Health Savings Accounts / High-Deductible Healthcare Plans

[Cyclones_R_GR8]

Yeah, I think it's a good option overall in a range of options. I guess my biggest beef with them is that it seems now the High Deductible Plan is Option #1 of a grand total of 1 plans offered by the employer. In my nearly 30 years of working now, I've seen the plan offerings from employers go from four different plans to three decent options, to now just the only coverage option. I spent over 25 years subsidizing the plans I've been in without anything more than an a cortizone shot in my elbow, and now that I'm entering the years where I may need to use some services in the next decade or so, there aren't any lower deductible plans and I don't have 25+ years worth of HSA accumulated savings. I suppose one could say I should have saved money along the way to pay for it, and they would have a point. I would loved to have seen the HSA HD plans be more widely available when I was young, because it would have really paid off for us. I'm glad they will be more mainstream now and I hope that the Millenials and Gen Zeds will learn from the mistakes of us from the previous generations, given there are so numerous and clear for anyone willing to examine them (that goes for a number of policies really).

With an HDHP and HSA you also have a maximum out of pocket for the year. Once you hit your deductible your out of pocket costs drop dramatically. Once you hit the maximum out of pocket for the year insurance picks up 100% of any other costs.
People think that with an HSA they just basically pay all their medical bills from the HSA. It works much better than that. I never even hit the maximum out of pocket when I had double hernia surgery and I think that was about $18,000 total.
Being that a colonoscopy is considered preventative mine cost me $0 out of pocket.

 

[clone52]

I guess I'm not sold on the HSA thing. Healthcare costs can be so high that I question that you'd be able to adequately save for something in the HSA account. My wife recently had a surgery on her septum to help with frequent sinus infections and the make some of her allergies better. The bill through insurance was $35,000, for something that wasn't a critical, life endangering need. It certainly increased her quality of life, but I question how well we could have afforded that under an HSA/HDHP scenario, especially with two kids that leave giant question marks on what their health expenses will be (never know when someone will break a bone being a kid). So we do traditional health insurance through our employers. She has hers through ISU and our only out of pocket costs for the $35,000 procedure were the copays. I'm sure under the HSA/HDHP scenario, we might have been able to negotiate the costs down some, but IMO not enough to make it worthwhile to not be on traditional insurance. I guess it probably comes down to the cost of the coverage from the employer. We both have good employers that cover a large share of the cost.

I have an HSA witha $6500 deductible, $12K family out of pocket max and $6500 out of pocket max per person.. In the case of your wife's surgery, if you had my plan and you had no other health expenses, then you would pay $6500 and insurance would cover every penny of your wife's medical expensies for the rest of the year and the rest of your family's medical expenses would be a 20% copay until you hit the max out of pocket for the family.

Whats crazy to me is this. I had appendicitis. If I didn't have insurance, the bill to the hospital/doctor would have been around $30K. Since I have insurance, the hospital/doctor are going to be paid less than $8K total.

 

[clone52]

But the point is, I don't think her procedure would be considered catastrophic. One could certainly argue that it was an elective thing. It wasn't going to cause her any life threatening danger. So I question if it would have been covered under a catastrophic plan and I doubt we would have done the procedure knowing that it would have had that large amount of cost. However, she is certainly better for having done it.

Again, the decision point probably comes down to how much your premiums are each month for the coverage offered by the employer. We both work for employers that cover a lot of our premium cost, I'd be surprised if we paid more that $150 a month for coverage. Certainly HSA/HDHP might be more beneficial to someone with a higher monthly cost.

In the end, I think the real solution to solving healthcare costs would be looking at how hospitals and doctors bill insurance. There is such a vast difference on how different insurance plans are billed that it's almost impossible to know what the true cost of the service actually is.

If you're worried that a High Deductible plan wouldn't cover the procedure, then any insurance plan wouldn't cover the procedure.

 

[NickTheGreat]

I think the healthcare "problem" in this country largely started because people don't know and don't care what things cost. Or don't want to know.

You can blame insurance companies or politicians or whomever, but when there's no financial stake for the customer you get runaway pricing.

I don't know if HSA's are the answer to this problem but I think it may be a step in the right direction.

 

[Clonehomer]

This is interesting to me. Maybe it is just me but I'm this way even if it were free for me to go. I just don't like to go to the doctor. Do people really regularly go to the doctor just for a cold? Is that why it is so hard to get into the doctor?

Our doctor is like two weeks minimum wait.

Thinking mostly kids with fevers and the urgent Care clinic.