Talking stocks, trading, and investing in general

[stimulacra]

Scenario:

Husband and wife, both work for a government entity or nonprofit. Both at least 50, both have a 457 and a 401/3, and at least one has an HSA.

Add that up. Boom.

HSAs are nice but they've only been a part of my financial picture since 2015 and haven't had that much runway to outpace my out-of-pocket health expenses. I'm curious to know how long others have had them?

 

[patrickBOOTH]

That's my reasoning for being skeptical of them. I don't think I would be using it a savings vehicle, much rather playing the part of my own insurance company at least trying to break even. I know some younger people at work who have had them for years and do really well with them because they never go to the doctor. Some people around my age switched back to a Cadillac plan after they had kids because the high deductible hsa didn't cut it anymore.

 

[jcman311]

Yeah I could never go the HSA route because when I was younger, I couldn't afford the deductible hit in the first month of the year. My diabetic supplies would hit month 1 and I would need to cough up the full deductible (I forget what the deductible was, like $3k or 5K and that was about the full cost of a 3 month supply). Being that I was young and had no money, I stayed on my monthly plan. I suppose now I could start but it seems like too much work at this point.

 

[imatlas]

Do you have employers who offer HSAs and HDHPs, or are you self insured?

I don’t have that option at work.

 

[jbarwick]

My work offers an HSA for all insurance options. My previous job introduced a HDHP and it didn't make any sense other than to give the option of an HSA to highly comped people. I can't wait to see that company go BK for all their terrible decisions...

 

[venividivicibj]

Do you have employers who offer HSAs and HDHPs, or are you self insured?

I don’t have that option at work.

My employer offers HSA for the basic and enhanced/Cadillac plan. Only the PPO doesn't (FSA).
Yearly deductible is 2k/4k (personal/family) but they give you 750/1.5k each year.

 

[otc]

It is worth running the numbers. For instance, we have two tiers of HSA plan and a normal plan. The *max* difference between the two HSA plans was around $400 for me last year. It was something like, if expenses were less than the deductible OR expenses were above the out of pocket max...then the cheaper plan was better (saved about $400 vs the other option). If expenses were somewhere in the middle, the higher tier HSA plan was better (but only saved a max of ~200 vs the cheaper plan).

Since I view myself as landing on the the extremes (either I consume very little healthcare...or something bad happens and I bash into the out of pocket max), it made sense to go with the cheap one.

Running that comparison to the normal plan is a bit harder. The normal plan replaces a lot of expenses with straight copays so things like frequent doctors visits (that are covered by copay rather than deductible) or prescriptions thus cost less than they would.

That being said...the premiums were significantly higher. Like 5-6x the low-tier HSA plan and 3-3.5X the better HSA plan. You would have to use a couple thousand dollars worth of copay-covered visits/meds before you came out ahead on the traditional plan. If you ran up big non-copay expenses (like you had an accident, got a cast, and needed physical therapy) that made you hit your out of pocket maximum, you would still come out thousands behind.

 

[brokencycle]

We have an HSA plan and a cadillac plan, and there is almost no scenario where the cadillac plan wouldn't cost me more. The max out of pocket is actually the same, so if you get hit with a huge bill, at least you'll have lower premiums over the year.

 

[Piobaire]

Our premiums are covered and her employer drops 2k into our HSA over the course of the year. We add in the extra 5k and so far are paying deductibles out of pocket. I'm viewing it as a rainy day fund (just cash out saved bills) or retirement fund just for healthcare costs. Right now there's a first day Medicare deductible of 1.5k for a hospital stay. I figure a couple that both make it to 90 can chew up 300k or so in out of pocket costs pretty easily.

 

[otc]

I mean, I really think the only way it works out is with heavy use of copay-services.

Out of pocket max is almost the same, but the premiums are very different. So if you end up with a situation where you would hit out of pocket max on the HSA plan, but you don't come anywhere near it on the regular plan, you come out ahead.

But that does still seem hard to do. Easier on a family plan with multiple children, but still not a guarantee. Basically you'd need like...a skin/nail problem that has you making monthly visits to a dermatologist ($20 copay vs maybe $200 a pop pre-deductible on the HSA plan) and that includes a monthly prescription that is in a low tier for copay, but is still pricey overall ($8 copay vs a $100 payment pre deductible). But even then, once you hit the deductible, you are only paying 20% up to your out of pocket limit.

Just seems really hard to make happen, at least as an individual. The max premium+out of pocket on my current HSA plan is only ~$900 more than just the premium alone on the regular plan...so you'd need some situation where the care you receive hits your out of pocket max on the HSA plan...but somehow costs less than $900 (copays + deductible) on the regular plan.

 

[otc]

Also, for those of you whose employers contribute to their HSAs...I suspect that nets out in what you pay in premiums.

My company stopped contributing to HSAs...and magically all of the plan premiums went down by exactly the amount the company contributed.

 

[Piobaire]

Reading this makes me appreciate our situation even more. No premiums, 2k HSA contribution. Hard to knock that.

 

[Texasmade]

My company only offers HSA for the HDHP and contributes up to $750 a year. Since I don’t have any kids and rarely use the doctor, it doesn’t make sense for me to do a Cadillac plan.

 

[brokencycle]

Reading this makes me appreciate our situation even more. No premiums, 2k HSA contribution. Hard to knock that.

Ah, the rich get richer.

 

[jbarwick]

My company varies HSA contributions based on salary. I assume mine will go away soon.