High Deductible Health Plan?

[V1GiLaNtE]

MM have experiences with this and HSA's?

I've done some initial research but curious to hear first hand pros/cons.

[Kaan]

I can write more on this later, but I'm working to transition to a HD plan. Essentially you evaluate your lifestyle, assess the risks (life style, your medical history, and genetics), figure out how much you need in the HSA to cover "risks" and then you switch over when your HSA hits the magic number. at least that is the ultra conservative way to do it.

[Evan]

Yes. I have a $3k deductible. Not by choice. Thanks Obamacare.

it fucking sucks.

You essentially have no health insurance until you hit that deductible. So guess what, you dont go to the doctor when you probably should, which decreases the chance of you hitting the deductible even more and turns your health insurance into a catastrophic-only policy that you pay full price for.

the numbers *can* work, but you really have to run the numbers, be honest with yourself about paying several hundred dollar dr visits, and look at it realistically to make sure you end out ahead and dont compromise your health.

[JPolen01]

You essentially have no health insurance until you hit that deductible. So guess what, you dont go to the doctor when you probably should, which decreases the chance of you hitting the deductible even more and turns your health insurance into a catastrophic-only policy that you pay full price for.

One of my best friends is in this exact situation. He constantly is complaining about not feeling well or an injury but refuses to go to the doctor because his deductible is $2-$3k. The insurance his company provides is shit and I feel bad about that. You shouldn't have to choose not to go to a doctor because you don't want to pay hundreds of dollars per visit.

[HAULN-SS]

Same 3k deductible here, 5k out of pocket max. That's for the most basic plan. Ive never spent anywhere close to that on Dr. Visits, but for a good while I was taking Nexium prescription, which would cost me 20% coinsurance after deductible. (About $30/month) I don't know if you've priced out name brand prescription drugs for acid reflux, but they are high as shit. Pre-obamacare I paid $10 per prescription for a drug called Aciphex that was twice as expensive with a different insurance company.

Lifestyle changes have meant that I pretty much quit taking any drugs, (even though the Dr. said that it was genetic, and lifestyle didnt matter), but it would be irritating if I had to fill that every month.

[V1GiLaNtE]

You essentially have no health insurance until you hit that deductible.

So if I go to the Dr and don't hit the deductible threshold I'm paying out of pocket?

I'm very healthy without any prescriptions and hardly go to the doctor unless it's an emergency.

[Ken]

You essentially have no health insurance until you hit that deductible.

So if I go to the Dr and don't hit the deductible threshold I'm paying out of pocket?

I'm very healthy without any prescriptions and hardly go to the doctor unless it's an emergency.

Yes - I'm the same way but I don't know, just scares me that if something did happen you pretty much don't have insurance.

[.RJ]

You essentially have no health insurance until you hit that deductible.

So if I go to the Dr and don't hit the deductible threshold I'm paying out of pocket?

Basically, yes. My plan is something like 20% co-pay until you hit the deductable, after that its 100% covered. Its more money per month out of pocket though, so you have to decide whether that's worth it.

With the high deductable you can usually add in a HSA, which will let you pay for things pre-tax so that should save you 25-40%, or whatever your tax rate is.

[Apoc]

I'm very healthy without any prescriptions and hardly go to the doctor unless it's an emergency.

Yes - I'm the same way but I don't know, just scares me that if something did happen you pretty much don't have insurance.

That's kinda misrepresenting things. You have insurance... you paying the first $x out of pocket. You wouldn't say you didn't have car insurance if your deductible was $2000 because if you total your car, you're gonna get most of the value back.

That said, high deductible is really only for anyone who doesn't go to the doctor that much. I don't know I'd want to be incentivized not to go to the doctor, but I can see saving money on premiums if you're in very good health. FWIW, we have very good insurance and still pay $2000 out of pocket every year on deductibles for two people. Like Evan said, do the math. Regardless of the plan you choose, you should be considering HSA/FSA to save money on medical expenses.

[Evan]

You essentially have no health insurance until you hit that deductible.

So if I go to the Dr and don't hit the deductible threshold I'm paying out of pocket?

Yes. Think of it as you do not have insurance until you hit that deductible. (but you still have to give them your insurance card of course so you get credit for what you do spend) Also for prescriptions. Prescriptions can be expensive as F.
Some Drs make you pay full price right there in the office, some send you a bill.
What really f-ing sucks is the doctors who wont tell you how much anything costs until after they treat you.
Had to pay for a $2k surgery for my daughter all out of pocket, which is really frustrating when you are already paying $500/mo in premiums. "wtf am I paying for when I already pay full price for care?"
psychologically it really really sucks, even if in the end the cost does work out in your favor.

Yes - I'm the same way but I don't know, just scares me that if something did happen you pretty much don't have insurance.

not really, in fact thats exactly the scenario that high deductible plans are meant for. Covering that "something" car accident, major health event, hospitilization etc while still allowing for low premiums (well, before obamacare fucked that part up). Of course in that scenario youre probably not just hitting your deductible, but your out of pocket max since hospital visits are also subject to coinsurance and % based coverage, so $2k -$3k turns into $5k-$6k out of your pocket. (and hopefully it will happen in january not december)

[Apoc]

What really f-ing sucks is the doctors who wont tell you how much anything costs until after they treat you.
Had to pay for a $2k surgery for my daughter all out of pocket, which is really frustrating when you are already paying $500/mo in premiums. "wtf am I paying for when I already pay full price for care?"

Don't you still get the benefit of the negotiated rate? Most doctors provide a deep discount on billed services to insurance plans, even if the final amount is paid out of pocket. For example, I had a $900 MRI and the actual billed amount was like $400. I'm on a "shared deductible plan" (we pay $1k, Amazon pays $1k) so my out of pocket was like $200. I would think the same applies for high deductible plans.

[Ken]

I'm very healthy without any prescriptions and hardly go to the doctor unless it's an emergency.

Yes - I'm the same way but I don't know, just scares me that if something did happen you pretty much don't have insurance.

That's kinda misrepresenting things. You have insurance... you paying the first $x out of pocket. You wouldn't say you didn't have car insurance if your deductible was $2000 because if you total your car, you're gonna get most of the value back.

That said, high deductible is really only for anyone who doesn't go to the doctor that much. I don't know I'd want to be incentivized not to go to the doctor, but I can see saving money on premiums if you're in very good health. FWIW, we have very good insurance and still pay $2000 out of pocket every year on deductibles for two people. Like Evan said, do the math. Regardless of the plan you choose, you should be considering HSA/FSA to save money on medical expenses.

Sorry, yes, I grossly oversimplified. It basically becomes, "in case really bad shit happens" insurance. Which, as discussed, turns someone off to go to the doctor for that nagging cough or what-not.

EDIT: Can't type today.

[Evan]

What really f-ing sucks is the doctors who wont tell you how much anything costs until after they treat you.
Had to pay for a $2k surgery for my daughter all out of pocket, which is really frustrating when you are already paying $500/mo in premiums. "wtf am I paying for when I already pay full price for care?"

Don't you still get the benefit of the negotiated rate? Most doctors provide a deep discount on billed services to insurance plans, even if the final amount is paid out of pocket. For example, I had a $900 MRI and the actual billed amount was like $400. I'm on a "shared deductible plan" (we pay $1k, Amazon pays $1k) so my out of pocket was like $200. I would think the same applies for high deductible plans.

yes, very good point. You pay what the insurance company would have paid. Now, why people without insurance get charged more for the same work and how thats legal, thats a topic of retardation for another time.

[V1GiLaNtE]

. Regardless of the plan you choose, you should be considering HSA/FSA to save money on medical expenses.

Interesting. I looked into having a HSA/FSA but given my current plan those are only eligible with a HDHP through my company. At least what I'm reading on our policies.

It sounds that for people with families a HDHP might not be such a great path given the out of pocket expenses.

[BLINGMW]

Two thoughts:

Obviously you'll have to run your numbers yourself, but last year I switched myself and family to the highest deductible plan available at work. Basically from 0 sick to minor issues and handful of percriptions, the savings to us in monthly premiums was a big win. And then the max out of pocket for a year for all the plans was the same, something sucky like $11K. So if one of us has a bad injury or gets the plague, I'm out (theoretically) $11K that year regardless of plan. Only for a specific middle ground did the "better" plans potentially save us any money at all. It'd cost me more in most cases, and max is the same. :dunno:

Sorry, yes, I gross oversimplified. It basically becomes, "in case really bad shit happens" insurance. Which, as discussed, turns someone off to go to the doctor for that nagging couch or what-not.

FWIW, Obamacare or not (I'm not a fan) and using car insurance as the model (which to me would be ideal, not tied to employer, free market and all that) that's what insurance is SUPPOSED to be for. So, you should still go to the doctor with a high deductible plan, and use the money out of pocket then that you saved on premiums.

Maintenance on your car = going to the doctor for well visits = <$100

Minor fender bender or alternator died = going to the doctor for a sinus infection or broke a bone = $100-2000

Totaled = cancer = $$$??@1f3$2 insurance land

Mod your car = having a kid = you did this you're on your own :lol:

Makes sense to me.

[Apoc]

HSA is offered in conjunction with an HDHP.

FSA can be used in conjunction with any plan.

[Steve85]

Threads are hitting home lately...

Pretty much agree with Evan and have similar plan, 600/Month, 5K deductible, although the 600/mo includes the HSA contribution amount which gets us to 5K annually. I wanted to reduce that but last year my wife bruised her ribs and they thought she might have done internal damage so several visits and expensive scans drained the account.

This year it's my son's concussion from a month ago, the bills are starting to trickle in. Initial doctor visit for prolonged headache, then ER when the headaches starting getting worse a few days later, then MRI, etc. Account will back to zero. It sucks to have an MRI scheduled, and then your kid improves dramatically over the course of a few days (to the point where if you went to the Dr that day, they probably wouldn't request the scan) and you sit and think about whether you should cancel it.

It helps I guess that the out of pocket amount is never seen so not included as income for budgetary purposes and reduces taxable income. It pisses me off though that the "premium" has not gone down even with the new HD plan.

How do you guys determine your HSA contribution amount? My idea was to have an amount equal to the deductible over the course of the year. I looked at a few years leading up to the HSA and we were spending pretty close to 5K / yr so it seemed to make sense.

Also, how much does bubble wrap cost? I think I'm gonna wrap my wife and kids for 12-16 months...

[BLINGMW]

Also, how much does bubble wrap cost? I think I'm gonna wrap my wife and kids for 12-16 months...

Don't forget air holes!!!!!

[SlimKlim]

Are you guys using HDHPs and HSAs self-employed or consultants? If not, do you not have an insurance option with your employer?

My dad is self employed and I remember him switching over to an HDHP and HSA setup when I was in high school, but I don't know if he's still doing it.

I'm lucky enough to get a good plan through my employer so I haven't really given this any thought.

[HAULN-SS]

I'd love to hear your HSA experiences as well. We're talking about the ones that act like investment vehicles right? Any gains made in the market have to go into a health care issue, or they get taxed at your INCOME rate right? What about losses? Does it go with you from employer to employer? I can't remember all the details, but I think I pretty much determined it was a waste of time for a relatively healthy person with no dependents.