Keep HMO or go for High Deductible and HSA?

[maat55]

I am a big advocate of the HDHP/HSA. Like Scanner, I think it is better for competition and reduces excessive office calls. People do tend to not want to use their HSA's if possible.

I had one before we got on my wifes plan at her work. You can add accident riders very cheaply to limit your out of pocket due to accidents.

My only concern is having to shop every few years to keep lower rates.

[LivingAlmostLarge]

Here's the problem I have with HDHPs. Why should people bother saving? The best case scenario which happens now, and what young people (under 30 usually) figure nothing bad will ever happen. So screw health insurance.

Plus i have no assets. Then when an accident happens and they need care, they expect the government to pick up the bill, which happens.

So the gamble is if I'm healthy, why should I be responsible and save to pay for my healthcare? Why should I be forced to save?

I mean look how great 401k retirement savings has been working out. People haven't been savings, not saying pensions are the answer.

But personal responsibility, which a lot of people on this particular thread are talking about is NOT the norm. Nor is it the way most people feel when they ACTUALLY have to foot the medical bill.

It's what you mouth when you have employed provided or HDHP and nothing bad.

The moment something catastrophic happens and your HDHP individual plan doesn't cover what you think it should, then you realize, gee, it sucks.

Then you say why should I pay? Why don't I take advantage of the systems like everyone else?

Not saying it's right, but it happens.

My BIL went 6 months without health insurance. And MOST of his friends in the US (Below 30, college educated, working) do as well. They figure, just go to ER, then skip out on the bill, screw the hospital.

Turns out it works. Nothing you can say will make them shell out the $100/month HDHP, let alone for their own care.

[zetta]

I wouldn't go for a HSA/HPDP if you're considering having a child in the next year or two -- you won't have time to build up a good savings cushion in the HSA to use for maternity and newborn care. There are about 8-12 preventive prenatal doctor visits. I think a standard delivery costs about $10k, and a c-section about $40k, so you're sure to have to pay your max deductible the year of the birth. Standard preventive pediatric care is about 6-7 visits in the first year, and that's if the kid doesn't get sick at all! Usually an HMO will be pretty good about covering all these preventive costs.

It makes sense to do an HSA/HDPD when you're in your 20's and don't plan on kids for several years, or when your kids are old enough that they only go to the doctor for annual checkup and illness.

[disneysteve]

LAL - Very good post. Unfortunately, you are right. Most of us on this forum are not the norm. We are not typical Americans. We look at the big picture. We take responsibility for our own well being and our own actions. We plan for the future. Because of that, it is often hard for us to understand why everyone doesn't do the same. I've said many times that I can't comprehend why anyone has a balance on their credit card. Why would someone buy something that they know they can't afford? I just don't get it.

Same goes for healthcare. How can someone who can afford coverage go without? How can they be willing to risk their life and the lives of their family by going uninsured? It makes no sense to me.

[LivingAlmostLarge]

Zetta, not to mention any complications, and the insurance company will say it was a pre-existing condition or not covered by typical methods, so you pay for X, Y, or Z above the deductible with an HDHP. This test isn't standard, not covered by our insurance. Insurance companies are out to make money. It's all about risk management.

And maternity is risky with so many unknown complicating factors. Thus why many plans won't cover it unless forced.

And DS, exactly, people here aren't the norm. I would NEVER go without health insurance, but I'm not willing to risk my life. Others don't care. And many are educated.

Read this article how the people now willing to walk away from FORECLOSURES are the RICH and educated. It's a calculated gamble.