Author Topic: High-deductive healthcare & HSAs in the US  (Read 11992 times)

RetireAbroadAt35

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High-deductive healthcare & HSAs in the US
« on: October 22, 2014, 08:17:13 AM »
I dropped my PPO and switched to a high-deductible plan.  I typically have few if any medical expenses each year so I think this is a good move.

* My monthly contribution fell to $40.
* My company will put $20/month into my HSA.
* I will max out my contribution to the HSA, which will hopefully become an additional tax-deferred retirement vehicle a la Mad Fiendist.

Not bad for 15 minutes work on the employee benefits site.

justajane

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Re: High-deductive healthcare & HSAs in the US
« Reply #1 on: October 22, 2014, 08:24:52 AM »
My husband works for a major financial institution, and they just announced that in a few years they will only offer high deductible plans. It will undoubtedly scare some people and punish the non-Mustachians in our midst (who don't have a reserve), but it is a good thing long term.

We've been on a high deductible plan for years and love it. There was no way we could lose money, since the premiums were so much lower and my husband's company puts $1,000 a year in his HSA. We met our $4,500 deductible in the first week of 2014 (damn pregnancy complications) and luckily most of our health problems have happened in one calendar year. How convenient! I didn't want a second hospital stay in one year, but I had just that this past week. Better in October than in January of next year! Also, on the years that we meet our high deductible, we make it a point to see all the specialists. I had some moles removed at the dermatologist and am seeing an ENT about some ear problems I have, as well as my internist to do routine blood work.




RetireAbroadAt35

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Re: High-deductive healthcare & HSAs in the US
« Reply #2 on: October 22, 2014, 09:08:10 AM »
I only get $240/year matched but my deductible is lower.  Still, this seems like a win/win.

justajane

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Re: High-deductive healthcare & HSAs in the US
« Reply #3 on: October 22, 2014, 09:49:14 AM »
I think it's probably rare that it isn't a win/win for people. It's just that people actually hate to see what health care actually costs and fork over their HSA card to pay for it. They prefer to pay a set co-pay every visit and not think about it. But the premium difference, plus the ability to bank money in the years when you don't have appointments or medical emergencies, means that you will likely always come out ahead.

I've also read about people using their HSA as a future retirement vehicle by maxing it out each year and not actually pay for their medical expenses with it.

dadu007

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Re: High-deductive healthcare & HSAs in the US
« Reply #4 on: October 22, 2014, 01:48:38 PM »
Timely post as my company just closed their benefits options selection window (for plans effective Jan 2015).
I also chose an HSA plan for the first time. 
I'm a little anxious about it though, having been spoiled with straightforward copays from years past and also because I have an extra cog in my works: a highschooler with Type 1 Diabetes.
All doctor and pharmacy costs go towards the deductible ($3600 for family).  I won't have any trouble meeting that since one order of insulin will approach $1500 dollars - one order lasts about 6 months.
I only hope I have a little left in the account by end of 2015 to carryover over into 2016.
I'm having them take quite a bit out of my check for tax advantage purposes.
I know these plans are great for single, healthy individuals; I'm just a little wary of how it will be for a family like mine where one dependent has a chronic illness.
Hope it goes okay... 

TrulyStashin

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Re: High-deductive healthcare & HSAs in the US
« Reply #5 on: October 22, 2014, 01:58:24 PM »
Last year, I switched to a high-deductible with HSA because I had no other choice.  I have mixed feelings about it because it has resulted in some pretty significant financial uncertainty.

I am in SL debt paydown mode and do not have the $11k sitting around to cover the deductible should I get hurt or sick.  That worries me.  It will be years before my SL's are paid off and I can afford to leave $11k sitting in the HSA just in case. 

I have no idea what a medical appointment, procedure, or RX will cost before I commit to it.  I've asked and the providers say "We won't know until after we submit the bill and get the EOB back."  So, when I had to have a diagnostic procedure in May, I had no idea if it would cost me $200 or $800.   More uncertainty.

It makes me hesitate to go to the doctor.  No kidding.  I need to schedule a 6-mo f/u for the diagnostic procedure I had in May and I'm scared to do it.

Every dime I've put into my HSA ($90/ mo. + $1000 from my employer) has been sucked up by medical costs this year.  I'm 46 and healthy, but my costs aren't going to go DOWN at this point in my life.  Even if I could max out my HSA contribution next year, I still wouldn't have the $11k I'd need for a deductible.

In short, it has injected worry, insecurity and uncertainty into my medical/ financial decisions.   And.... I supported the ACA.  Still do, though reluctantly........

JetBlast

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Re: High-deductive healthcare & HSAs in the US
« Reply #6 on: October 22, 2014, 09:16:02 PM »
I know these plans are great for single, healthy individuals; I'm just a little wary of how it will be for a family like mine where one dependent has a chronic illness.
Hope it goes okay...
This is what has prevented my wife and I from switching to the high deductible plan my company offers. My wife is a Type 1 Diabetic, and even with company contribution it's quite close between the plans in a typical year, but much bigger downside in a bad year. Between visits to her GP and endocrinologist, insulin, infusion sets and reservoirs for her pump, test strips etc... the contribution to the HSA would be gone in a few months.


Gin1984

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Re: High-deductive healthcare & HSAs in the US
« Reply #7 on: October 22, 2014, 09:26:04 PM »
I think it's probably rare that it isn't a win/win for people. It's just that people actually hate to see what health care actually costs and fork over their HSA card to pay for it. They prefer to pay a set co-pay every visit and not think about it. But the premium difference, plus the ability to bank money in the years when you don't have appointments or medical emergencies, means that you will likely always come out ahead.

I've also read about people using their HSA as a future retirement vehicle by maxing it out each year and not actually pay for their medical expenses with it.
Not all places have such a difference in premiums.  Also sometimes the plan itself sucks.  We looked at all his plans and the high deductible plan had huge co-insurances, after the deductible and the costs was only slightly cheaper than the HMO/PPO. 

TrulyStashin

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Re: High-deductive healthcare & HSAs in the US
« Reply #8 on: October 23, 2014, 07:59:50 AM »
I think it's probably rare that it isn't a win/win for people. It's just that people actually hate to see what health care actually costs and fork over their HSA card to pay for it. They prefer to pay a set co-pay every visit and not think about it. But the premium difference, plus the ability to bank money in the years when you don't have appointments or medical emergencies, means that you will likely always come out ahead.

I've also read about people using their HSA as a future retirement vehicle by maxing it out each year and not actually pay for their medical expenses with it.
Not all places have such a difference in premiums.  Also sometimes the plan itself sucks.  We looked at all his plans and the high deductible plan had huge co-insurances, after the deductible and the costs was only slightly cheaper than the HMO/PPO.

My difference in premium is only $77/ mo.   Not even remotely enough to mitigate the uncertainty.  I miss my HMO.

RetireAbroadAt35

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Re: High-deductive healthcare & HSAs in the US
« Reply #9 on: October 23, 2014, 10:16:14 AM »
I am in SL debt paydown mode and do not have the $11k sitting around to cover the deductible should I get hurt or sick.

$11k?  Holy nuts, that sounds crazy.  I think mine is $3k.  I guess that's a benefit of working for the man.

Middlesbrough

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Re: High-deductive healthcare & HSAs in the US
« Reply #10 on: October 23, 2014, 10:32:04 AM »
At my work, the difference between traditional and High Deductable are small if you hit the max out of pocket costs. However, as a healthy youngling, my company contribution to my HSA tends to cover all my yearly expenses and I have an extra stocking to stuff money into.

SunshineGirl

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Re: High-deductive healthcare & HSAs in the US
« Reply #11 on: October 23, 2014, 10:37:15 AM »
I read an article recently that people who have high-deductible health plans tend to seek medical help less frequently, even when they should, because of the "pain" of seeing the money come out of the account. Being in my first year of such a plan, I have found this to be true.

Having also recently witnessed several people close to me have sudden, unexpected huge medical bills, it has made me want to get the best health plan possible next go-around, of the three choices we are typically offered.

The nice thing is this can be a year-by-year decision.

justajane

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Re: High-deductive healthcare & HSAs in the US
« Reply #12 on: October 23, 2014, 10:53:27 AM »
I think it's probably rare that it isn't a win/win for people. It's just that people actually hate to see what health care actually costs and fork over their HSA card to pay for it. They prefer to pay a set co-pay every visit and not think about it. But the premium difference, plus the ability to bank money in the years when you don't have appointments or medical emergencies, means that you will likely always come out ahead.

I've also read about people using their HSA as a future retirement vehicle by maxing it out each year and not actually pay for their medical expenses with it.
Not all places have such a difference in premiums.  Also sometimes the plan itself sucks.  We looked at all his plans and the high deductible plan had huge co-insurances, after the deductible and the costs was only slightly cheaper than the HMO/PPO.

My difference in premium is only $77/ mo.   Not even remotely enough to mitigate the uncertainty.  I miss my HMO.

What's the uncertainty? How high is the deductible on the high deductible plan? I'm not trying to be snarky here or insensitive, but if you have the cash reserve and the plan works out to be a better deal, then you just realize that in any given year you might be paying thousands of dollars. But in the years that you don't, you are banking over $800 plus whatever other incentives your company might or might not provide.

Point taken, however, that not all high deductible plans are created equal, but people should always run the math on it. You might be rather surprised. Another perk of my high deductible plan at least is that all preventative care is 100% free. On regular plans do you pay a co-pay for an woman's wellness visit?

Edited to add that I now see your plan has a 11K deductible. That's steep. After that you pay nothing or do you still pay a percentage?
« Last Edit: October 23, 2014, 10:55:23 AM by justajane »

Gin1984

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Re: High-deductive healthcare & HSAs in the US
« Reply #13 on: October 23, 2014, 11:02:06 AM »
I think it's probably rare that it isn't a win/win for people. It's just that people actually hate to see what health care actually costs and fork over their HSA card to pay for it. They prefer to pay a set co-pay every visit and not think about it. But the premium difference, plus the ability to bank money in the years when you don't have appointments or medical emergencies, means that you will likely always come out ahead.

I've also read about people using their HSA as a future retirement vehicle by maxing it out each year and not actually pay for their medical expenses with it.
Not all places have such a difference in premiums.  Also sometimes the plan itself sucks.  We looked at all his plans and the high deductible plan had huge co-insurances, after the deductible and the costs was only slightly cheaper than the HMO/PPO.

My difference in premium is only $77/ mo.   Not even remotely enough to mitigate the uncertainty.  I miss my HMO.

What's the uncertainty? How high is the deductible on the high deductible plan? I'm not trying to be snarky here or insensitive, but if you have the cash reserve and the plan works out to be a better deal, then you just realize that in any given year you might be paying thousands of dollars. But in the years that you don't, you are banking over $800 plus whatever other incentives your company might or might not provide.

Point taken, however, that not all high deductible plans are created equal, but people should always run the math on it. You might be rather surprised. Another perk of my high deductible plan at least is that all preventative care is 100% free. On regular plans do you pay a co-pay for an woman's wellness visit?

Edited to add that I now see your plan has a 11K deductible. That's steep. After that you pay nothing or do you still pay a percentage?

Preventive care is suppose to be without a copay unless you are on a pre-ACA plan.

madage

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Re: High-deductive healthcare & HSAs in the US
« Reply #14 on: October 23, 2014, 12:20:56 PM »
Last year, I switched to a high-deductible with HSA because I had no other choice.  I have mixed feelings about it because it has resulted in some pretty significant financial uncertainty.

I am in SL debt paydown mode and do not have the $11k sitting around to cover the deductible should I get hurt or sick.  That worries me.  It will be years before my SL's are paid off and I can afford to leave $11k sitting in the HSA just in case. 


Something's not adding up here. If your self-only deductible is really $11,000, you don't have an HDHP as defined by the government, and therefore you are not eligible to contribute to an HSA. Because you said you have an HSA, I'm wondering if you're confusing the OOP max (though even then, the max self-only OOP is $6,350 in 2014) with the deductible. There are two possible explanations:

1. You actually have family coverage, in which case an $11,000 deductible for the family is allowed under the HDHP definition. If this is the case, you should have a lower individual deductible. A person must only meet the individual deductible before co-insurance kicks in.

2. You do not have an HSA, but rather an FSA to go with your disappointing health plan. The big difference here is that FSA dollars cannot be rolled-over year after year. There is a relatively new IRS rule (pdf) that allows $500 of FSA money to be rolled into the following year, but your company has to opt-in.

solon

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Re: High-deductible healthcare & HSAs in the US
« Reply #15 on: October 23, 2014, 01:28:24 PM »
Can you build an HSA/HDHP individually, without an employer? My employer doesn't offer any health plan, so I'm thinking about the best way to create one for myself.

Gin1984

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Re: High-deductible healthcare & HSAs in the US
« Reply #16 on: October 23, 2014, 01:34:19 PM »
Can you build an HSA/HDHP individually, without an employer? My employer doesn't offer any health plan, so I'm thinking about the best way to create one for myself.
You don't build one, you can buy one on the open market, however FICA is not deductible in a private health plan like it would be in a employer based one.

PathtoFIRE

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Re: High-deductive healthcare & HSAs in the US
« Reply #17 on: October 23, 2014, 02:14:23 PM »
[snip] FICA is not deductible in a private health plan like it would be in a employer based one.

Although that is not such a big deal if your individual income is well beyond the OASDI (social security) ceiling

TrulyStashin

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Re: High-deductive healthcare & HSAs in the US
« Reply #18 on: October 24, 2014, 07:56:49 AM »
Last year, I switched to a high-deductible with HSA because I had no other choice.  I have mixed feelings about it because it has resulted in some pretty significant financial uncertainty.

I am in SL debt paydown mode and do not have the $11k sitting around to cover the deductible should I get hurt or sick.  That worries me.  It will be years before my SL's are paid off and I can afford to leave $11k sitting in the HSA just in case. 


Something's not adding up here. If your self-only deductible is really $11,000, you don't have an HDHP as defined by the government, and therefore you are not eligible to contribute to an HSA. Because you said you have an HSA, I'm wondering if you're confusing the OOP max (though even then, the max self-only OOP is $6,350 in 2014) with the deductible. There are two possible explanations:

1. You actually have family coverage, in which case an $11,000 deductible for the family is allowed under the HDHP definition. If this is the case, you should have a lower individual deductible. A person must only meet the individual deductible before co-insurance kicks in.

2. You do not have an HSA, but rather an FSA to go with your disappointing health plan. The big difference here is that FSA dollars cannot be rolled-over year after year. There is a relatively new IRS rule (pdf) that allows $500 of FSA money to be rolled into the following year, but your company has to opt-in.

The $11k deductible is on the family plan.  After that we're 100% covered.   I didn't realize that there should be a lower individual deductible.   [checking]  The individual deductible is $5500.   Meh.  I have an HSA, not a FSA.  We had FSA's but my employer ended those last year when they shifted to the high deductible plan.

I could opt for a lower deductible plan ($1500) but then insurance pays only 80% of costs after the deductible is met.   I don't like this risk as that 20% share for me could be tens of thousands of dollars.

Preventive care is covered for free -- so my annual well-woman exam is free, but if anything needs follow up that's not free.

Last week, I scratched my eye and had to go to the eye doctor.  I asked how much an eye exam would cost and they couldn't tell me because it depends on the specific contract that United Healthcare and my employer negotiated and they won't know until they get the EOB.  So, I had to commit to the appointment before knowing the cost -- I hate that.  Same drill for other visits with other doctors.   

madage

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Re: High-deductive healthcare & HSAs in the US
« Reply #19 on: October 24, 2014, 08:22:41 AM »

I could opt for a lower deductible plan ($1500) but then insurance pays only 80% of costs after the deductible is met.   I don't like this risk as that 20% share for me could be tens of thousands of dollars.

Preventive care is covered for free -- so my annual well-woman exam is free, but if anything needs follow up that's not free.


Under the lower-deductible plan, your share after meeting the $1,500 deductible shouldn't be "tens of thousands" of dollars. If your plan is ACA-approved, which I believe is must be because you said it's new this year, which means it couldn't be grandfathered, it must have an OOP max of $13,200 or less for family coverage. Again, however, if you or a family member was the only person with hefty medical expenses, the legislated individual OOP max is $6,600 for 2014.

I'm not recommending the lower-deductible plan. The benefits of maxing out an HSA are too good, and the lower-deductible plan is not eligible. You might have to re-examine your choice of aggressive SL paydown vs. maxing out the HSA.

Quote
Last week, I scratched my eye and had to go to the eye doctor.  I asked how much an eye exam would cost and they couldn't tell me because it depends on the specific contract that United Healthcare and my employer negotiated and they won't know until they get the EOB.  So, I had to commit to the appointment before knowing the cost -- I hate that.  Same drill for other visits with other doctors.

Another strategy is to try to negotiate an up-front "cash" rate for the appointment, bypassing your insurance altogether. I've never personally done this, but it's possible with many providers. Note that whatever you pay will not could as part of your deductible. I'd only try it if I knew I wasn't going to meet a deductible in a given year.

TrulyStashin

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Re: High-deductive healthcare & HSAs in the US
« Reply #20 on: October 24, 2014, 08:41:38 AM »

I could opt for a lower deductible plan ($1500) but then insurance pays only 80% of costs after the deductible is met.   I don't like this risk as that 20% share for me could be tens of thousands of dollars.

Preventive care is covered for free -- so my annual well-woman exam is free, but if anything needs follow up that's not free.


Under the lower-deductible plan, your share after meeting the $1,500 deductible shouldn't be "tens of thousands" of dollars. If your plan is ACA-approved, which I believe is must be because you said it's new this year, which means it couldn't be grandfathered, it must have an OOP max of $13,200 or less for family coverage. Again, however, if you or a family member was the only person with hefty medical expenses, the legislated individual OOP max is $6,600 for 2014.

I'm not recommending the lower-deductible plan. The benefits of maxing out an HSA are too good, and the lower-deductible plan is not eligible. You might have to re-examine your choice of aggressive SL paydown vs. maxing out the HSA.

Quote
Last week, I scratched my eye and had to go to the eye doctor.  I asked how much an eye exam would cost and they couldn't tell me because it depends on the specific contract that United Healthcare and my employer negotiated and they won't know until they get the EOB.  So, I had to commit to the appointment before knowing the cost -- I hate that.  Same drill for other visits with other doctors.

Another strategy is to try to negotiate an up-front "cash" rate for the appointment, bypassing your insurance altogether. I've never personally done this, but it's possible with many providers. Note that whatever you pay will not could as part of your deductible. I'd only try it if I knew I wasn't going to meet a deductible in a given year.

Thanks.  This is really helpful.  I'm generally on top of stuff but I wasn't aware of the OOP max of $13,200/ $6,600.   I may reexamine which plan I'm in and go for the lower deductible plan.   That would really help me have more peace of mind.   Under the lower deductible plan, I had this fear that I'd get in an accident and rack up a $100k medical bill and get stuck with 20% of that bill.

I'll do some more reading and reevaluate.  Thanks for taking the time to post.

madage

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Re: High-deductive healthcare & HSAs in the US
« Reply #21 on: October 24, 2014, 08:52:03 AM »

Thanks.  This is really helpful.  I'm generally on top of stuff but I wasn't aware of the OOP max of $13,200/ $6,600.   I may reexamine which plan I'm in and go for the lower deductible plan.   That would really help me have more peace of mind.   Under the lower deductible plan, I had this fear that I'd get in an accident and rack up a $100k medical bill and get stuck with 20% of that bill.

I'll do some more reading and reevaluate.  Thanks for taking the time to post.

I'm happy to help. You do have to be careful, though, of out-of-network costs in the event of a hospital stay. Your plan may not have a separate out of network OOP max, in which case your fears are justified. Just as an example, my OOP max for out-of-network is double the in-network OOP max.

TrulyStashin

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Re: High-deductive healthcare & HSAs in the US
« Reply #22 on: October 24, 2014, 08:57:46 AM »
Reading the summary of benefits for the two health plan options available to me, I found these two footnotes:

2 The Plan does not require that you or a covered Dependent meet the individual Deductible in order to satisfy the family Deductible. If more than one person in a family is covered under the Plan, the individual coverage Deductible stated in the table above does not apply. Instead, the family Deductible applies and no one in the family is eligible to receive Benefits until the family Deductible is satisfied.

3 The Plan does not require that you or a covered Dependent meet the individual Out-of-Pocket Maximum in order to satisfy the Out-of-Pocket Maximum. If more than one person in a family is covered under the Plan, the individual coverage Out-of-Pocket Maximum stated in the table above does not apply. Instead, for family coverage the family Out-of-Pocket Maximum applies.


So, the way I read it, having my kids on my plan bumps us into the "family Deductible" category, so the individual Deductible is irrelevant.  My choices are:

HDHP 1:   $3k deductible and $10k OOP maximum per year (cost per month, $146)
HDHP 2:   $11k deductible and $11k OOP maximum per year (cost per month, $10)

Note, I am currently putting $90/ mo into my HSA and my employer adds $500 in January and then another $500 in June SO LONG AS I've put in $500. by that time.

Oh, and yes, that's all for in-network care.  Out of network has a different pricing structure.  So frustrating.........   Now that I'm reviewing this, I can see why I chose the HDHP 2.     

Your thoughts welcome.
« Last Edit: October 24, 2014, 09:08:05 AM by TrulyStashin »

madage

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Re: High-deductive healthcare & HSAs in the US
« Reply #23 on: October 24, 2014, 09:27:13 AM »
Reading the summary of benefits for the two health plan options available to me, I found these two footnotes:

2 The Plan does not require that you or a covered Dependent meet the individual Deductible in order to satisfy the family Deductible. If more than one person in a family is covered under the Plan, the individual coverage Deductible stated in the table above does not apply. Instead, the family Deductible applies and no one in the family is eligible to receive Benefits until the family Deductible is satisfied.

3 The Plan does not require that you or a covered Dependent meet the individual Out-of-Pocket Maximum in order to satisfy the Out-of-Pocket Maximum. If more than one person in a family is covered under the Plan, the individual coverage Out-of-Pocket Maximum stated in the table above does not apply. Instead, for family coverage the family Out-of-Pocket Maximum applies.


So, the way I read it, having my kids on my plan bumps us into the "family Deductible" category, so the individual Deductible is irrelevant.  My choices are:

HDHP 1:   $3k deductible and $10k OOP maximum per year (cost per month, $146)
HDHP 2:   $11k deductible and $11k OOP maximum per year (cost per month, $10)

Note, I am currently putting $90/ mo into my HSA and my employer adds $500 in January and then another $500 in June SO LONG AS I've put in $500. by that time.

Very interesting. Sorry to learn I don't know as much about health plans as I thought I did :(. I guess my plan is pretty good in that coinsurance kicks in when a covered family member meets the individual deductible.

I believe you said you're on the $11k deductible this year. Has it been a relatively normal health care year for your family? It should be pretty easy to estimate your total costs, including premiums, under both plans and use that to decide what to do for 2015. You can also include a "worst case" in which you hit the OOP max under both plans and compare the total cost.

dadu007

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Re: High-deductive healthcare & HSAs in the US
« Reply #24 on: October 24, 2014, 09:35:33 AM »
For comparison, here are notes from the plan I chose:

"What is the overall deductible?:
$1,800 individual/$3,600 family in-network; $2,700 individual/$5,400 family out-of-network (includes prescription drugs, Mental Health and Substance Abuse). With family coverage, the entire family deductible must be met (even if one member has met the individual deductible). $350 individual/$700 family is contributed to your HSA by [my company]. Additional funding is available via earned [rewards program, up to $500]. The maximum amount you and [my company] can contribute to the HSA is $3,350 for individual coverage and from $6,650 for family coverage."

"Is there an out–of–pocket limit on my expenses?:
Yes. $5,000 individual/$10,000 family in-network; $6,500 individual/$13,000 family out-of-network (includes deductible, prescription drugs, coinsurance, Mental Health and Substance Abuse)."

I plan, at the end of this calendar year, to add up how much I spent this year on premiums that were deducted from my paycheck as well as all copays and prescriptions (Type 1 diabetic in the family) using my current EPO healthplan and then compare that next year to all the expenses with my new HSA.  I'm guessing this year premiums and prescriptions will total ~ $7500. (Annual premium this year was ~ $5000, under the HSA the annual premium will be $2880).  Remember that this year prescription deductibles kicked in right away; next year they won't until I hit the $3600 family in-network deductible.

It will interesting.  I only hope it's not wallet-busting.  I've been stocking up on insulin and other diabetes supplies for my son to weather the coming financial storm.

MrSal

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Re: High-deductive healthcare & HSAs in the US
« Reply #25 on: May 03, 2015, 10:03:10 PM »
This is very timely since my wife's employer is now make us choose between their plan or we go on our own.

Please help me in this case to see if it's worth it or not.

My wife is a teacher and her school offers health benefits.

The health plan covers all the family which add of now we stand as only 2.

There is a contribution of 40$ per month for the plan which is a top of the line plan -  a 50$ deductible and specialist co payments of 10$.

The school has a window for us to choose either their plan or opt for the money incentive instead which is only 1000 dollars of bonus. If we were to choose the 1000 dollars would it be worth it considering we'd still have to pay for premiums now and fund the HSAs?

My reasoning is that is not worth it although I'm not sure if I'm missing anything... Maybe the hsa access is  worth it?

sisto

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Re: High-deductive healthcare & HSAs in the US
« Reply #26 on: May 08, 2015, 02:09:13 PM »
My husband works for a major financial institution, and they just announced that in a few years they will only offer high deductible plans. It will undoubtedly scare some people and punish the non-Mustachians in our midst (who don't have a reserve), but it is a good thing long term.

We've been on a high deductible plan for years and love it. There was no way we could lose money, since the premiums were so much lower and my husband's company puts $1,000 a year in his HSA. We met our $4,500 deductible in the first week of 2014 (damn pregnancy complications) and luckily most of our health problems have happened in one calendar year. How convenient! I didn't want a second hospital stay in one year, but I had just that this past week. Better in October than in January of next year! Also, on the years that we meet our high deductible, we make it a point to see all the specialists. I had some moles removed at the dermatologist and am seeing an ENT about some ear problems I have, as well as my internist to do routine blood work.

I too have been on a HDHP for several years. I was a bit leery at first, but after I learned how it worked I knew it would save me money in the long run. I utilize it the same way you do where I get in everything I can if we hit the max out of pocket. I put in the money pre-tax where before it all went to a premium and I still had to pay a co-pay.

MoneyRx

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Re: High-deductive healthcare & HSAs in the US
« Reply #27 on: May 08, 2015, 04:07:02 PM »
My husband works for a major financial institution, and they just announced that in a few years they will only offer high deductible plans. It will undoubtedly scare some people and punish the non-Mustachians in our midst (who don't have a reserve), but it is a good thing long term.

We've been on a high deductible plan for years and love it. There was no way we could lose money, since the premiums were so much lower and my husband's company puts $1,000 a year in his HSA. We met our $4,500 deductible in the first week of 2014 (damn pregnancy complications) and luckily most of our health problems have happened in one calendar year. How convenient! I didn't want a second hospital stay in one year, but I had just that this past week. Better in October than in January of next year! Also, on the years that we meet our high deductible, we make it a point to see all the specialists. I had some moles removed at the dermatologist and am seeing an ENT about some ear problems I have, as well as my internist to do routine blood work.

I too have been on a HDHP for several years. I was a bit leery at first, but after I learned how it worked I knew it would save me money in the long run. I utilize it the same way you do where I get in everything I can if we hit the max out of pocket. I put in the money pre-tax where before it all went to a premium and I still had to pay a co-pay.

While HSAs are a better way of doing things for our healthcare system as it gives the consumer some price sensitivity, you can see why its still not perfect as it allows people who hit their deductible/max out of pocket to over-utilize discretionary services.

Since everything is done on a calendar year basis, it is best (for you) to do exactly what you guys are doing to attempt to minimize spending and I would do the same thing if it were me.
« Last Edit: May 08, 2015, 04:11:03 PM by MoneyRx »

justajane

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Re: High-deductive healthcare & HSAs in the US
« Reply #28 on: May 08, 2015, 05:39:00 PM »
My husband works for a major financial institution, and they just announced that in a few years they will only offer high deductible plans. It will undoubtedly scare some people and punish the non-Mustachians in our midst (who don't have a reserve), but it is a good thing long term.

We've been on a high deductible plan for years and love it. There was no way we could lose money, since the premiums were so much lower and my husband's company puts $1,000 a year in his HSA. We met our $4,500 deductible in the first week of 2014 (damn pregnancy complications) and luckily most of our health problems have happened in one calendar year. How convenient! I didn't want a second hospital stay in one year, but I had just that this past week. Better in October than in January of next year! Also, on the years that we meet our high deductible, we make it a point to see all the specialists. I had some moles removed at the dermatologist and am seeing an ENT about some ear problems I have, as well as my internist to do routine blood work.

I too have been on a HDHP for several years. I was a bit leery at first, but after I learned how it worked I knew it would save me money in the long run. I utilize it the same way you do where I get in everything I can if we hit the max out of pocket. I put in the money pre-tax where before it all went to a premium and I still had to pay a co-pay.

While HSAs are a better way of doing things for our healthcare system as it gives the consumer some price sensitivity, you can see why its still not perfect as it allows people who hit their deductible/max out of pocket to over-utilize discretionary services.

Since everything is done on a calendar year basis, it is best (for you) to do exactly what you guys are doing to attempt to minimize spending and I would do the same thing if it were me.

For clarification, I went to the doctor tons and tons that year and still didn't hit my out of pocket maximum. Thus, I was still paying for these "discretionary" visits at 20%. I only did the things that were necessary for my long term health. I wouldn't call routine health maintenance over-utilization.

Based on this logic, isn't everything but emergency services elective?

In general, the thing I despise about the high deductible plans is that it probably keeps people from going to the doctor when they should for fear of what it will cost.

TheDude

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Re: High-deductive healthcare & HSAs in the US
« Reply #29 on: May 08, 2015, 06:50:50 PM »
I know when I have to make a choice between a couple of plans I like to graph them as total cost (x) vs out of pocket (y). Its a great way to look at the difference in total costs of a plan. If you can estimate you costs it really gives you a good idea of what you will be spending.

MrSal

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Re: High-deductive healthcare & HSAs in the US
« Reply #30 on: May 08, 2015, 07:26:25 PM »
This is very timely since my wife's employer is now make us choose between their plan or we go on our own.

Please help me in this case to see if it's worth it or not.

My wife is a teacher and her school offers health benefits.

The health plan covers all the family which add of now we stand as only 2.

There is a contribution of 40$ per month for the plan which is a top of the line plan -  a 50$ deductible and specialist co payments of 10$.

The school has a window for us to choose either their plan or opt for the money incentive instead which is only 1000 dollars of bonus. If we were to choose the 1000 dollars would it be worth it considering we'd still have to pay for premiums now and fund the HSAs?

My reasoning is that is not worth it although I'm not sure if I'm missing anything... Maybe the hsa access is  worth it?


Anyome?

Gin1984

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Re: High-deductive healthcare & HSAs in the US
« Reply #31 on: May 08, 2015, 07:40:32 PM »
This is very timely since my wife's employer is now make us choose between their plan or we go on our own.

Please help me in this case to see if it's worth it or not.

My wife is a teacher and her school offers health benefits.

The health plan covers all the family which add of now we stand as only 2.

There is a contribution of 40$ per month for the plan which is a top of the line plan -  a 50$ deductible and specialist co payments of 10$.

The school has a window for us to choose either their plan or opt for the money incentive instead which is only 1000 dollars of bonus. If we were to choose the 1000 dollars would it be worth it considering we'd still have to pay for premiums now and fund the HSAs?

My reasoning is that is not worth it although I'm not sure if I'm missing anything... Maybe the hsa access is  worth it?


Anyome?
Stay on the plan unless your employer has a HSA plan because buying any plan on the open market out be worse than they are offering and much, much more expensive.

 

Wow, a phone plan for fifteen bucks!