Author Topic: Should I choose HSA/High Deductible plan (VA tweak thrown in)?  (Read 1809 times)

lemonlime

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Should I choose HSA/High Deductible plan (VA tweak thrown in)?
« on: October 07, 2015, 03:47:33 PM »
My employer is having open enrollment next month and I am considering switching from my current PPO plan to the high deductible plan with HSA, which also functions as a PPO.

Currently I contribute $130 per monthly paycheck, if I switch only myself (currently covering only myself) this would go down to $50/month, if I add myself and husband, $113/month. Employer contributes to HSA on Jan 1 $500 for individual coverage, $1000 for family/spouse. Deductible is $1300/individual, $2600 family/spouse.

Husband has free healthcare for life through the VA given the level of his service-connected disability (he can work, just not very physical things and is currently in school studying accounting). However, getting care from VA can be a headache. Took a year to get him in to look at a suspicious mole that turned out to be melanoma (Stage 0, hacked it out of his arm and all is fine now with regular mole checks). Actually asked for help from a VA doc that I work with who scheduled him for his own non-primary care clinic and made the referral to dermatology for us.

For me, I am generally healthy although I have some issues with anxiety/depression. I currently take medication for anxiety prescribed through my PCP. It's apparently a controlled substance so I have to see her every four months or so to get a refill, and about once a year I get a cold or something and need to see the doc. Preventive care is 100% covered on the high deductible plan ($20/copay with current plan), but I'm not sure if the refill appointments are considered preventive care or not.

We are currently hair-on-fire debt. We have one year to go and that will be over (September 2016). I don't want to make any decisions that will slow this down.

Question:
1. Should I switch?
2. Should I add my husband to my policy or not?
3. If I do switch, given debt-payoff constraints, is it reasonable to contribute say, $50 or $75 (pre-tax) per month to the HSA given the annual employer contribution?

I need some help with weighing out the math, and I don't want to sacrifice the debt-free in 11 months goal, I would like to accelerate it if possible.

Thank you!

Added info after questions: Co-pay after reaching deductible is 20% in network, 40% out of network. I don't have a reason to go out of network at the moment, my PCP is in-network. So based on the rate on past statements the co-pay would end up being $50 in-network.

My only meds are contraception and anxiety med. The contraception is covered 100%, and the anxiety drug is only about $20 at full price with no insurance for a supply that lasts me 2 - 3 months.

OPM: for the high deductible plan in network individual is $4K, family is $6400. Out of network: $8K individual/ $16K family.
For my current plan, the coming year the OPM will be for preferred provider $1500 individual/$4500 family, non-preferred: $3K individual, $9K family.

I'm starting to think that I should make the switch and add my spouse. He probably won't use it, but then we get the lower monthly contribution (only $20 under my current contribution), and $1000 v. $500. And we have the option to use it for him if he needs it if there is an insurmountable issue with the VA.
« Last Edit: October 08, 2015, 10:16:52 AM by lemonlime »

Gin1984

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Re: Should I choose HSA/High Deductable plan (VA tweak thrown in)?
« Reply #1 on: October 07, 2015, 05:29:35 PM »
Refill appointments are not considered preventive.
You need check the cost of your meds, the current sick visit, and what the OPM is for both plans. 

AlwaysLearningToSave

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Re: Should I choose HSA/High Deductable plan (VA tweak thrown in)?
« Reply #2 on: October 07, 2015, 07:01:25 PM »
If only you go to the HDHP/HSA, you can cover the deductible by contributing what you would have otherwise paid in PPO premium with no change to your current cash flow.  Not true if you add your DH. What is your co-pay after reaching your deductible?

lemonlime

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Re: Should I choose HSA/High Deductable plan (VA tweak thrown in)?
« Reply #3 on: October 08, 2015, 10:15:58 AM »
Co-pay after reaching deductible is 20% in network, 40% out of network. I don't have a reason to go out of network at the moment, my PCP is in-network. So based on the rate on past statements the co-pay would end up being $50 in-network.

My only meds are contraception and anxiety med. The contraception is covered 100%, and the anxiety drug is only about $20 at full price with no insurance for a supply that lasts me 2 - 3 months.

OPM: for the high deductible plan in network individual is $4K, family is $6400. Out of network: $8K individual/ $16K family.
For my current plan, the coming year the OPM will be for preferred provider $1500 individual/$4500 family, non-preferred: $3K individual, $9K family.

I'm starting to think that I should make the switch and add my spouse. He probably won't use it, but then we get the lower monthly contribution (only $20 under my current contribution), and $1000 v. $500. And we have the option to use it for him if he needs it if there is an insurmountable issue with the VA.

Any opinions? Will edit original post to add this info.

AlwaysLearningToSave

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Re: Should I choose HSA/High Deductible plan (VA tweak thrown in)?
« Reply #4 on: October 08, 2015, 10:58:38 AM »
I'm looking at moving to a HDHP/HSA next year as well, and this is how I considered it.

I compare the options with the assumption that I will incur sufficient medical expenses to meet the out of pocket maximum on each policy.  Then I consider what I would need to do in order to fund my obligations under the policy.  In my area, I found that there is not much difference in the out of pocket cost between a Gold PPO plan and HDHPs when using this assumption.  Thus, I found that to the extent I save money by opting for the HDHP, I need to save what I would have otherwise paid for the PPO to ensure I am able to meet the deductible/coinsurance obligations if I need to.  I will not gain any additional cash flow by switching to a HDHP.  The differences will be: (1) who bears the cost at each point below the out of pocket maximum (me or the insurer) and (2) how much money I have left over in the event I do not incur big medical expenses

Edit to Add Paragraph:  The second difference above is what is enticing me to make the change to a HDHP.  My family is young and relatively healthy, so I am willing to take the risk that we will not incur huge medical expenses in the next few years in hopes of being able to build a significant HSA balance.  Then, having a significant HSA balance will allow us to pay low insurance premiums and save aggressively.  For me the potential long-term premium cost savings are significant because I pay the entire premium for my wife/child's coverage.  It looks like your employer covers a significant portion of your premiums, so the calculus may point in a different direction for you.

You say that your DH has free healthcare, and I assume from that statement that he is not otherwise covered by health insurance at this time.  Thus, I am assuming that if you add him, you will not have any other reductions in your current health insurance expenses that could be contributed to the HSA.

If these assumptions are true, adding your husband to the HDHP could leave you in a financially vulnerable position because your premium savings plus employer contributions to the HSA would NOT be sufficient to cover your deductible.  You would need to redirect money that is currently not spent on healthcare toward healthcare in order to be able to satisfy the deductible. 

Whether you are comfortable with this risk depends on how much flexibility you have in other areas of your budget.  The less extra money you have in your budget, the more I would lean toward not adding your husband.  The more extra money you have in your budget, the more comfortable I would be with adding your husband to the plan.  You have to make the call. 
« Last Edit: October 08, 2015, 01:46:48 PM by AlwaysLearningToSave »

lemonlime

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Re: Should I choose HSA/High Deductible plan (VA tweak thrown in)?
« Reply #5 on: October 08, 2015, 02:20:34 PM »
Thanks very much for the replies! I've at least narrowed it down to staying with my current plan or not adding my husband if I switch to the high deductible plan, at least this year.

Just checking my gut, switching is making me feel really anxious. So now I'm leaning towards sticking with my current plan this year. Next year at open enrollment we will be completely out of debt and it would be very easy to contribute the OPM (in-network) in just two or three months of income for either.  Considering that we really need to put that hair fire out, I am reasoning that the switch right now could be potentially expensive beyond our reach if I have medical issues, it would not yield really any savings for us in this coming year (when we are trying to get rid of the last of the debt).

Thanks again for the help.

goatmom

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Re: Should I choose HSA/High Deductible plan (VA tweak thrown in)?
« Reply #6 on: October 08, 2015, 08:54:32 PM »
If your husband accepts VA healthcare, is he eligible for a HDHP/HSA plan?  I thought you weren't.  I am certainly not an expert in this area, that was just my understanding.

AlwaysLearningToSave

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Re: Should I choose HSA/High Deductible plan (VA tweak thrown in)?
« Reply #7 on: October 09, 2015, 05:35:35 AM »
If your husband accepts VA healthcare, is he eligible for a HDHP/HSA plan?  I thought you weren't.  I am certainly not an expert in this area, that was just my understanding.

Good question. A person covered by a non-HDHP is not eligible for an HSA but I do not know whether VA coverage disqualifies.

Even if your husband does not qualify for an HSA, you would still be able to use your HSA money to pay his medical expenses.

lemonlime

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Re: Should I choose HSA/High Deductible plan (VA tweak thrown in)?
« Reply #8 on: October 09, 2015, 09:03:47 AM »
According to the VA website, if you have VA coverage you can have private insurance as well and retain the VA coverage.

I don't see anything about having additional coverage making my husband ineligible for the plan, but it's looking like I'd have to call someone to find out at this point.

Shropskr

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Re: Should I choose HSA/High Deductible plan (VA tweak thrown in)?
« Reply #9 on: October 10, 2015, 12:00:06 AM »
If your husband is rated or paid at 100, should look to see if he qualifies for champva.  If so it covers dependent so too and is great. 

Another thing I learned when going to the VA you have to go at least once a year to keep your primary health Doctor.