pre-FIRE Health Insurance approach

[Abe Froman]

I am months away from FIREing - and have a question regarding my Healthcare election during the annual benefits signup at work. This occurs for us between 1 Feb and 28 Feb, and then effective on 3/1.

- I am currently on an HSA with current deductible amounts paid this year (3/1/2020-3/1/2021) of around $1800 out of $3K family limit for the in-network rates. We typically do not go out of network which has a $8K family limit.
- I have selected an HSA for the last number of years, once it became available through work, and have maxed contributions to where they sit around $29K.
- I am staring down the barrel of a shoulder surgery - for what exactly and for what cost yet - I do not know. Online guesses of average costs are around $21K- so lets round it up to $25K.
- I plan to FIRE immediately after the surgery. If I can get the surgery BEFORE 3/1 - this question is moot. If the surgery is planned after 3/1 - when the new benefit plan year starts for us ... Is it better to move to a POS type plan where Out of Pocket Limit is $1800 for the individual (me)?

As I write this question out - I am thinking that it makes sense to switch to the POS only if I have a scheduled surgery after 3/1.

Is there anything else I should consider?
Does this make sense?
---------------------
_{**MOD - meant to post this to the Welcome and General, and not POST-Fire**}

[Dicey]

Yes, you should consider the sage advice of @Malcat. I have batsignaled her for you. She is very wise.

[Malum Prohibitum]

HSA is designed for betting on low expenditures for health care.  A shoulder surgery will max out your deductible.   This is not a simple case of math, though, the difference in premiums v. the difference in deductibles.  There is also the loss of HSA tax deductible investing space if you are already maxing out all other tax advantaged options.  I guess you could factor in the tax savings, too, and still make it a simple math problem.

[FIRE 20/20]

I was in a similar position prior to FIRE.  I had been enrolled in health care plans with an HSA for 5-10 years before FIRE.  However, in my last year I had shoulder surgery (torn labrum) and quit my job a couple of months after my surgery.  For me, everything worked perfectly.  My new plan had the highest premiums of the options offered by my company, but the surgery ended up costing something me a few hundred dollars out of pocket plus a few hundred in extra premiums from January - April. 

I don't really have any thoughts on something else to consider other than things I'm sure you've already thought about.  Make sure the surgeon and everyone else (anesthesiologist, PT, etc.) are all in the new network.  You'll probably want to get authorization as soon as possible after you're on the new plan to be certain that it'll be covered.  What will you do for health insurance post-FIRE?  Do you know how much COBRA will cost or will you move to an ACA plan?  If you hit your OOP limit and deductible then staying on with COBRA through the end of the year might make more sense, depending on the cost. 

I don't know what your surgery is going to be like, but for me the worst parts of recovery were sleeping and being so limited in what I could do for the month or so post-op.  I don't have a recliner, but I think that would have been worth almost any price during the no-sleep 3-4 weeks after surgery.  Seriously, if I have to have shoulder surgery again I'd buy a recliner just for those few weeks.  I ended up buying a foam wedge to try to help with that problem but it only helped a little bit.