June 2017 Moms

HSA Plans?

We may be switching insurance plans over the next month if my hubs gets a new job opportunity. The new job would be absolutely fantastic for him, but in leaving his current job we would lose our currently awesome health benefits. We would be switching to my company's HSA (Health Savings Advantage) plan. Anyone else have a high-deductible plan like an HSA? How has it worked for you?

Not only is my HSA plan high deductible, but it still also has high premiums so it's like a double whammy. 

Re: HSA Plans?

  • Your high deductible insurance plan and HSA are two different things. The HSA is an account that you ( and possibly your employer) will contribute money to each week/month/quarter. The monies that are in your account can be used for anything medical. 

    It's a great tax advantage and if you play your cards right, you can accrue a large allowance in one year. 
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  • HSA accounts also follow you forever via your SS# so you never lose them and can use whatever you contribute for medical expenses even if you wind up on another plan in the future.  I've had an HSA plus high deductible plan for years and love it...the tax benefit of maxing out the HSA contribution is great for us given our tax bracket.
  • itsfine  in our benefits enrollment brochure, the plan itself is called a HSA. Part of it includes the pre-tax contributions that you can elect to contribute (similar to a FSA or flexible spending account), but the plan coverage itself is also being referred to as HSA with an annual deductible, out of pocket limit, etc.
  • @acrose0226 this must be something new. I've never heard of an HSA plan have premiums or deductibles. 
  • delujm0  good point on leveraging pre-tax contributions for a tax benefit. So you just plan for having X amount of cash on-hand (or you pull from what you've contributed to your account) to cover the high annual deductible?

    It seems like something we could get used to, but were just surprised that at least at my company, the premiums cost the same if not more than a standard PPO/low deductible plan, PLUS we have the high deductible. I've often heard that high deductible plans have lower premiums per pay period.
  • itsfine  It's new to me, too!!
  • We put the max in every year...the insurance plan we use has an out of pocket maximum that is less than the maximum HSA contribution.  So as long as we fully fund the HSA we can use that for all of our expenses in a year plus carry some forward.  You can also use HSA dollars for dental and vision expenses, so we do that with our extra sometimes.

    The annual deductible and out of pocket maximums are determined by the underlying insurance plan...so your employer likely has different numbers than mine for those.  Max HSA contribution is controlled by the IRS so it's the same for all people that have insurance plans that qualify for HSA accounts.

    The HSA account and insurance plan are independent of each other, but my employer also refers to it as "the HSA plan" in our internal documents.  They are actually two separate things.  High deductible insurance plans are widely variable as to maximums and coverage but the HSA account options are the same for everyone (bc the account is an IRS thing rather than an employer thing like the insurance plan is).
  • I had one for about three years. High deductibles suck, but most employers will contribute half your deductible amount into your HSA account for you, so that makes a big difference. I didn't mind it, the tax write-off was great, you just have to make sure you plan and save for big bills. Definitely check what your coverage is once you've met your deductible. One plan I was on still made me pay 25% even after meeting a $5,000 deductible, and that sucked. I think I paid almost $10,000 when dd was born. 

    I think pp mentioned this, but a big benefit is that unlike an FSA, you can keep your HSA money year after year, even if you go off of an eligible high-deductible plan. I always maxed out my contributions (yearly limits are set by the IRS), so now I have money I can spend on medical expenses even though I am back on a traditional plan. If you still have money left at retirement age, your account transforms into a retirement account and can be used for anything, not just for medical expenses.
  • I just switched since my husband got a new job with better benefits in August, but I did the high deductible with HSA plan this last year. I contributed $2600 and I believe my employer contributed another $750 or so. The biggest difference to me was dealing with payments up front. I had to have a D&C in May, and it ended up costing around $4,000 after the limited insurance coverage was applied. The hospital called me before the procedure tryng to get full payment. I paid about half up front and they were more than willing to set me up on a payment plan for the rest once the final bill came out so I could use my monthly HSA contributions. I was actually surprised at how well they worked with me, probably because a lot of people are not willing to or able to pay. 
    I would look into how much labor and delivery and prenatal care will cost next year and make plans to set at least that amount aside. The nice thing as others may have mentioned, is that unlike an FSA,  you can roll over any funds you do not use. 
  • For comparison sake, I have family coverage (me, DH, and kids) and my deductible is $3800, out of pocket max $5700.  During the coinsurance period expenses are 80/20 generally, but maternity is 90/10.  The year I had DD (also in June) I never hit my out of pocket max.  I was close but didn't go over.  Premium is about $200/paycheck (get paid every other week).

    We also offer a "silver" plan which costs about $100/paycheck and has $5700 deductible $9600 out of pocket max.  I was on the silver for 2016 but moved back to gold for 2017 bc I know we'll be in a high expense year due to the birth.  When we don't have forseen high expenses we usually do the silver plan to hedge our bets.  We have enough carryover in our HSA that we would be able to cover full out of pocket on that plan if disaster struck, but the premiums are way cheaper so in a year like this one where we likely won't even hit the deductible that winds up being cheaper for us.
  • @delujm0 I switched over to a HDHP with an HSA back in 2010 when I switched jobs and never looked back.  I think people get afraid of moving away from a PPO or HMO style insurance as most people aren't connected to the cost of medical procedures, visits, medication, etc.  A great example I was sharing with a co-worker... they went with the top of the line option, PPO, highest premiums, lowest deductible, and co-pays.  They pay $30 for every sick visit at their pediatrician... well, my insurance negotiated rate is $76... so I pay $76 each time until I hit my deductible and then it is only 10% of my negotiated rate... so I literally pay < $8 after while and they will ALWAYS pay $30.  By the time your calculate the difference in premiums and realize the costs of your normal healthcare... its amazing more people haven't switched sooner IMO.

    I feel like as long as we don't reach our out of pocket max, we are making out like bandits!!  We also contribute the max amount each year to our HSA and don't use it all which means we don't ever feel the burden of our deductible the following year.  Once it hits a certain amount you can invest it like a retirement account as well... once you reach a certain age (~ 60's+), I believe you can also use it for anything... not just medical.
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