High Deductible Healthcare Plan with HSA

[wdwnomad]

It is open enrollment time at my job. This year my employer is offering a High Deductible Healthcare Plan with a Health Savings Account through Aetna. The premium for this plan is the cheapest out of all of the various plans offfered. They also will contribute $500 (for singles) to the HSA. I am thinking about doing chosing this plan as I rarely go to the doctors.

I wondering if anyone has any experience with this type of plan. I've had an HMO forever and really didn't mind it. The HDHP is a POS type plan where you don't need referals. I have always wanted this type of plan in the past but balked at the premiums. They were like two to three times the HMO.

The premium is about $53/month. The deductible is $1500/year for singles and the maximum out of pocket is $3000. If I went with the HMO is about $58/month with no deductible but with lots of co-pays and such. There are also two other POS plans being offered. One is about $100/month and the other is about $150/month.

I figured the HDHP would be a nice way to built up some cash in an HSA while I am still healthly. There is always that risk something will happen though.

Just wanted to know anyone's thoughts on the situation who has a similiar plan. Any regrets? How was it keeping track of who plans what? Did you have any problems when the plan starts picking up costs? Did you have to fight with the doctors office over coding if they overbilled you?

 

[rvchat]

I've had it for a few months. I also rarely go to the dr. And it was so much cheaper.

I guess if I have to (throat, eyes, cold, flu, etc) I could go to a walk in nurse / doctor which would still be so much cheaper.

wdyt?

 

[meriface11]

Do you have enough money for the deductible in savings in the event something happened that would require you to use it? if so, i might try it out. i had a HD plan with an HSA for one year and contributed the difference between the HD plan the co-pay plan into the HSA. was lucky enough that i didn't even come close to spending what i contributed to the HSA and built up enough to meet the deductible for the following year if necessary.

 

[bear_mom]

We have had one for three years now as a family and it has worked out fine. In that time we have had the typical doctors visits associated with having two children plus dh has been taken to the ER.

Emily

 

[Prose]

$1500 is a good deductible for an HDHP...Mine's $2500, but we get $750 contributed by our employer to our HSA.

I am assuming that your HSA is the type that rolls over from year to year, not a 'use it or lose it' type. If so, contributing to the HSA each month is a must. If you rarely go to the Dr, you will eventually have enough to cover your deductible and more.

What are the percentages of coverage after you meet your deductible..80%? 90? 100? What kind of coverage do you get for preventive care? Prescriptions? Is there a copay? Some (maybe most) HDHP plans don't have a copay for office visits, so you end up paying more for each visit, but you hit your deductible sooner. If your post-deductible coverage is 90 or 100%, you'll be good.

I always told our staff that the HDHP was good if you rarely get sick...and then I got sick. I had to pay the $2500 deductible, but I had almost that much already saved up in my HSA....then my coverage kicked in at 100%. I ended up paying $2500 for almost $100,000 in expenses. So it can work if you do get sick, as well, if you save up. (YMMV, of course).

 

[rvchat]

i don't get this. what does contributing mean? to what and whome?

we have savings from years back just in case of medical emergency. so?

$1500 is a good deductible for an HDHP...Mine's $2500, but we get $750 contributed by our employer to our HSA.

I am assuming that your HSA is the type that rolls over from year to year, not a 'use it or lose it' type. If so, contributing to the HSA each month is a must. If you rarely go to the Dr, you will eventually have enough to cover your deductible and more.

What are the percentages of coverage after you meet your deductible..80%? 90? 100? What kind of coverage do you get for preventive care? Prescriptions? Is there a copay? Some (maybe most) HDHP plans don't have a copay for office visits, so you end up paying more for each visit, but you hit your deductible sooner. If your post-deductible coverage is 90 or 100%, you'll be good.

I always told our staff that the HDHP was good if you rarely get sick...and then I got sick. I had to pay the $2500 deductible, but I had almost that much already saved up in my HSA....then my coverage kicked in at 100%. I ended up paying $2500 for almost $100,000 in expenses. So it can work if you do get sick, as well, if you save up. (YMMV, of course).

 

[rvchat]

We have had one for three years now as a family and it has worked out fine. In that time we have had the typical doctors visits associated with having two children plus dh has been taken to the ER.

Emily

but we're not 'allowed' typical dr. visits on ours. did you pay out of pocket?

 

[bear_mom]

but we're not 'allowed' typical dr. visits on ours. did you pay out of pocket?

Paid for them using HSA money. Through ours we have a credit card that is linked to our HSA account (more like a debit card, I guess) and when we get the bill from the doctor, we use the debit card to pay for it.

The whole idea behind the HSA account is you pay 100% up to your deductible - for our family it is $2500. Between $2500-$4500, it is an 80/20 plan and if we were to get above $4500, they would pay 100%. We have been under our deductible every year except the year that dh went to the ER, that year we ended up in the 80/20 part.

Since we have started this plan, 4 years ago, we haven't paid out of pocket (non-HSA money) for any medical bills. It is nice because we don't feel the effect of going to the doctor/ER on our budget.

Emily

 

[amylevan]

We've had one for several years. The first couple of years it was just DH and me, and we rarely if ever went to the doctors. We contributed regularly to the HSA account though and had a nice little savings there.

Then I got pregnant, got severe pre-eclampsia so they induced at 34 weeks. DS spent 3 weeks in the NICU. All told, hospital bills were over 100,000. We obviously hit our 3,500 deductible, when our 90% coverage goes into effect. We have a maximum out of pocket of 9000, and we hit that that year too. Luckily we had a decent amount saved in our HSA, so it worked out fine for us.

We still have it, but obviously with a toddler, we are at the doctors much more. I still think it saves us in the end when comparing to paying the premiums for the PPO our company offers.

 

[amylevan]

Also, keep in mind that while you are paying 100% until you hit you're deductible, you're not paying the prices that non-insured people pay. You still get the rates that the insurance company has set with the doctor. i.e. a regular doctor's visit may bill $100, the insurance company will knock that down to the $50 which is what you are responsible for paying. You pay it with the pre-tax money from your HSA (saving you whatever tax bracket your in) and it counts towards your deductible.

 

[mrsklamc]

Also, keep in mind that while you are paying 100% until you hit you're deductible, you're not paying the prices that non-insured people pay. You still get the rates that the insurance company has set with the doctor. i.e. a regular doctor's visit may bill $100, the insurance company will knock that down to the $50 which is what you are responsible for paying. You pay it with the pre-tax money from your HSA (saving you whatever tax bracket your in) and it counts towards your deductible.

Which is actually really great. One of the many many reasons insurance is so expensive is that so many people think they should never have to pay any copays for anything, ever. IMHO, a HDHP is what insurance SHOULD be for- to keep a major medical event from destroying your life.

I look at it this way- you can pay the regular insurance premium and KNOW the money is gone, or you can put it in your HSA and if you're lucky you won't have to use it.

 

[nunzia]

We have one for my DH...we've ended up using it quite a bit and it's worked out fine. We have to self insure him and rates went up this year, but still under $200 a month. Although it is an HSA plan we don't have an HSA saving account so just pay out of pocket..not pre tax.

 

[Shelly F - Ohio]

We have had one for a couple of years and LOVE it. Love the fact that the money we pay toward our health care premiums goes in an acct that we get to spend . If we don't have any medical expenses then we get to keep the money in our HSA acct.

Especially if you are rarely sick. Why pay a premium for a traditional plan when you can have an HSA acct and bank your money.

Do the math. If a traditional plan will cost you say $500 a month times 12 months you will pay out $6000 a year. With HSA the max out of pocket you have to have in the HSA acct is $2600 before we are covered at 100%. So would you rather pay $6000 and never see that money again or maintain $2600 in a savings acct that is yours to keep.

 

[rlduvall]

I have had one for several years now through my employer. Like others have mentioned, because I am rarely sick the significantly lower premium and the fact my employer puts $500 a year in my HSA, makes it very worthwhile for me. A plus under our plan is that women annual visits and yearly mammograms are covered at 100% with no deductible.

 

[rvchat]

I have one and my only question at this point is, is this a tax saving?

wdym pre-tax money? Not sure I'm getting any tax ded by having an HSA.

mine costs me about $2500 a year in monthly premiums. Have not had any bills other than that, LUCKILY, thus far.

 

[ceecee]

We choose it this year for the first time. Our deductible is $4000.00 then ins pays 100%, DH's employer puts in half the ded and we do the rest by FSA like we always did. I went to the hospital in Feb. so my yearly ded is met. A lot of the people DH works with never go to the Dr and they love getting to keep the money at the end of the year. I was leary about going to the Dr and not paying a co-pay, but apparently they are used to this, because I haven't had any problems and I've been to a few Drs this year unfortunately!

 

[Jaime4004]

I have one and my only question at this point is, is this a tax saving?

wdym pre-tax money? Not sure I'm getting any tax ded by having an HSA.

mine costs me about $2500 a year in monthly premiums. Have not had any bills other than that, LUCKILY, thus far.

The tax savings comes if you are using the HSA (healthcare savings account) with the high-deductible plan. For us, a certain amount of money is transferred into the HSA monthly, pre-tax, which you then use to pay the out-of-pocket stuff. Rather than paying out of your checking account with money that has already been taxed.

I like our plan. We also have $2500 deductible, then everything is paid 100%. We are a family of 5 and relatively healthy. One year, one of my kids ended up in the hospital for 5 days in January! So we had to pay the $2500 right at the beginning of the year. Of course, I didn't have it, but the tax refund that year helped. Now I make sure we have $2500 in savings, as a cushion, just in case. Good news was that the rest of the year, everything was covered 100%. So i took the opportunity to refill every medication monthly that we could possibly need the following year (not including antibiotics and other things that pop up, I mean expensive migraine meds, things used intermittently).
But generally, we all rarely go to the doctor so it does save quite a bit of money...

 

[rvchat]

 

[ccgirl]

It is open enrollment time at my job. This year my employer is offering a High Deductible Healthcare Plan with a Health Savings Account through Aetna. The premium for this plan is the cheapest out of all of the various plans offfered. They also will contribute $500 (for singles) to the HSA. I am thinking about doing chosing this plan as I rarely go to the doctors.

I wondering if anyone has any experience with this type of plan. I've had an HMO forever and really didn't mind it. The HDHP is a POS type plan where you don't need referals. I have always wanted this type of plan in the past but balked at the premiums. They were like two to three times the HMO.

The premium is about $53/month. The deductible is $1500/year for singles and the maximum out of pocket is $3000. If I went with the HMO is about $58/month with no deductible but with lots of co-pays and such. There are also two other POS plans being offered. One is about $100/month and the other is about $150/month.

I figured the HDHP would be a nice way to built up some cash in an HSA while I am still healthly. There is always that risk something will happen though.

Just wanted to know anyone's thoughts on the situation who has a similiar plan. Any regrets? How was it keeping track of who plans what? Did you have any problems when the plan starts picking up costs? Did you have to fight with the doctors office over coding if they overbilled you?

Haven't read all the posts. My employer has the samet thing. Except, my company pays the first $2,000 and we pay the next $1,000. Total stop loss is 5K per year per family. I was very leary about it at first as we have always been covered at 100%. However, the stop loss is key. I would never have to pay more than 5K a year. Knock on wood, my family is fairly healthy. We do go to the ER a few times a year for my son's breathing. But, other than that it's just well visits. Considering a dr's visit is in the neighborhood of $200 it would take us quite a few visits to even get to the point of paying any copays. I talked to my office manager and she said she has yet to use all of the 2K so has never had to pay any OOP expenses, except for prescriptions. So far, I am very happy with it.

 

[Kellydelly]

I'm impressed that people have employers contributing to their HSA accounts for them! Must be nice .