HSA Health Insurance plans - yay or nay

[janine]

With benefits going up at many firms with coverage going down, many companies are pushing HSA. We are at the point where it makes sense to put our whole family on my plan (HSA). In the past I was reluctant to put the kids on this plan, but they have no preexisting conditions and typically we go for an annual and maybe 1 or 2 extra visits for a bad cold, that kind of thing.

Am I missing anything - does anyone regret putting their family on an HSA?

[abh5e8]

no regrets - we love it. I can use the HSA funds to pay for things that my regular insurance won't cover (like eye glasses or dentist visits). I think you can even use the funds for things like OTC meds, vitamins and sunscreen, but I havn't done this yet. Make sure to know what your deductible and OOP max/limits are. we have that amount set aside, so that if we needed something, the money would be there. fully funding the HSA is also a nice tax shelter.

[Indianamom2]

We just signed up for ours again this year. Last year we opted in for the first time and of course, I ended up needing three surgeries and all sorts of interventions and therapies. I have literally spent days every month of this year at a doctor's office of some sort. I think we will ultimately come out ahead with the HSA. It took some getting used to, but like the PP mentioned, it covers things like glasses/contacts that my regular plan never did.

[MelissaTC]

Another yay. We have been really happy with our plan.

[marymoo86]

I just signed up for this b/c due to the Cadillac tax my PPO plan is being phased out

Seems okay if you do not need a lot of outside routine care. Luckily well checks/preventative is 100% covered and the company contributes a lump sum to defray the cost of the deductible. DH and I can both do health screenings to have more money deposited as well.

[o_mom]

We have been very happy. We had basically no financial risk to go to it because the difference in premiums was so drastic. Our worst case scenario was that we would spend no more than our previous PPO plan and we ended up significantly ahead. We now have enough in the HSA that we could cover the OOP max on the plan, so we are not maxing out the contributions next year.

ETA: We have three people on daily medication and average 6 specialist visits per year along with usually one unexpected bill (ER, moderate illness, etc) and still come out ahead.

[brittone2]

Echoing o_mom again. That's about how it works for us. Our worst case scenario year basically breaks us even with adding onto DH's employer's plan (12K per year).

[belovedgandp]

General rule is that people who are healthy and use their health care very little or those who are extremely sick are better with an HSA. We are four years into it and are definitely ahead. We fall on the healthy side. Maybe one sick appointment per family member in a year. No regular medications. Our biggest health expense is eye care with 3 of us wearing glasses and/or contacts, but the health coverage available through DH's employer paid such a minimal amount of that it wasn't a big benefit.

A closer co-worker has two family members with diabetes. They love the plan because they know exactly what their maximum OOP will be each year and say they are ahead compared to the traditional coverage plan.

The first two years we did the maximum contribution to provide a buffer if we did have a major medical event. With a secure buffer, we've dropped it modestly, but our overall health expenses have not increased. Having those funds follow us for years will be helpful. Dentist is starting to make noises about braces for at least one of my kids, so I'm already earmarking funds in the HSA for that.

[MSWR0319]

This was our first year on it and I love it. We actually maxed out and for the last two months everything will be paid for. I could not for the life of me figure out how we had hit our $6000 deductible. I then figured out that our monthly meds that we use the savings cards for actually count toward the max before the coupon. So for example, DS's epipens were $125 before the coupon, but I only paid $25. $125 went to the deductible. We have three meds in our family that we get monthly which we use these savings cards for, which apparently added up quick. I have 4 $400 savings cards from Auvi-Q, so will will get there quick next year too!

[pb&j]

General rule is that people who are healthy and use their health care very little or those who are extremely sick are better with an HSA...

...They love the plan because they know exactly what their maximum OOP will be each year and say they are ahead compared to the traditional coverage plan.

This is not necessarily the case. Someone at my work created some tools to decide between our "gold' (traditional) and "bronze" (hsa) plans. For our specific scenarios (family of 4), the Gold plan costs less oop (including premiums), if total medical expenses were greater than about $10,000/yr. For us, even though we are relatively healthy, 3/4 of us have had surgery in the last three years. My daughter has had three (minor) surgeries and some very expensive specialist visits and follow-ups that we didn't anticipate. My son also had some unanticipated health needs that have tipped us well over the $10,000 mark. We have definitely come out ahead on the traditional plan, making close to the max contributions to FSA. At about $30K worth of medical expenses, the difference between the traditional and the HSA (making max contributions to HSA as well) is substantially in favor of the traditional plan for us (~$4K less overall than HSA plan). A broken arm could easily be $30K. I had an outpatient surgery a few years ago that was $20K at the negotiated rate.

You can know exactly what your oop will be for *any* plan, not just an HSA. I know exactly what my deductibles and coinsurance are, and what my max oop is. My max oop is *much* less on the traditional plan than on the hsa, plus the deductible kicks in sooner. There are also slightly different rules around how max deductibles are calculated for our traditional plan vs the HSA plan - between the four of us, we are hitting individual and max deductibles more quickly on the traditional plan. Also, federal law now allows $500 in an FSA to be rolled over to the next year, so while it's not a savings vehicle like an HSA, there's not as much "use it or lose it" pressure.

I'm not saying that traditional plans always come out ahead, just that you need to do very careful analysis based on your plans limits, deductibles, premiums, and max OOP. The HSA plan seems great in theory, but a couple years in a row like we've just had, and we would not have a penny left in our HSA account, and would be thousands in the hole.