Not necessarily true. A few months after we started on our HSA plan the kid broke his leg. Suddenly we where on the hook for the big family deductible. After it was all said and done, I calculated out the difference between the HSA plan and what the standard PPO option would have cost. Guess what – break even. It’s really just a shifting of costs – pay now, each and every month in your increased premiums. Or pay later via the high deductible when you actually use it. The key is being disciplined enough to put money into the HSA account. You can also manage the years the deductible hits by accelerating/delaying care around the end/beginning of the plan year.