HSA Eligible Health Plan

Updated on March 07, 2011
J.C. asks from San Rafael, CA
14 answers

The company my husband works for pays for his insurance only. I'm self-employed and have a separate plan for myself and my children. My Anthem Blue Cross plan has become so ridiculously expensive. It's really stressful to have to wonder if I can afford to take my son to the ER because it sounds like he's having difficulty breathing. With an $800 monthly premium, I still received an ER bill for $1100 plus another bill from the ER doctor.
I'm starting to gather some info about HSA Eligible Health Plans. I'm pretty confused though. I realize these are high deductable plans, but are the premiums low? With one of these plans is it optional to open up an HSA account? After the deductable is met, what percentage is covered? A friend has one for his family of 5, but what he told me seems too good to be true...that he pays $200 a month and has a deductable of $4000. After that is met, 100% percent is covered. Could this be correct?
I realize all plans are different and everyones families may not be eligible for the same plan, but if anyone has any input or suggestions I would really really appreciate it. Thank you so much!

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answers from Kansas City on

Yes, this could be correct. I deal with ins at work and there are so, so many plans out there, it gets confusing. I would call around to some of the major companies and get quotes. here are just a few of the many companies you can contact. Humana, BCBS, Coventry, United Health Care, Aetna,.

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answers from Dallas on

Is it possible to get added to your husband's policy at work if you pay all the premiums? This might be cheaper to be apart of a group plan than trying to get coverage on your own. Shop around--get an independent agent to compare several different plans for you.

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answers from Boston on

When me and my husband lived in Denver we had a HSA. I can't tell you about specific plans and deductibles, but the advantage was that we only paid for the services we used. We were young and relatively healthy, so we got great coverage for emergencies, and were able to save alot of money. It's definelty worth looking into. The cost of health insurance is ridiculous and after paying high premiums, you often end up still paying alot when you need to use the insurance ( like the ER visit you mentioned). Health Savings accounts are a great alternative.

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answers from Washington DC on

With our BC/BS HSA plan - we have a $2500 deductible and NO co-pays at visits.

they pay 90% of everything. I was a tad shocked this year - as this was a new plan for us and we did it to save money...i scheduled my hysterectomy totally forgetting about the deductible - but we are good.

There are different plans. Investigate, ask questions of them and get everything in writing so there are NO ASSUMPTIONS!!

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answers from San Francisco on

We had an HSA plan for about 8 months. His work paid the monthly premium so I'm not sure what that part cost. We had a $2500.00 deductible. If I remember right well child visits were no cost. Taking a sick kid to the doc was what ever the negotiated rate was. We would go to the doctor, pay no copay, and get the bill later. It would show doc visit charge $110 and insurance approved cost of $98, we paid the $98. Yes you can open an HSA account and make deposits regularly into it. When you get a doctor bill you pay it directly out of the HSA account by check or debit card. You can only use the $ in the HSA for medical bills. If you use it for anything else you are penalized like its an IRA. If you ever cancel the HSA plan and have money left in the HSA account but no bills to pay, then you can have it converted to an IRA. You also have to pay full price for prescriptions so we moved our stuff over to Walmart for cheaper costs. If you are on birth control, find out how much they are w/out insurance. Mine were $49.99. You'll want to see if you can switch to another brand that's cheaper. Good luck deciding, picking a plan for the family is a nightmare.

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answers from Sacramento on

We have an HSA high deductable insurance plan through my husbands work. We don't pay anything out of his paycheck, but we have a $3500 annual deductable to meet. Once that is met we pay 10%. Also, we don't pay the full price each time we go to the doctor. The doctors bill the insurance company and they get us a discount and that's what we pay. So for example, I have iron infusions I'm getting. The office bills it for something like $700, but the insurance company negotiates it down to around $600. Since you will be getting this insurance yourself, you will likely have to pay a monthly premium (that my husband's employer pays for us), but it will be way less than you are paying now. You really have to look at each plan and see what their deductable is and make sure that the HSA account you get can roll over each year so that you don't lose the money you've put in the account. We put a certain amount each month in to our HSA account so that by the end of the year we have put in enough to meet the deductable, just in case we need that much money. Last year was the first year we did it and we saved ourselves $3000 because we hardly went to the Doctor and all our bills combined once paid out of the HSA was only around $2000, whereas the year before we were paying $5000 for our insurance plus our co-pays. However, this year because of the iron infusions we have already met our deductable and it's only March. So this year we will be spending a lot more on health care than last year. This type of insurance is a bit of a gamble, but if you don't use your insurance much more than for annual physicals than it's probably a good way to go. Things to look for with Anthem are, What is the annual deductable, what is the Cap you can put in the HSA, does the HSA roll over each year, What will your copay be once the deductable is met, What is the out of pocket max for the year (once our out of pocket is met the insurance covers 100%) Hope this helps.


answers from Boca Raton on

Hi JC,

My husband runs a health/life insurance company so I know how this works......( It was confusing for me when we first got on it also 3 years ago)

First, if anyone in your family has a lot of health issues I DON'T recommend it...

When we first got onto our HSA (with Humana) we were paying about 180.00 for the 3 of us with a 7k deductible for a total family payout....
Example: If you bring your child to the pediatrician, with a normal group plan you would probably pay about 20 copay, with a HSA you pay the repriced amount.. (example: we pay 44.00 for my son's pediatrician visits, not that big of a difference from 20 to 44).....All children's wellness visits are FREE....

We WERE paying almost 750 for the 3 of us with Aetna.. My husband didn't want to keep paying that because we didn't have any health issues BUT YET we would still HAVE to pay the 750 per month...

After you meet your deductible it is 100% covered.. We never meet our deductible though....

BUTTTTTT I started having dizzy/numbness/tingling issues so I've had to go for MRI's, CT scans and now neurologist ... That's where the HSA's can get expensive (that's why I say if you have a healthy family, HSA's are great) but now that I'm having health issues, we are paying.....
EXAMPLE: I went to the MRI center and got a brain and neck MRI , it was about 1800 BEFORE the repriced amount... I got a bill for 600.... So I did save 1200 but still owe 600 (which in that case I always just call the doctors office to set up payment arrangements and there always fine with that).....

How my husband looks at it: Why pay 750 EVERY SINGLE MONTH whether we go to the doctors or not when we can pay 180 per month and when we have to go to the doctors, yes we will pay more than the average copay, but it's better than paying 750 every single month and not even using it some, if not, most months....

PS It's the same with prescriptions with meeting your one time deductible.... And until you meet the deductible the meds are repriced....

You can get either a yearly pap or mammogram once per year for free....

HSA are considered PPO's (95% of the time) so you DON'T need referrals to go to specialists...

Any other questions, you can privately email me

Good luck!



answers from San Francisco on

While its seems you have received some bits of good information some of it is also incorrect/misleading as far as CA goes. I'm not sure where you are located but I am a licensed broker in CA so those are the rules I am familiar with. Here's my best advice, please have your husband contact his HR dept and ask who their broker is. That is who you want to talk to. They will be able to tell you what plans the company offers, when their Open Enrollment is, if your loss of coverage is considered a qualifying event midyear, what the employer contributions are and of what plan it applies to (base plan), if the company has a Section 125 in place so you can pay your part of the premium and any HSA contributions on a pre-tax basis, etc. They can then walk you through the benfits and explain what happens when you access service. I'm sorry I don't have an answer for you but without the company specific in it's impossible to know. Best of luck to you and your family.



answers from San Francisco on

When my hubby was laid off we lost our insurance. We just signed up for an HSA through Anthem Blue Cross. We will be paying about $700 for our entire family (if it is just you and your son, it would be less). We will have a $5500 deductible, but once it's paid everything will be paid at 100%.
Trying to find the best plan for us was super confusing. I can recommend a good independent broker if you are interested. He was very helpful and happy to answer my repeated questions. :)


answers from San Francisco on

I learned about HSAs through the Dave Ramsey class. If you are quite healthy, they are the way to go. You can contribute up to $3,000/year tax sheltered. It works like savings. When you reach retirement, if you haven't used it for health you can take it out for anything.
I have mine through HealthNet and it's very reasonable, although my kids aren't on it. I pay around $150/mo. and I get well-woman checkups and the like. My deductible is around $4,000, but I rarely go to the dr. so it's worth it.
I opened the account through Stanford Federal Credit Union on the advise of a financial consultant. Seems to be the best deal around.
If I was going to the doctor a lot, it might not be worth it. I suggest making an all-out effort to eat a healthy diet, especially if your child has allergy problems. My son has no asthma symptoms since we went off sugar. Highly recommend that, as the rest of us have been healthier, too.
You might find more information at the Dave Ramsey website.
Hope that helps!



answers from San Francisco on

We have a Kaiser HSA plan & are pretty happy with it. We switched about 3yrs ago from a plan that was just getting so ridiculous....$2500 deduct & $1500 a mo for a family of 4...with no medical issues.

We nw pay about $500/mo. We have a HUGE deductible of about $7500 for the fam &I think $5000 per person. Then it all gets covered. We put the max into our HSA plan & we use almost all of it each year.

Even tho I still think it's expensive for what it is, it's the best I could find for us.

I can recommend highly my insurance broker in Concord who we've used for about 10yrs now & has advised us on different coverages. Her name is Lois Kubota & her # is ###-###-####



answers from Redding on

HSA compatible insurance plans can work fabulously for some people.
For the most part, they work for people who have very few, if any, health issues.
You put the money you save in premiums into an account to pay for medical things. If something disastrous happens, you pay out of pocket for your deductible and then the insurance kicks in.
Many policies have "out of pocket maximums", meaning once you have paid so much out of pocket, the insurance pays 100% after that.
Out of pocket maximums can be $5,000 or more, depending on the plan.
Personally, an HSA would never work for me because of my health issues.
But, they are great for people who don't really take meds or need to frequently visit the doctor.
HSA's are easy to open and you can google expenses that are HSA approved.

See if you can find a local broker to help you get more information.



answers from San Francisco on

You would want to have and HSA account as you can contribute the money pre-tax and you use that money to reimburse yourself for you your health related expenses. Yes your premiums can be $200-300 a month, but as to what it covers after you have met your deductible varies from plan to plan. Also, the deductible maybe $4000,but that is usually for aggragate, so it maybe $8000 annually for the family. Also very important to see what the coverage is out of plan as well as in.



answers from San Francisco on

Yes, i have Blue cross to. Wow! What type of insurance does your friend with 5 have? Pleas let me know, and let me know if you find anything good. ____@____.com

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