We currently have one we're on our second year of it. Ours has a higher deductible than the regular PPO would but my husband's company contributes half of the deductible (spread out over the year) to our HSA. It truly takes about a year to build up your account so that you're not paying out of pocket at the end of the year. When your funds are gone in your account you're paying out of pocket, until you build up again. The plus sides: you can use it like an FSA on medications etc. and ours earns interest, it's tax free cash coming out of a paycheck and it automatically rolls over each year - it's always your money, under our insurance plan all well child visits are completely covered. The cons: higher deductible, as in we probably won't meet it this year, and last year I was pregnant so there was very little if any money left for monthly medical expenses such as allergy meds etc. I'm still of a mixed opinion of whether or not I really like it.