HSA's?

[creditcardfree]

An HSA, by itself is not a insurance plan from a company. It is a savings account to cover medical expenses. It's like your own insurance plan for medical bills that need to be paid before a deductible is met.

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As DS notes, NJ doesn't allow the product of HSA's to be marketed in NJ, for whatever reason.

That being said, I plan to just keep an "account" for "uncovered/undercovered medical expenses" and probably in a very conservative account (maybe I-bonds or a NJ muni-bond fund) thereby conferring a tax advantage.

The problem I see with the concept of HSA's is almost what people allude to on this thread - there's a high deductible, you save up, and then you don't want to "spend it", on preventative care, on needed care, on nothing. I also seem to have a problem with the concept of "I am sick. . .so I'll go out and sign up for insurance."

From the insurance co. standpoint, that's like saying to my agent, "Um. . .my house is on fire. . .do you think I could buy that fire insurance policy now?" No wonder healthcare is so screwed up in the US and I do think ObamaCare is correct to make everyone buy health insurance.

I think it's fine to "earmark" money for healthcare, and you should. . .but that earmark should run a fine line of "saving" and "spending."

Most people in America (not SavingAdvicees) whip out the 50's and 100's in Atlantic City at the Borgata or Trump like it's going out of style but when it comes something uncovered or undercovered in healthcare, hold onto the 5's and 10's like Aunt Tessie spending her last nickel.

[Beppington]

The problem I see with the concept of HSA's is almost what people allude to on this thread - there's a high deductible, you save up, and then you don't want to "spend it", on preventative care, on needed care, on nothing. I also seem to have a problem with the concept of "I am sick. . .so I'll go out and sign up for insurance."

This is somewhat me: I tend to be thrifty with my $, & since I have an HSA & have maxxed out my contributions to it, it kind of feels like a savings/ investment account (it earns interest) that I don't want to touch. I've needed to a few times, & have done it, but it rubs me the wrong way. I would think that it might rub some people the wrong way so much that they just wouldn't spend it.

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Beppington,

That's the rub I am speaking of. . .like I had a conversation with my dentist today. . .my teeth are labeled as "good shape", a couple of problem molars in teh back but mostly good shape.

I explained my situation and how much should I earmark for "catastrophic" dental expense - he seemed to think $1500 was way good enough. But tehre is $140 cleanings 2x/year (with/without x-rays).

One should be allocated as a budgeted expnse. .. the other as "self-insurance" in case I break a tooth, need a root canal, whatever.

It's really the same thing across the board with all your medical/eye/dental/chiropractic.

[maat55]

This is somewhat me: I tend to be thrifty with my $, & since I have an HSA & have maxxed out my contributions to it, it kind of feels like a savings/ investment account (it earns interest) that I don't want to touch. I've needed to a few times, & have done it, but it rubs me the wrong way. I would think that it might rub some people the wrong way so much that they just wouldn't spend it.

I consider this model the best way to lower healthcare costs and not create massive government deficits.

HDHP's with an HSA are the most effective way to get the individual to frugally address healthcare needs. Most healthcare expenses should be cash between the patient and provider.

Government should stay out of the money transfer. Government should only promote fairness and reasonable regulations. The individual will bring down costs by shopping and scrutinizing health provision and costs, with their providers directly.

[swanson719]

The problem I'm facing, and why I posed this question to begin with, is that DW's medical bills are in the $1M a year range. She has Medicare A & B, so our portion sticks around $200K. I'm currently active duty military, so the army pays all of this without blinking. I'm due to get out in about 18 months and want to have all my ducks in a row before I do. The ONLY thing that will get me to re-enlist is not being able to find affordable health coverage to cover DW. We don't have kids, and I'm healthy. I get bi-annual physicals, dental, vision, all that stuff, at least every 6 months. But DW has been sick since she was 4, and has never had a single day in her life without health insurance, so it cannot be legally viewed as a pre-existing condition.

We have it budgeted to be able to pay $550 a month to cover both of us, her through a medi-gap policy if need be. Does anyone know of insurance that would work for us in this situation that has a lifetime cap of over $3M?

[creditcardfree]

I would guess your best bet is to start calling insurance companies, or find an agent who could shop plans for you and give details specific to your situation. It is great that you are looking into this before changing jobs.

Obviously, there are some insurance changes in the pipeline...so it could be different 18 months from now.