Whats your opinion on a HSA/HDHP health plan?

[shelbylovesmelby]

HSA/HDHP (Health savings account/ High deductable health plan)

My dh is interviewing for a job that would have this kind of insurance policy. I'm looking for insight on how this kind of plan works. As well as what kind of financial impact it could have in the future after retuirement ect.

We also want to have 1-2 more kids & how has this kind of plan impacted anyone?

Right now we have a plan where he pays $26/week for a family of 4, $5-$25 co pays, & they pay 100% for surgeries & births.

thanks everyone.

[shelbylovesmelby]

Also I'm asking this because if they don't offer him a high enough wage to compinsate for this plan we'd be upside down moneywise everymonth. Someone on a diff board said the high deductable can be as high as $3,000/yr & we just don't have that to spare if they only offer dh the same amt of pay.

[katwoman]

I looked into HSA qualified plans and they came up short in terms of health care coverage. It's a double edged sword.

If you are planning on have kids (and don't forget, kids are always going to the doctor for something or other) stick with the plan your husband already has.

[shelbylovesmelby]

it would be from a new empolyer I don't know that he would have a choice in another plan other than for us to purchase insurance on our own.

wow, that plan you're on now seems awfully good, co-pays from the start, 100% surgical for a hundred bucks a month!

I can certainly see where the compensation at the new place would have to be AWFULLY good if an HSA was your only choice.

I switched from my company's health plan to the HSA we began offering this year as quick as I could. but I am most definitely not in your circumstances (single guy, pretty much have to be hit by a bus before I go to the doctor). I could have chosen between a $1000 or $3000 deductible. I took the 3, I have that in my e-fund and I get a healthy match from my employer for money I put into the account. it only costs me $15 a month, no co-pays, its all me until the deductible is met but there's about a $5000 max out of pocket expense per year (again, supported by the emergency fund). what's more, I get control, something I like, the money goes into the account tax free, grows tax free, and isn't taxed when I pull it out to pay for "qualified expenses". when the account reaches a certain level, I can begin investing it if I choose in mutual funds or whatever the plan administrator is offering at the time.

but with a family...I don't know, I'd have to have a pretty solid pile of cash stacked up somewhere before I'd feel comfortable with the risk exposure (that out of pocket goes up to around 10 grand for a family).

[VJW]

HSAs are a scam to shift the cost of medical care from employers to individuals. The downsides are too numerous to list, but three large ones are that they are both unfair and the opposite of preventative care, and not surprisingly, heavily benefit the wealthy.

* They are inherently unfair, because if both you and I have thousands of dollars in our respective HSAs, and you get run over by a hit-and-run driver as you're crossing the street, your monies will be depleted from your HSA on the way to your catastrophic coverage threshold. The result is your HSA is empty, due to no fault of your own, while mine is still full.

* Proponents of HSAs purport that the accounts help contain costs by creating a financial incentive for people to avoid over-utilizing medical services. That assumption, however, is not supported by data. According to a famous RAND study, which looked into usage of HSA plans and found that patients did indeed use a bit less care, but they had no way to separate necessary care from unnecessary care. So instead of foregoing useless procedures, they simply neglected their hypertension or diabetes (as examples). Long-term, that means more strokes and heart attacks, and more emergency room visits, which in turn cost the system by orders of magnitude far more than blood pressure or diabetes medications and regular check-ups. That study and others have shown that, instead of a decline in over-utilization of services, high out-of-pocket expenses lead to delays in care, medical debt, and bankruptcy.

#

I'm not entirely sure I understand how something elective can be "inherently unfair." If you don't like it, don't use it. And let's be honest here, I don't have the statistics, but I'd be willing to believe most "wealthy" people have jobs that provide the kind of comprehensive health care we working class folks wring our hands and gnash our teeth about all the time and so would have very little use for an HSA.

completely unsubstantiated, just my opinion.


Even if an employer offers nothing but, you don't have to take it, there are sources for health care outside of your work.

Also, how much concrete behavioral data can they have on something that's only a couple of years old?

Again, for me the plan is fine based on my lifestyle and my financially responsible nature but if I had a family, I would be back on my company's regular health plan immediately. The HSAs aren't for everyone. My immediate goal is to get two year's worth of the out of pocket expense into the account as quick as possible which will be easier now that my employer is going to match 100% of my contributions up to $5000 a year.

Basically, I have the savings to protect myself and I'm after the free money.

[34saving]

You have an INCREDIBLE deal right now, so you'll have to evaluate taking the job in that context. In the meantime, "high deductable" or major medical plans aren't always all that bad. We switched to a "major medical" plan when having a $200 deductable saved us $1200 a year in insurance. (Kind of a no-brainer in our case, but the plans vary a ton, so read all of the fine print.) Oh, our major medical plan also covers all of the preventative stuff at 100% (annual exams, pre-natal, well child, etc.).

[Bluezy]

FIrst off I am a single mum so I know about medical bills for families.

The job related medical coverage your spouse's work has is almost unheard of these days. I suggest that your husband seriously reconsider his choice to change jobs. That coverage is enough to justify a stay with less pay. And when you have little ones, you do what you have to do to keep them covered!

I have high deductible health coverage (United HealthCare - Golden Rule) with an HSA. My employer will offer a similar plan to once I am at my new employment for 90 days. However, my HSA is the best. It is at Patelco CU and pays 5.12% APY. My deductible is $3,650 per year, so I am allowed to deposit that much each year in the account for qualified medical expenses. An HSA is tax deductible, so in essence the governmentt is paying for my health care savings. Therefore, my health insurnace arrangement is more a benefit to me than a job offered plan with lesser medical benefits and a lower paying HSA.

HSA's are a blessing in that any qualifed medical expense can be paid for through the savings account, tax free. HSA's are also a financial planning tool for retirement and a means of providing for your health care in one's elder years. I do not expect SS and Medicare to be around should I ever decide to retire, and this along with my IRA will be my sustenance good Lord willing.

Cheers!

[TBH]

I've heard it said that HSAs benefit healthy people the most. The scary thing is that you can't predict when your body is going to need some serious work. It may happen the day after you sign up for an HSA, when you have only a few bucks in the account. There's just no way to know.

I would try an HSA if I could save significant amounts of money by doing that. My spouse and I both work part time, so our out of pocket insurance costs are pretty high. If our out of pocket costs were the same, but the $$ was going into an HSA instead of the insurance company's pocket, I would sign up. But like rexdart I would first make sure I had enough in my E fund to cover the deductible until my HSA balance grew enough to cover it. Even then, I'd breathe a lot easier after the first year or so, when the HSA balance had crossed that important threshold.

I have some of the same concerns as VJW about the fairness of this plan. I think there will be a big tendency for people, especially lower income people, to forego medical care if their HSA doesn't have enough to cover it. So I have serious reservations about a large scale move to HSAs.

But for me personally, if the circumstances were right, I think I could come out ahead with an HSA.

I also think that HSAs may create a health care environment where people paid closer attention to medical bills. More errors would be caught, and there would be less opportunity for overcharging for routine medical services. But doctors are just so strapped as it is because of the low fees paid by HMOs, and because of the high malpractice insurance premiums they have to pay, that honest doctors with small practices are probably not going to be able to budge too much on their fees.

[VJW]

Originally Posted by claire

I've heard it said that HSAs benefit healthy people the most.

Quite true. They benefit the wealthy and the healthy.

I also think that HSAs may create a health care environment where people paid closer attention to medical bills. More errors would be caught, and there would be less opportunity for overcharging for routine medical services.

The Rand study discovered just the opposite happened.

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[VJW]

Originally Posted by rexdart

I'm not entirely sure I understand how something elective can be "inherently unfair." If you don't like it, don't use it.

You don’t have a choice if that’s all an employer wants to provide.

Even if an employer offers nothing but, you don't have to take it, there are sources for health care outside of your work.

How are people supposed to afford it ? The entire shift is in the wrong direction. As I posted some time ago, if you go down to your local Chevy dealer and purchase a new truck, and I go down to my local Chevy dealer and purchase 10,000 trucks, who do you suppose will get a better price ?

That’s why shifting to make individuals go up against large corporations on there own is a bad idea. A better idea is to model what Hawaii did, which was to adopt pretty much the ‘Managed Competition’ plan that the Clinton administration had proposed, with mandated employer based health coverage, large health insurance purchasing alliances, and the state picking up the tab for anyone who who is unemployed.

It’s why Hawaii has lower healthcare costs than all of the other 49 states, and lower premiums than the other 49 states, and lower healthcare inflation than the other 49 states, with 99.8% of their citizenry covered.

#

first off, when did all this become my employer's responsibility?! I still don't understand that mentality. there was a time when health insurance was a "perk" used to entice workers, when did it become a requirement? if it is to be their responsibility, are we prepared to allow them to deny employment to people because they smoke, are fat, or are otherwise unhealthy (even looking)? if they have to pay for your health, that seems only fair to me.

If we can get together a workable government supported system like you describe (maybe with a general, across the board tax on both corporations and employees to help support it) then great, I'm all for it but I'm talking about options I have today. I haven't found a healthcare plan yet that pays me money, my HSA does. I like that. I don't want to lose it.

And I'm sure it's great if you live in Hawaii - for lots of reasons - but I need a lab a little less isolated with more people than Dallas and a per capita income closer to the norm rather than 15% above the national average before I'm ready to turn it loose on everyone. In a capitalist society, someone has to pay for this stuff.

[VJW]

Originally Posted by rexdart

first off, when did all this become my employer's responsibility?!

WW II ?

If we can get together a workable government supported system like you describe...

I didn’t describe a “government supported system”.

(maybe with a general, across the board tax on both corporations and employees to help support it) then great...

That would be 'Single Payer'.

And I'm sure it's great if you live in Hawaii - for lots of reasons - but I need a lab a little less isolated with more people than Dallas and a per capita income closer to the norm rather than 15% above the national average before I'm ready to turn it loose on everyone. In a capitalist society, someone has to pay for this stuff.

Hawaii pays for their healthcare, they just do a better job of bargaining because they have the clout of the size of their purchasing alliances pools, while covering everyone.

Show me someplace else that has lower healthcare costs and covers everyone. HSAs surely don’t.

#

health insurance became a responsibility of employers in World War II?


and I don't want someplace else that covers everyone, I want to do it myself and as I said before, I want the free money. I have no problem with you fighting for whatever program you want but just don't take choice away from me.


I'm also curious...have you read the Rand study? Not an article about the study, but the study? Do you have a link to it? I'm wondering if it's the same one I just finished reading.

and I'm sorry, I was wrong about the government supported remark.

I generally don't see much difference between that and "mandated employer based" (who exactly is doing the mandating?) but I'll accept that they are not the same.

[VJW]

Originally Posted by rexdart

health insurance became a responsibility of employers in World War II?

Yep. They’re choice. Are you unfamiliar with the history ?

and I don't want someplace else that covers everyone, I want to do it myself and as I said before, I want the free money.

Giving you “free money” is not the goal of an efficient healthcare delivery system. That’s the point. That HSAs were not proposed to provide quality efficient healthcare. They are a political scheme to bribe people into shifting the responsibility of health insurance from employers to employees.

I have no problem with you fighting for whatever program you want but just don't take choice away from me.

A) All the comprehensive plans would allow all the choice you want.

B) The problem you’re not addressing is that if you are faced with a scenario similar to what I previously presented, a catastrophe illness, not only will you lose your “free money”, but you will be burdened with inadequate insurance coverage.

Half of the record bankruptcies being filed in recent years are due to medical bills, the vast majority by people who have a job, own a home, and have health insurance that they discover too late is inadequate.

I'm also curious...have you read the Rand study?

I did.

Do you have a link to it?

No, I read the print edition. That specific study was in a 2004 JAMA. The subsequent RAND studies are proprietary.

I generally don't see much difference between that and "mandated employer based" (who exactly is doing the mandating?) but I'll accept that they are not the same.

Regulating an industry is completely different than a “government supported system”.

#

[PrincessPerky]

hmm political bribe to shift healthcare from corporations to individuals, what a scam asking me to be in charge of my own health! (major sarcasm there)

but if you want my vote, I like my fancy well care 100% covereds, it saves me money...

[Ima saver]

Wish we could afford health insurance.

[TBH]

Originally Posted by Ima saver

Wish we could afford health insurance.

You can't afford NOT to. Putting all your attention on saving money is being shortsighted if you don't have health coverage. I know at least one extremely well-off family who is now destitute because of a multi-year (losing) battle with cancer.