Open Enrollment – School Teacher

I am a middle school teacher (35 yo, single, zip: 80206, $70-75k/yr) in suburban Denver, CO. We’ve always ONLY had Kaiser Permanente as an insurance option and then it was what flavor do you want? HOWEVER, this fall we have a choice between Kaiser and United Healthcare. That being said the plans are essentially identical (HDHP 6000, DHMO 2500) but the United premiums are lower.

Current (21-22) Plan: Kaiser DHMO 2500 with $1500 FSA

I have done some preliminary web research and both KP (not for profit) and UHC (for profit) are rated about the same (3-3.5 stars), inference: people in general don’t like dealing with their health insurance provider

22-23 SY/Open Enrollment Plans:

I am largely interested in either the KP or UHC high deductible plan as I like that our district funds 50% (3k), the funds roll over vs. FSA, and it is a retirement vehicle

I like that the UHC premium is lower but have been a perfectly happy/content Kaiser Permanente member for 7 years – I seek preventative care, see a dermatologist on occasion, PT, and mental health (therapist)

I wear glasses/contacts but opt in to separate vision insurance: VSP and plan to again, it is much simpler than KP if you’re a four-eyes

Kaiser PT (distance runner) is awful so I normally see a PT and chiro in town that do not take insurance period (FSA/HSA paid) and have for years

My therapist does not take either KP or UHC so no savings/benefit there

My main prescription is generic Truvada (or PrEP) that costs me $0 under the Affordable Care Act. However, I am worried, unsure of how to set this up again/get a prescription if I switch to UHC

While generic Truvada is covered as preventive under the ACA…posts/information like THIS give me pause on UHC via Aids Foundation Chicago…

2022-23 Benefits Guide:

KP/UHC HDHP: $6,000 deductible, $6,000 out of pocket max – everything covered after deductible

KP/UHC HDHP: employer contributes 50% of deductible or $3,000

HSA through HSA Bank for both

KP monthly premium: $81.60

UHC monthly premium: $53.06

No other differences in the plans or what they offer, they are identical