HSAs and age, etc.

[Jaybee]

So...we have to decide between a traditional insurance plan and an HSA. From what we can tell, they are both good plans. The company pays approximately the same amount; they will put into the HSA the difference between the lower deductible insurance plan and the higher deductible HSA compatible plan. (Does that make sense?) Our cost for the traditional plan would be about $70 more/month. 

 

We have always had really good insurance, so have never looked into HSAs before, so we are trying to understand how they work, for one thing. Our main question has to do with the wisdom of our starting an HSA in our late 50s. The dependents have no medical concerns that we are aware of, and dh is in very good health, so no present concerns for the three of them. I am overweight, insulin resistant (but good A1Cs for the past couple of years), and have hypothyroidism. I also have sleep apnea and use a CPAP. I feel good, and hope to get into a good exercise routine soon, but have trouble consistently controlling my weight. We know that we face risks either choice we make, but we are trying to get some input from others about what they would do in our situation. Kind of funny, but dh, who never reads these boards, was all kind of supportive about my asking on here, because "they know about all kinds of things," lol.

 

I reserve the right to ask ignorant questions in response to any replies, because we don't quite know how HSAs work. ;) 

[QueenCat]

HSAs are what I'd call a pretax savings account to help meet the deductible and out of pocket expenses in a more planned way than just coming up with money when things happen. You can use them for those expenses as well as some others. Medical history is not looked into as to whether or not you can have one, or get reimbursements for one.

[Jaybee]

HSAs are what I'd call a pretax savings account to help meet the deductible and out of pocket expenses in a more planned way than just coming up with money when things happen. You can use them for those expenses as well as some others. Medical history is not looked into as to whether or not you can have one, or get reimbursements for one.

 

I mentioned my medical history more for background info in making the best choice. 

[Arcadia]

The company pays approximately the same amount; they will put into the HSA the difference between the lower deductible insurance plan and the higher deductible HSA compatible plan. (Does that make sense?) Our cost for the traditional plan would be about $70 more/month.

Basically the company probably expect you to use the HSA to cover the difference in deductible. My hubby's current employer offers a HSA plan which is the same as the PPO plan we had but with the bonus of HSA. HSA is less restrictive than a flexi spending account (FSA) and the HSA leftover funds can be rollover year after year. We used up HSA funds previously for testing by a psychologist for our kids and now have quite a generous amount saved up again in HSA.

 

I think our HSA can be used for medical and optical but not dental costs. We are a mix of near sighted and astigmatism.

Edited August 7, 2017 by Arcadia

[xixstar]

I would need more information to answer this question: what is the difference in deductibles and coverage of the two plans and what has been your average medical usages for the past 2-3 years (like looking at all of your EOBs to see what the allowed amounts were regardless of what your co-pay was). 

With that information you can calculate out what it would have cost you to use each plan for the past couple years and you can see which one would have been more affordable. 

Edited August 7, 2017 by xixstar

[xixstar]

I think our HSA can be used for medical and optical but not dental costs. We are a mix of near sighted and astigmatism.

 

Dental care is an included class that you can use your HSA for. 

[Jaybee]

Dental and vision are a separate plan. Up to this point, our medical expenses have been such that an HSA would be more beneficial. Our concern is that with our getting older, and not having had years of building up a larger amount in the HSA, would the risk be too high to start an HSA at our ages.

[teachermom2834]

We have had an HSA plan for 3 years now and we are really happy with it. I really like being able to use it for optical and dental. That money is socked away there when we need glasses and it isn't as if the new glasses are coming out of our day to day budget. Our insurance did not pay for a wisdom teeth extraction for ds but we were able to use HSA funds. We are now using HSA funds for orthodontic treatment. It is pre-tax so I feel like all those pre-tax dollars add up to quite a savings vs. paying out of our monthly budget.

 

We initially chose it because we rarely had medical expenses and the higher deductible for the traditional plan felt like throwing money away vs. saving it in an HSA. We contribute the yearly max and over a few years we have built up a bit of a surplus even though we have had some major expenses.

 

We really are happy with it. I feel like we get more for our money than we would paying the higher deductible on the traditional plan. We have money deposited to it directly each paycheck so we don't even miss it yet we build a little savings.

[xixstar]

Dental and vision are a separate plan. Up to this point, our medical expenses have been such that an HSA would be more beneficial. Our concern is that with our getting older, and not having had years of building up a larger amount in the HSA, would the risk be too high to start an HSA at our ages.

It's not about plans, it's just about what you're allowed to spend your HSA funds on. It doesn't matter than I have an HSA because we have a high-deductible health insurance plan, we can still use any of the funds we put in our HSA for our dental care and vision care. 

 

I get the concern about timing and age - to me the best case scenario is being able to contribute enough to your HSA, through your employers contributions and your own contributions, to meet your deductible. Now, this could be the individual deductible or the family deductible -- family would be ideal but some plans make that hard these days.  

 

Doing it this way, if something happens, you're mostly covered with the savings you have accumulated. I say mostly because some plans now have a co-insurance kick in after you meet your deductible, so you still owe more money after you hit your deductible versus set co-pays -- honestly, there are soooo many variations, it's crazy. 5 years ago, I would have said that an HSA eligible plan was the best thing ever -- I'm no longer wearing those rose-colored glasses due to deductibles going up and coverage going down.

 

Generally, high-deductible plans with HSA have been good for people that either never go to the doctor or need a lot of medical care. If you use an average amount of health care each year, it's generally not the most economical. 

 

But again, run the numbers and see how the plans would have compared over the past couple years. You might find that an HSA is a better fit for your family -- if it is, I wouldn't immediately let fear of age discount it. Just make a reasonable guess as to what you can put in this year, does it reach the individual deductible for one person? If so, if a new medical needs arise, how likely is it that everyone will have something come up versus just one person? 

[3 ladybugs]

We just went to the HSA this year and I have a history of cancer. I am really loving it. I feel I have more control over my healthcare choices for my family and that is a WONDERFUL feeling. I also love that HSA can accumulate and be used in retirement. Something my in-laws are just now seeing would be a good thing. So even though you are in your 50's I would highly recommend it. 

 

Do you have different options with your HSA? For instance, we had a choice of 2 HSA insurance plans. One had a higher deductible then the other. We chose the one with the lower deductible for this year, figuring that it would be better if we had an unthinkable happen. I figure as we build up funds in our HSA, we can go to the higher deductible plan (and lower cost) once we build up some money in our HSA. Baby steps you know?

 

I guess I should also say what I mean about more control. I am able to use programs like Good RX to find the cheapest place to get prescriptions for my family. I am also able to look at scripts I am prescribed to determine if I feel they are best for us. I have also been able to use my insurance when it is beneficial to me, and not use it when that is more beneficial. I am controlling the cost of things this way. For instance, in April my son fell and hit his head on a bookcase. It looked like he needed stitches so I took him to an urgent care clinic and I was self pay (April was a gap in our insurance). They told me that if I enrolled in a program, I would be able to get a discount. My son is rarely sick so I declined at that time. A couple of weeks later, I got a bad cold and needed to go to the urgent care clinic. This time I signed up for the program because I am prone to get sick and I loved the lack of wait time at the urgent care clinic. They told me that it was viral and sent me on my way. A week later my cold was worse so I went back. Because I was self pay the first time and it was within 10 days of the first visit for the same reason, the office visit was free (how often does that happen with PCP's??). They prescribed me an antibiotic and a few other things. I took all the scripts home and researched them and felt that all I needed was the antibiotics and a couple of over the counter products. I was able to go onto the Good RX app and find the best price and get the scripts filled there. 

 

In the past if a doctor prescribed something, I would just get it. Didn't think twice about it. With the HSA plan that we have now, I really do question everything and I don't need to use my insurance if I don't want to. Sometimes doctors give discounts if they don't have to deal with insurance. The HSA in those cases is just like a normal credit card to the doctor, but to you it is pre-tax money. ;) 

 

I hope this all makes sense. :) Good luck with your decision. 

[Jaybee]

I'll have to look at it more, but I don't believe there are options. It's a good plan as is, from what I can tell. Higher deductible, but not ridiculously high. One thing I know I like about it as per PP, is that it has bugged me when, due to insurance, I needed to buy supplies for my CPAP through a more expensive route. I like the idea of bargain hunting when it comes to durable medical equipment!

[SparklyUnicorn]

We tried an HSA.  I didn't care for it.  I didn't feel any sense of control over anything because for one thing so many medical service places are not upfront about cost and the insurance company doesn't give out contract information either.  This whole idea that you can call around and ask to get the best deal?  A joke.  We tried many times and so many wouldn't tell us the cost!  Crazy, but true.  And a little known fact is sometimes contracts aren't as favorable if your employer is self funded.

 

To compare the two plans in terms of overall what they cover and will cost you, look at stuff like the out of pocket max and ESPECIALLY what counts towards the out of pocket max. Sometimes several of your costs (copays, coinsurance, deductibles, medications) don't count towards the maximum.  So the max is quite a bit higher than what they say. 

 

If you rarely use medical, an HSA is good.  Otherwise...not so much IMO. 

 

 

[SparklyUnicorn]

I'll have to look at it more, but I don't believe there are options. It's a good plan as is, from what I can tell. Higher deductible, but not ridiculously high. One thing I know I like about it as per PP, is that it has bugged me when, due to insurance, I needed to buy supplies for my CPAP through a more expensive route. I like the idea of bargain hunting when it comes to durable medical equipment!

 

Ah but see here is the problem.  If you use the insurance to be credited for purchasing the medical supplies, you must go by their contract and not by "the best deal you can get".  Otherwise, that stuff may not be credited towards your insurance OR if they do allow out of network purchases they will still only credit you whatever fee schedule they go by. 

[SparklyUnicorn]

To add to the last thing I said, if you go out of network, coverage might also be quite a bit less so they will credit you for your expenses even less than if you use in network. For our plan in network is covered 85% or more for most services whereas out of network is covered 60%.  So, again, you will be credited even less by "shopping around" and going with a provider who is not in network.

 

 

 

 

[3 ladybugs]

Ah but see here is the problem.  If you use the insurance to be credited for purchasing the medical supplies, you must go by their contract and not by "the best deal you can get".  Otherwise, that stuff may not be credited towards your insurance OR if they do allow out of network purchases they will still only credit you whatever fee schedule they go by. 

This is a chance you take, but you also can save money provided you never get close to your deductible in a given year. You can also have enough in your HSA (or HSA and savings) should you need to hit your deductible in a given year. 

 

Personally I would rather save money then to be forced to not save money. 

[SparklyUnicorn]

This is a chance you take, but you also can save money provided you never get close to your deductible in a given year. You can also have enough in your HSA (or HSA and savings) should you need to hit your deductible in a given year. 

 

Personally I would rather save money then to be forced to not save money. 

 

There are various instances where stuff does not count towards the deductible.  Which means you could end up spending far more than your deductible before any insurance kicks in. 

[Jaybee]

We tried an HSA.  I didn't care for it.  I didn't feel any sense of control over anything because for one thing so many medical service places are not upfront about cost and the insurance company doesn't give out contract information either.  This whole idea that you can call around and ask to get the best deal?  A joke.  We tried many times and so many wouldn't tell us the cost!  Crazy, but true.  And a little known fact is sometimes contracts aren't as favorable if your employer is self funded.

 

To compare the two plans in terms of overall what they cover and will cost you, look at stuff like the out of pocket max and ESPECIALLY what counts towards the out of pocket max. Sometimes several of your costs (copays, coinsurance, deductibles, medications) don't count towards the maximum.  So the max is quite a bit higher than what they say. 

 

If you rarely use medical, an HSA is good.  Otherwise...not so much IMO. 

 

 

But don't you have this problem no matter which way you go? I know I have been frustrated a lot with our "regular" insurance in not having any idea what something was going to cost, or in getting unexpected bills months after they were initiated. I don't know how to eliminate that problem. :(

ETA: Adding that: the deductible issue is frustrating either way. I don't necessarily mean "shopping" for services, because...network. But for supplies, it might be possible, I don't know.

Edited August 7, 2017 by Jaybee

[3 ladybugs]

But don't you have this problem no matter which way you go? I know I have been frustrated a lot with our "regular" insurance in not having any idea what something was going to cost, or in getting unexpected bills months after they were initiated. I don't know how to eliminate that problem. :(

I just got one of those unexpected bills, so I feel you! 

 

Just to be clear, I do use my insurance when needed. For my oncologist, it was just easier for me to use my insurance outright. Turns out it saved me money. I typically pay $238 when I was self pay to see her (8 years remission, I have seen her a lot in this time!). This time when I saw her in June, it was only $130 something for her visit. I then got a bill last week for $60 something for the lab work (you see a hematologist, there is going to be blood work!). 

 

Yes if you go too much away from your insurance it can be a bad thing. However you can also do a bit of both. You said that you have durable medical equipment. So you can find out the price is through your insurance, if it isn't good, then go out. Just make sure you realize that it isn't going to your deductible and so on. :) Oh and somethings don't go to your deductible no matter what, so just be aware of that too.

[SparklyUnicorn]

But don't you have this problem no matter which way you go? I know I have been frustrated a lot with our "regular" insurance in not having any idea what something was going to cost, or in getting unexpected bills months after they were initiated. I don't know how to eliminate that problem. :(

 

Oh I agree it sucks either way.  But this idea that you can shop around?  That's a joke unless you have zero insurance and offer to pay cash upfront.  As soon as you have insurance they often say they can't discuss contract information with you.  BTDT because I don't mind calling around and asking.  Tried it several times and wasn't given ANY information.  If they are contracted, forget it you will not get any information because that's often part of the contract..that they can't discuss the contract.  Out of network they can, but coverage out of network can be a lot less and the insurance company can easily turn around and not credit you for the full amount of money you have spent. 

[SparklyUnicorn]

But don't you have this problem no matter which way you go? I know I have been frustrated a lot with our "regular" insurance in not having any idea what something was going to cost, or in getting unexpected bills months after they were initiated. I don't know how to eliminate that problem. :(

ETA: Adding that: the deductible issue is frustrating either way. I don't necessarily mean "shopping" for services, because...network. But for supplies, it might be possible, I don't know.

 

But if you buy supplies elsewhere for a better deal is it really a better deal ultimately if they don't give you any credit towards the deductible?  KWIM?  It might be...but then it might not be at all. 

[SparklyUnicorn]

I mean if you can easily change your mind the following year, try it for a year and see how you like it.  Might work out great.  I just didn't think it was as magical as it was hyped up to be. 

[Jaybee]

I just got one of those unexpected bills, so I feel you! 

 

Just to be clear, I do use my insurance when needed. For my oncologist, it was just easier for me to use my insurance outright. Turns out it saved me money. I typically pay $238 when I was self pay to see her (8 years remission, I have seen her a lot in this time!). This time when I saw her in June, it was only $130 something for her visit. I then got a bill last week for $60 something for the lab work (you see a hematologist, there is going to be blood work!). 

 

 

 

I don't understand this. I thought you used the HSA to pay the deductible, then the insurance part kicked in. How did this work?

[JumpyTheFrog]

HSAs are an account that lets you accumulate money to use to pay your part. It is separate from the insurance part. Even if you are uninsured, but have money in an HSA, you can use it for qualified medical/vision/dental expenses. Which insurance you have determines if you eligible to make new contributions to an HSA in a given tax year. Contributions are tax deductible when going in and tax-free if used for a qualified expense. The money rolls over from year to year and can be invested in various mutual funds. (We have our HSA through Health Savings Administrators, the company Vanguard recommends. https://healthsavings.com)

 

Once you reach retirement age, you can also withdraw money for non-medical expenses by paying the tax on it. Some people who have already maxed out an IRA and 401k will contribute to an HSA and never withdraw from it for medical expenses (paying them from their regular budget instead) as a way to save more for retirement in a tax-advantaged account.

[JumpyTheFrog]

Here's an article about how people use HSAs to help fund retirement.

http://www.doughroller.net/investing/the-lowdown-on-health-savings-accounts-as-retirement-savings-vehicles/

 

 

[3 ladybugs]

I don't understand this. I thought you used the HSA to pay the deductible, then the insurance part kicked in. How did this work?

Someone already answered this, but yes, you can use an HSA card (it looks like a credit card but you can only use it for certain medical expenses) and not use your insurance. That is what I did when I went to the urgent care center in my prior example. At first it felt wrong to do, however for me it saved me time, and money so I got over that quick. ;) We also tend to use it for medications (without insurance) as it is cheaper to do it that way for us.

[shawthorne44]

Filing paperwork is an expensive bother for medical providers.   You pay for that expense.  You can negotiate with the medical provider as someone without insurance who will pay immediately.   I've found that cost is 50-70% less.   Paying with the HSA card is equivalent to them as paying cash since they are paid immediately.   Then you turn in the medical paperwork to make it apply to your deductible.  

[Guest]

Filing paperwork is an expensive bother for medical providers. You pay for that expense. You can negotiate with the medical provider as someone without insurance who will pay immediately. I've found that cost is 50-70% less. Paying with the HSA card is equivalent to them as paying cash since they are paid immediately. Then you turn in the medical paperwork to make it apply to your deductible.

 

That method does not work here...the insurer and provider have a negotiated rate. They each know what it is. I can cash pay, but if I want it to apply to deductible, it must be the negotiated rate.

 

What is saving money is using FSA for medical equipment rather than negotiated rate via insurance. Unless it makes us hit the deductible,.which won't happen since deductibles are family only for us now, no individual deductibles. So we won't ever satisfy the deductible unless something catastrophic happens. The math with family deductible means we will be better off not on HSA. With individual deductibles,we were better off with HSA. Do the math every year.

[Annie G]

Here's an article about how people use HSAs to help fund retirement.

http://www.doughroller.net/investing/the-lowdown-on-health-savings-accounts-as-retirement-savings-vehicles/

 

Good article!

 

We're using our HSA to build up a medical fund for when dh retires in a couple of years. We max it out but don't spend it- we pay our medical expenses out of pocket. We have only financially been able to do this for the past few years though.

 

One thing that is great about an HSA is that if you let your employer deduct money from your check for the HSA you pay NO tax on it- not even social security or medicare. Maxing out a family HSA saves about $500 in FICA alone. Combine that with the income tax savings and it's been good for us. The first year we maxed it we did it by check at the end of the year and we saved the tax money but missed out on the FICA savings. Lesson learned. 

[Jaybee]

Thank you all so much! One more question (I think): With the HSA/high deductible combo, how does it work with the preventive care procedures/exams that regular insurance takes care of at no cost, like pap smears, mammograms, etc.? Or is that specific to the particular HSA? Just wondering if that must be paid at normal rates through the HSA account.

 

Still not quite sure what we will be doing, but you all have been helpful.

[teachermom2834]

Thank you all so much! One more question (I think): With the HSA/high deductible combo, how does it work with the preventive care procedures/exams that regular insurance takes care of at no cost, like pap smears, mammograms, etc.? Or is that specific to the particular HSA? Just wondering if that must be paid at normal rates through the HSA account.

 

Still not quite sure what we will be doing, but you all have been helpful.

We still get the preventative care covered. All plans are different but for us the only real difference in coverage was the deductible. Our choice was higher deductible vs. higher monthly premium. The co-pays, etc were the same.

[MommyLiberty5013]

So they are separate? This confuses me. In everyone I know, people have both. The HSA is pretax money one can use to pay medical bills that insurance doesn't meet. But in all cases I know of insurance still exists.

 

Because how else will you cover catastrophic care? For example, an ER visit once could wipe out an HSA. Whatever you've saved in your HSA isn't going to cover that. You still need insurance to pay for emergency care. Or although you're healthy now, what will you do as you age but aren't to the Medicare threshold yet?

 

I don't get why you have to have one or the other, not both? I'm worried there will be gaps in your coverage. Huge ones.

[Annie G]

So they are separate? This confuses me. In everyone I know, people have both. The HSA is pretax money one can use to pay medical bills that insurance doesn't meet. But in all cases I know of insurance still exists.

 

Because how else will you cover catastrophic care? For example, an ER visit once could wipe out an HSA. Whatever you've saved in your HSA isn't going to cover that. You still need insurance to pay for emergency care. Or although you're healthy now, what will you do as you age but aren't to the Medicare threshold yet?

 

I don't get why you have to have one or the other, not both? I'm worried there will be gaps in your coverage. Huge ones.

 

You're right-to qualify for an HSA you have to be enrolled in an insurance plan with a high deductible.  The OP will have insurance plus a health savings account that she can draw from to pay out of pocket expenses.  I don't think HR is doing a good job of explaining this to the OP. 

[JumpyTheFrog]

I don't get why you have to have one or the other, not both? I'm worried there will be gaps in your coverage. Huge ones.

Most people do have both. You can only contribute to an HSA in the years you have a qualifiying high deductible plan. For example, last year my family had one and we maxed out our HSA. This year we have a different plan and although the deductible is high, for reasons I don't understand, it doesn't qualify. This means that although we still have the HSA, we can't contribute this year. We can spend the money on qualified expenses, but we can't put more money in. If we change plans next year to one that qualifies, we can contribute money again.

[Dmmetler]

We have one. At least so far, though, DH's company makes it really attractive- by doing the HSA and putting X or more amount in, they match X. I assume it still saves them money, and so far, it's worked for us (mid 40's, Hashimoto's for me, gallbladder issues for DH, but nothing too major).

[TravelingChris]

When you haven't been around these plans and didn't have choices, it is a lot easier.  No matter if its high deductible insurance and HSA like you have or low deductible insurance, supplementary insurance and FSA like I have, we all would do wisely to figure out our costs each year- because changes can really make a difference.  Like for us, each year, I make sure that the cost of our supplementary insurance is less than our catastrophic limit on our primary ( which is a low 3000).  We do put money in our FSA each year because we know we will spend it (and more) on co-pays with dental, extra costs of glasses (we do have a vision plan too but we always have extra costs), and paying for our concierge doctor service (we used to pay 1500 per year but it is rising to 1650 per the two of us, dd gets to go for free).  If we weren't sure about having extra expenses or if our insurance wasn't so good or the supplementary cost more, we would do things differently.  As it is, we save a few hundred dollars a year with the supplement.

[Guest]

Thank you all so much! One more question (I think): With the HSA/high deductible combo, how does it work with the preventive care procedures/exams that regular insurance takes care of at no cost, like pap smears, mammograms, etc.? Or is that specific to the particular HSA? Just wondering if that must be paid at normal rates through the HSA account.

 

Still not quite sure what we will be doing, but you all have been helpful.

The cost of the preventable care depends on the insurance plan. We have had to pay for several things that are supposed to be free with AFA, but aren't with our plan. I appealed and was given words about grandfathered plan provisions.

Edited August 8, 2017 by Heigh Ho

[xixstar]

Thank you all so much! One more question (I think): With the HSA/high deductible combo, how does it work with the preventive care procedures/exams that regular insurance takes care of at no cost, like pap smears, mammograms, etc.? Or is that specific to the particular HSA? Just wondering if that must be paid at normal rates through the HSA account.

 

Still not quite sure what we will be doing, but you all have been helpful.

 

I think you're still struggling with on main concept about this - just because a plan is eligible for an HSA isn't the essential part. You're asking us questions we can't answer because it depends on what you're being offered because yes, what is covered depends on what the plan you're being offered covers (preventative care should be covered according to ACA -- but even the healthcare.gov website says "Most health plans must cover a set of preventive services — like shots and screening tests" - so there must be loop holes).

 

The important part is that you are comparing two different insurance plans. 

 

They are both health insurance plans that have different costs, deductibles, co-pays, co-insurance, etc. They may have different things they cover at different rates -- you'll have to look at the detailed data sheet on each. The only difference of the HSA plan is that you (and your employer) can contribute funds to a savings account to save up and pay for some of your annual medical care needs.

 

But in evaluating each plan, the presence of an HSA isn't really that important -- it's looking at what will each plan cost you out of pocket for your family's medical care. 

 

The only thing that makes one of these plans special is that it has a high enough deductible to make it eligible to use an HSA with it. It's kinda like saying -- you have two jobs and one of them has a 401K plan as a benefit and one doesn't. You'd still evaluate with both jobs based on the salary, expectations, location, and total benefits -- the 401K would just be part of the benefits for one of the jobs but probably not the deciding factor.

 

Not sure if that helped, or not I cannot express enough that it really does work out well to basically take the exact amounts you paid last year and calculate them out for each offered plan to see what it would have cost. Be sure to also include what you would pay for premiums and you can offset that a little with what your employer would have put in your HSA, if that is an option. 

 

I did this calculation for a friend earlier this year when she was first considering switching to an HSA and using the prior year health care cost, it was basically a wash either direction for her. She decided to not go with the HSA because she was not comfortable with what felt like greater risk, where I would have taken the HSA if I was her-- so it's still a judgement call. 

[Pegasus]

The only way to be sure is to run the numbers and evaluate the differences between the high deductible plan with an HSA and the low deductible plan.  I recommend running three scenarios:

 

1. Low healthcare cost year with preventive care and maybe a couple office visits. A couple scripts.

 

2. Average healthcare cost year.  Throw in an emergency room visit and several more office visits and a couple more scripts.

 

3. High healthcare cost year.  Hospital stay, surgery, expensive scripts, etc.

 

Once I ran all these scenarios for my own choice, the "better" plan was obvious. I saved with the high deductible plan every time. Be sure to include:

 

a. Difference in premiums.

b. Any HSA contributions by the plan/employer.

c. Any tax savings for your own HSA contributions.

d. Difference in deductible.

e. Difference in co-insurance.

f. Difference in out-of-pocket max.

 

No one can advise you without having all this information at their disposal.

[StephanieZ]

For me, HSAs have been just a great way to pay for some stuff pre-tax (braces, expensive co-pays/deductibles) . . . We were able to have an HSA for 3 years, about 2-5 years ago, and we fully funded it each year (around 6k/yr IIRC) and we've now nearly spent it all, and will zero it out shortly when some recent big medical bills come in. We didn't use it for long term savings, but we were able to get some good returns on the account while the funds sat in a stock index fund for a few years, so that was nice, and the pre-tax thing is big for us as we're in a pretty darn high marginal tax bracket. 

 

I hope we can get an HSA plan again someday . . . for now, our insurance options are very limited, and the currently offered HSA plans aren't sensible (at all) for us in our current market. (I hate insurance. . . Maybe we'll get universal single payer coverage someday . . . that'd be way better than another HSA . . . lol). 

 

 

[J-rap]

We had to make that same decision three years ago.  (And have the opportunity to make it again each year.)  We chose the HSA because multiple people told us that if you generally receive a significant amount of medical care each year, or very little, it makes sense.  So that's what we chose.   :)  We need a lot of medical care.  The deductible for the HSA plan is twice as high, but our employer deposits into our HSA account the difference between the HSA deductible and the traditional plan deductible, which is about $7,000.  We still run everything through our insurance card because then it registers toward our deductible, but then we pay for it with our HSA credit card.  Until we reach our HSA limit, that is.  After that we pay out of pocket for the rest until we hit the the deductible.  We do meet the deductible each year.

 

It's very easy to use, but honestly, I don't really know which plan would save us the most amount of money.  I think it all kind of evens out in the end, in our case.

 

Edited August 9, 2017 by J-rap