<p>It’s good to hear the opinions of those that have these things.</p>
<p>From another perspective, the high deductible probably disincentivizes people from going to the doc when they actually need to, and that can ultimately lead to higher costs. I kind of know I have some medical stuff going on, but with all our other expenses this year I just don’t want to pay out any more. Seems crazy that I am paying thousands of dollars in insurance a year, but am still scared to go to the doctor because I just can’t afford it right now. I guess that makes my insurance for catastrophic purposes only right now. </p>
<p>Out of curiosity, has anyone else found that their cost differential for a high deductible policy and a PPO is shrinking? When I first switched to a HD there was a substantial difference and it was clearly worth taking the higher deductible for the monthly savings (given the lack of serious health issues). In fact it was almost a wash the first year, with the premium savings offsetting any potential deductible, but with the added benefit of the HSA that I could use for other expenses like vision and dental. The cost difference is getting less and less each year making the choice a lot less clear cut for me. maybe I need to do a little spread sheet</p>
<p>Oh and another thing, if you switch from a high deductible to a regular plan and have HSA savings left over, any issues with using those? (I know I can research it, but hoping someone already knows - my brain is already in M D Anderson scanxiety mode and my IQ is beginning to drop).</p>
<p>^swimcatsmom, if your D is married, I’m wondering how she can be YOUR dependent (not up on tax rules for such things)? </p>
<p>Our deductible is $5K, second level of $7K. The main purpose of insurance at the level of “non-catastrophic” is that you get the insurance company negotiated rates, which can be significantly less than if you had no insurance at all. OTOH, with the cost of everything medical, you can eat through a high deductible in a hurry even if it isn’t something most people would consider “catastrophic”. Last year we ate through $5K in a matter of hours after S’s bike accident :(. Not what we needed a month before freshman tuition was due!</p>
<p>We rarely use medical services but cost isn’t really an issue if we felt that we needed to use them.</p>
<p>I like to minimize recurring costs as a matter of good financial stewardship and I go around looking at expenses from time to time to see if we really need to be paying for a particular product or service. In this case, it’s open enrollment season and it’s a good time to take care of this so that I hopefully don’t have to look at it for a few years.</p>
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<p>This was my concern too but our HSA plan is administered by our regular plan administrator (UHC) and it looks like we get the negotiated rates that the other plans get.</p>
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Sylvan - she can’t be my dependent, that is the whole problem and what most of my posts have been about - I am having trouble with trying to figure out the HSA thing. Thankfully she can still be on my health plan because of Obamacare even though she is married, but is not a dependent for tax purposes which is where my confusion is coming from for the HSA. (she just got married this year, so last year was not an issue). </p>
<p>FWIW There are situations where she could be my dependent even though she is married, but she would have to have a very low income and not file a joint return with her husband. Her income is pretty low (graduated this year but her job opportunities are very limited as there is nothing related to her degree in the small college town where her husband is a Grad student - she is working at a Pet store after completing her undergrad - pretty broke, but absolutely loves it!), but not low enough for her to be my dependent with the married rules.</p>
<p>$5,000 deductible - ouch. I thought our $2800 was bad enough.</p>
<p>I’m biased, but I dont care for HSA and HDHP plans. Mainly because I have a chronic illness, and my costs are predictable. The PPO plan is cheaper for me, because I dont have thsoe years where the only time I see a doctor is for a checkup. What the HDHP/HSA plan seems to be doing is encouraging healthy, younger people to self insure, thus making it more expensive for everyone else by taking premium out of the pool. PPO plans are going to get so expensive that companies will just quit offering them (some already have). The idea of an HSA itself is an easy sell-who wouldn’t want a tax deferred medical savings account that stayed with them regardless of employer? But coupled with HDHPs, its a raw deal for people with chronic problems. Anyone who was serious about lowering medical costs for struggling consumers would support decouplings HSAs from HDHPs, and making them accessible to anyone who wanted to use them.</p>
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<p>well isn’t that just terrific…something that was helping a lot of self payers is getting phased out…thanks a bunch obamacare</p>
<p>Vyse…I do understand your point…but HDHP coupled with HSA’s are indeed terrific for the young/healthy. They are what insurance actually should be…for sudden serious injuries/illness…not for running for the doctor every time little Johnny has a runny nose. Our HD plan saves us 5-7k a year every year over plans with much lower deductibles. The incentive is to stay healthy to save money…but in the future if/when we need to use that $10k deductible, we have many years of savings to pay that deductible, from the actual savings in the much lower premiums and the HSA contributions.</p>
<p>Let’s hope the HSAs don’t end up being phased out, there are so many rules & requirements coming and going, I am trying not to stress the details until they are actually happening. </p>
<p>SwimCat- the way you read it is the way I understand it, Like FAFSA not caring about who is a tax return dependent, your health plan can include your DD as an insurance dependent, the family deductible applies to all of you, so you can contribute the full amount.</p>
<p>Because no one looks at the big picture you cannot pay her expenses out of the HSA, but hey, put in the full amount any way, that’s a good choice for you. Your DD still has HD catastrophic coverage so, great, should she have something bad happen, she is covered. If she used that entire deductible, either she pays it or you could gift her the payment, just not from the HSA. Either way you are building up money in the HSA and are taking that tax deduction.</p>
<p>That is terribly confusing. It means this: you can set aside pretax money to pay medical bills and use those fine for a person on your plan who is also a dependent for your taxes. If the person is not a dependent for your taxes and you use pretax money, that’s a violation. So say you have a 24 year old kid on your health plan but that kid files his or her own tax return. You can’t pay deductibles, etc. for that kid out of pretax money from you. That pretax money is only for people on your tax return.</p>
<p>That is why they say the person on your plan who is not on your tax return can set up a separate pretax plan.</p>
<p>So weird and complicated. Thanks somemom and Lergnom. I will have to do some more research, but if the way we are interpreting it is correct (i.e. I can Contribute the full family max - plus the extra for me being an oldie - but am not able to pay D’s expenses using the HSA even though the fact that of her being on the plan enables be to contribute the max), then that might sway me on the direction of sticking with the high deductible. I know I have a hefty dental bill coming up next year and my husbands prescriptions are always high - was in the Med D and out the other side the first 2 months of 2012 (meaning his out of pocket prescription costs exceeded $4700 by the end of Feb).</p>
<p>Need to get my brain around all this by Nov 15th!!</p>
<p>Seems like so many contradictory things - she is on the HD medical plan so i can contribute the max to the HSA because that makes it a family plan. *But *I can’t use the funds to pay for her expenses. On the other hand, my husband can not be on the plan because he is already medicare eligible so I can’t contribute anything based on him (wouldn’t make a difference right now but once my daughter is off the plan it will). But I *can *use the HSA funds to pay for his expenses.</p>
<p>Geeps, I see what you’re saying. By decouple, I just mean they should offer HSAs with AND without HDHPs. If you’re young and healthy, yeah, HDHPs would still be a great option. But we should give HSA options to people with PPOs too imo. I also agree with incentives for making good choices like not smoking and not being overweight. But some medical problems don’t come about because of poor choices, they’re just a matter of rotten luck.</p>
<p>AGREE!!! Why not offer HSAs with any medical plan. That would be perfect.</p>
<p>I do not get this right now. The total costs for the HDHP for us is $10,192. The total costs for PPO is $11,700. So there’s a savings of $1,508 and there is a $10,000 family deductible. The HDHP plan attached to the HSA has to provide a lot more coverage for this to be worth it.</p>
<p>Ouch. That does not sond like a good deal at all. Our $2800 deductible is looking a whole lot better.</p>
<p>The ten k deductible is for family. The individual amount is 2k.</p>
<p>I get the feeling that a lot of services are covered which makes this different from what other people report. The company pays about 8.5k.</p>
<p>With our HDHP, the individual deductible is only available if the HDHP is for an individual. If you have a family HDHP. the family deductible applies. Not $1400 for her and $1400 for me, but $2800 in total . I thought it was the same for all high deductible plans (the family vs individual, not the $ amounts), but I may be wrong. That was one of the things we had difficulty understanding the first time we considered the HDHP plan and I had to talk to the provider who confirmed that if we had the family plan we had the family deductible - no individual deductibles at all. You may want to check that out. (now our PPO is individual deductibles and a capped family maximum deductible, but not the HDHP)</p>
<p>HDHP’s are required to cover certain preventative medicines and procedures. So mammograms, pap smears, colonoscopies etc are covered. Ours covers no prescriptions until the deductible is met except certain preventative ones such as birth control (not an issue for me).</p>
<p>There are so many different things to take into account. Need a little computer program that you can plug all my data in and it will tell me which plan will ultimately cost me the least.</p>
<p>The 10k amount is max out-of-pocket. Max deductible is 3k.</p>
<p>The HSA coverage is almost the same as the PPO. </p>
<p>Just some minor differences in copay vs percentages and higher deductibles. So it is essentially a PPO with higher deductible limits and percentage company’s instead of fixed dollar amounts. We could use this plan with a minimal contribution.</p>
<p>Re: [ObamaCare</a> Putting Squeeze on Health Savings Accounts](<a href=“http://www.thenewamerican.com/usnews/health-care/item/11982-obamacare-putting-squeeze-on-health-savings-accounts]ObamaCare”>http://www.thenewamerican.com/usnews/health-care/item/11982-obamacare-putting-squeeze-on-health-savings-accounts)</p>
<p>Presumably, this is reference to medical loss ratio minimum requirements, which are lower for HD plans than for higher coverage plans, because employee contributions to HSAs are not counted in medical loss ratios (even if they are just from premium or payroll deduction savings).</p>
<p>However, some employers which traditionally offered higher coverage plans offer HD plans with employer-funded HSAs, which presumably improve the medical loss ratio of the HD + HSA plan. It would not be surprising if such an offering were (a) cheaper for the employer, (b) advantageous cost-wise for the employee who uses little medical services, and (c) approximately break-even for the employee who uses lots of medical services, when compared to a higher coverage plan. (Of course, this does depend on the specific plans involved.)</p>
<p>The savings of HD plans comes in two ways: (a) less administrative overhead paying smaller claims through insurance, and (b) some level of self-rationing by the participant (i.e. instead of always wanting more, the participant may consider whether a given service is of value to his/her health, since there are some common medical services which are of dubious value in improving medical outcomes, even if they were free).</p>