit your annual out-of-pocket maximum, insurance usually covers 100% of costs. Click here for complete Plan Details, including your out-of-pocket maximum.

  • Does my plan choice affect which doctors are in-network or out-of-network?

    The list of “in-network” doctors and hospitals is the same whether you choose Option 1/Option 2 or Choice Account/Choice Account Plus, but the amount you pay at those doctor’s offices will depend on the specific terms of your plan.

  • How do I know which plan is right for me?

    Review the plan details (including cost per paycheck and specific benefit details), think about what medical expenses you might have this year (and in the future), and choose the plan that best fits your needs.

    Option 1 and Option 2 might be a good choice if you expect to need medical services this year. Choice Account and Choice Account Plus might be good choices if you don’t expect many medical expenses this year, and want to save for the future.

  • Do I have to have an HSA if I choose Choice Account or Choice Account Plus?

    An HSA is not mandatory, but it does allow you to save money for future medical expenses — and the account is triple-tax-protected. You don’t pay income taxes on the money that goes into your HSA, you don’t pay taxes when you spend the money on qualified medical expenses, and you don’t pay capital gains tax if you invest the money.

  • How does my HSA get funded?

    During annual enrollment, you decide how much you want to contribute to your HSA. (If you choose the Choice Account Plus plan and decide to fund an HSA, Lowe’s will additionally contribute $260 for an individual or $520 for a family.) As you make contributions throughout the year, your HSA will grow.

  • Can I cash out my HSA?

    If you spend the money on non-qualified expenses, you will be subject to a 20% penalty and income taxes on the distribution amount. If you are age 65 or older and spend the money on non-qualified expenses, only income taxes will apply (you are not subject to the 20% penalty).