Need Advice on HSA Plan and Health Discount Plans?

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.

We don't use an HSA but I am thrilled with the Health savings plan that my company (Melaleuca) offers. We saved and additional $880 on braces on top of the $1200 from our insurance. It's a plan you can join and cancel at any time so there's no waiting periods etc...and several of my customers also use the plan to get significant discounts on dental and vision. It's been a bonus to us..but alas..it depends on the plan...and your needs of course!

Jen Ohrman

Insurance is so confusing and I have some of the same questions.

We are on a high deductible plan and have an HSA and absolutely love it. Our deductible is $4000 out of pocket for family and then everything is covered at 100% after that (with the exception of prescriptions they are on a co-pay). So we put $350 a month into the HSA which covers our deductible but we only did that because I am pregnant and we knew that we were going to hit the deductible either way this year. After the baby we plan on cutting back the HSA to only $200 a month which is the difference between what we would pay if we were on the PPO vs. the high deductible plan. We found (by doing A LOT of math) it saved money to go with the high deductible even if you go to the doctor frequently. It is sooo much cheaper for us to have our baby even on the high deductible it is great! You really have to do the math and see what works best for you. If you don't have any expenses the money just sits there in the HSA until you need it, which is great if anything unexpected comes up. We used it for doctor bills, prescriptions and even things like Tylenol, band-aids, etc. It is tax deductible and you don't loose it at the end of the year if you have not used all of it.

We love HSA's personally, hope that helps.

We use an HSA and I love it. This was a new plan offered about 3 years ago through hubby's work. I did some quick calculations (premium of 80/20 plan vs. HSA, how many sick visits I could expect with small kids which equaled a $20 co-pay for the 80/20, etc.) It cost me more to have the 80/20 plan that it did to do the HSA. The premium savings is huge at our company, probably 1/2 the price of a traditional 80/20 plan. We HAVE run out of HSA funds each year, but even adding the out of pocket of $1000 to the other costs is still lower than the premium and copays of the 80/20. Plus, in our plan, if we have a big issue (hospital stay or some other pricy event), we still make it back to the traditional 80/20 plan, so either way, we are covered 80/20. We've used it for 3 years now and it's great. The HSA does not take funds out for well checks, immunizations and regular appts like physicals, pap smear, etc. We also have the opportunity to earn more HSA money by filling out a quick health survey where they give us ideas of how to live healthier.

Another consideration of the benefits of HSA is the tax deduction. We own our own small business so health insurance is totally our own responsibility. The HSA plan was the only option with the premiums we could afford, we have BC/BS which actually does cover some of the office visit and prescription expenses (our former company didn't pay for anything at all!) We just have to remember to deposit money into the HSA account monthly, knowing full well we'd be paying those bills regardless of which account the money came from, but come tax time, there is a HUGE write off. Consult with a tax preparer before you make any decisions based on this information, I only offer this as another plus in considering HSA.

I currently have a HSA through my work and I hate it! I went for my annual eye exam so I could continue getting my contacts and if I would have filled the experimental eyes drops my ex doc wanted me to get I would have spent a total of $400. The prescription alone was $185! so I did not fill it as my work contributes $600 per year. So you can see that after just One annual it will use up most of what you have in there! One of the girls at work went for her annual mammagram (which is supposed to 100% covered under wellness visit) just because the doctor needed to check her cholosterol level, the insurance would not cover it and she had the pay the entire $385. Our deductible is $3,000 and until you get to that point, you pay the entire bill on all your visits with the exception of annual physicals, pap smears and mammograms(provided they do nothing extra). I totally regret getting it and wish I would have gotten the basic plan where I pay a monthly fee. My advice to you, DON'T TAKE THE HSA PLAN! You will regret it.

A. C
Texas

I am single mother of a 4 year old. My son has three non-generic meds that he takes on a monthly basis, each at $40. This plan has actullay given me a piece of mind. We also visit one or more doctors a month. At $ 35 a visit.
Do you see the math. If ididn't have the plan that would be money out of pocket i would have to come up with. So for $40 dollars a paycheck, I can spend well beyond that amount. If you run out money the deductions are still coming out, you are now responsible for you health care cost. I hope this is helpful . Good Luck!!!!!

Hi A.---We use an HSA. My husband's company is small so it does not offer a group insurance plan. They do give my husband an extra check to buy insurance however.

Our family is of the opinion that we are primarily responsible for our health. We are very proactive, making sure we eat a diet that consists mostly of fruits, veggies, whole grains, legumes, nuts and seeds. We are active and exercise regularly.

We do our yearly exams but we do not do all of the tests that most doctors offer. A lot of tests are unnecessary. For example, I no longer get mammograms, instead I get thermascan screening, which costs about 1/5 to 1/6 of what a mammogram costs. Research shows that thermascans find problems in the breast years before a mammogram does.

We have a high deductible so our monthly premiums are low. Partly, these choices are based on the fact that our youngest just finished his first year of college. Without small children, we simply go to the doctor less often.

It is convenient. If your HSA account runs out, you are paying deductibles out of pocket. The benefits of the HSA is that you don't pay taxes on the $ that you put into the acct. So when the account is used up, you are then paying with $ that you will need to pay taxes on.

Any good insurance agent should be able to explain the pros and cons. I don't know much about health discounts. Much, I guess, would depend on how much your family uses the health care system.

I hope I've answered some of your questions. Please feel free to give me a call and we can go into more detail, if you'd like. Good luck with your exploration. D. ###-###-####

I would only select an HSA as a last resort (personally).

Companies are moving to them because they're less expensive for the company, more expensive for the employee/family.

One of the biggest reasons NOT to use one (my company offers one) is that it prevents people from going to the doctor because they don't want to put out the money. In our company's case, it's a $2000 out of pocket deductible before insurance kicks in. Most people don't want to pay $100/month for cholesterol meds, $75 for a visit to the pediatrician, so they wait and hope the condition improves.

As a recent cancer patient, we were fortunate to have incredible insurance to cover what is likely now almost $400K in expenses related to my treatment and recovery.

A HSA is better than nothing, but it's certainly not the best option out there. I personally chose not to accept the HSA and went with the more expensive traditional PPO because the coverage was more comprehensive.

I think someone below got the HDHP confused with HSA. We love our HSA and set it up to be just shy of our deductable on our plan. If we find we have to pay out of pocket, we just submit it and the check comes in a few weeks.
They are pre-tax dollars, so you are taxed less. Occassionally we have gotten burned where we didn't use all the $$. As our kids have gotten older, we have also put less and less in there.
Re: the membership, I would really look at what it offers and if there are services that you could apply and the discount is greater than the cost, go for it. Personally, I have found a lot of those services talk a good game, but when you go to use them so many strings attached, not quite worth it.

You may also want to call and talk to the office gals at your PCP. They do the billing, etc and could offer you some of their thoughts.

We have a high deductible plan ($5,000 per person, $10,000 a family) and we utilize a HSA. We currently put about $180 a month into this account and will use every bit of this. Know this before you spend $40/month on a discount. With our high deductible plan, there have been arrangements made with our providers to give us the rate that the insurance company would otherwise pay them as long as we stay in-network. For example, I had to go to ER over the Christmas holiday for pneumonia. This is something that I would never do and was trying to hold out til the doctor's office opened on Monday but I had been running a 104 temp for four days. I absolutely did not want to go to ER because I knew I would have to pay out of pocket for this. To sum it up....my bill was original bill was $3000 but it was lowered to $1000 because that is what insurance would have paid. $1000 is still alot of money but I was very thankful that I had been putting money into a flex spending account to pay for it. It distance hurt quite as bad as it would have if I didn't have that money set aside.

HSAs are typically only available for employees enrolled in a high deductible health plan (HDHP). To make that decision, you really need to know what are your average annual medical expenses and be really good at budgeting. I was enrolled in an HDHP and had an HSA account. We are a family of 5 (two adults, three children) but we are all in relatively healthy condition so we had no expectation of extreme medical costs. We never hit our annual family deductible level (which is usually higher under an HDHP), and I didn't put enough money into my HSA to cover what we had to pay out of pocket (doctor visits, prescriptions, etc.). Plus, if there is any major medical incident your HDHP coverage probably won't be as good as a traditional health plan (it may be something like 70% insurance coverage and 30% out of pocket, vs. a 90% / 10% ratio, depending on what your company offers). So after two years of unsuccessfully trying to figure out how much money to put in the HSA to cover our higher out-of-pocket expenses, I gave up and went back to a PPO so now I know exactly what I'll pay for doctor visits, prescriptions, etc. I also put some money into a flexible spending account (FSA) to help cover some of the out-of-pocket expenses (like co-pays).

The one nice thing about an HSA is that if there is still money in it at the end of the year it will roll over to the next year. With an FSA, whatever is left the IRS gets!

I don't know anything about discount plans.

My husband and I were on the HSA with my company until this year and loved it. We switched over to the POS not knowing what kind of expenses we were going to have with our newborn (copays were more predictable). After this year we will be changing back. I go along with one of the others, in that I have a certain amount deducted from my paycheck to match the deductible which is $3000/family. Just like some put money into a FSA. Plus, my company puts in $1500 to start as an incentive to go on the HSA.

A lot of good thoughts already but I thought I'd add my 2 cents.

I think you do have to look at your family, family's health and costs related to health care. I disagree with the poster who said people will wait and not go to the doc. At least from my experience, we are NOT paying the $75-$100 for my husband's med, it is still just a $4 co-pay. Our 20 year old son just had a case of strep throat, that med too was covered. But that is where you come in to be your own advocate.
When I saw my doc last fall for my physical, I explained we had an HSA and was there any difference if I was considered a "private pay" and it was considerably less! Unfortunately, your PPO's and HMO's may "pay" better in what you see, but many times their contracts with the docs/hospitals discount things so much that it really all comes out in the wash. You just don't see it, (unless you watch your statements and insurance EOB's).

We also looked that we were overall very healthy. I see a chiropractor for many things and our traditional insurance did not cover so I was paying that out of pocket.

We "funded" ours with my husband's bonus check one year but another way is the monthly like someone mentioned. And you do NOT have to use or lose it. It carries over year to year, or at least ours does.

I personally would not go back to a traditional insurance plan.