Health savings accounts

I finally realized my mistake with regard to health savings accounts. I was never really interested in the high-deductible plan because I thought that was a plan for people who never go to the doctor.

My mistake, I now realize, is that if you can afford to do so, you should get a high deductible plan with an HSA. You should make maximum contributions to the HSA. You should cover any out of pocket expenses, well, out of pocket and not out of your HSA. In this way, your HSA grows, tax protected and will potentially be pretty large by the time you really need it (e.g. when you are retired or your health worsens significantly).

On the other hand, if you spend most of what you put into an HSA every year on qualified expenses, it doesn't seem like that great a deal.

I love my HSA. I don't put in the max but I put in the difference between my premium now and my would be premium under the regular EPO (since I would be spending it anyway). Coupled with me and my child's relatively good health, I have enough saved to meet my out of pocket max in any one year. This is our 3rd year enrolled in the plan. Best decision ever.

ETA: I also invest the balance over a certain amount in mutual funds within the HSA. Love it.

Two examples of how this plan favors the better off at the expense of the poor and working class.

HSA might also be an advantage even if you don't get bigly sick. I pay about $200 in medical co-pays per year. These are not tax deductible. They would be under HSA in that the payments to the account would be deductible.

Not much of a big deal but having a few $k into the account when my health declines might not be a bad idea.

---- just checked. I am not eligible.

max_weisenfeld said:

Two examples of how this plan favors the better off at the expense of the poor and working class.

yes. I'm glad to have an HSA. But I recognize the fundamental unfairness of a health care system that substitutes this and tax credits for subsidies, or better still Medicare for all.

We can certainly blame the GOP and feckless Democrats for this, but the reality is that the majority of Americans seem to fully support screwing over poor people. Generally, and specifically with regard to health care.

While I can appreciate the dysfunction of our healthcare system, it's precisely because I'm poor that I chose the HSA. I leveraged the cost of a high deductible against paid and unused premiums and good health and came out ahead, fortunately. I work for a very large employer so I'm lucky, but if I found myself suddenly unemployed, I hope my HSA 'nest egg' could pay for my COBRA while my child relies on spotty Medicaid.

max_weisenfeld said:

Two examples of how this plan favors the better off at the expense of the poor and working class.

I left my job and got stuck with a $5 monthly maintenance fee. So watch out for that.

ElizMcCord said:

While I can appreciate the dysfunction of our healthcare system, it's precisely because I'm poor that I chose the HSA. I leveraged the cost of a high deductible against paid and unused premiums and good health and came out ahead, fortunately. I work for a very large employer so I'm lucky, but if I found myself suddenly unemployed, I hope my HSA 'nest egg' could pay for my COBRA while my child relies on spotty Medicaid.

max_weisenfeld said:

Two examples of how this plan favors the better off at the expense of the poor and working class.

You also must be relatively healthy for this to work.

Please note that I am not criticizing you for maximizing your benefits. On the contrary. My wife's company gives us an FSA and we work it like a bossa nova. I am just pointing out that this will be a solution with more losers than winners, and the losers will be more likely to be the people who do not have the resources to cope.

max,

Don't let the perfect be an impediment to the good.

Ain't no system gonna be perfect. Somebody will be left out.

TomR

check your plan as well- there are often little publicized things you can do to get free $ into these. For example, we earn $500 Year for enrolling and going for well visits, completing a health profile, signing up for on-line health programs,etc. Under our high deductible plan,all well visits are covered and I generally wind up with a test and visit or two out of pocket around $500-750 total. This little bonus $ generally covers those ooo expenses.

Tom_R said:

max,

Don't let the perfect be an impediment to the good.

Ain't no system gonna be perfect. Somebody will be left out.

TomR

that's a lame excuse not to try

conandrob240 said:

check your plan as well- there are often little publicized things you can do to get free $ into these. For example, we earn $500 Year for enrolling and going for well visits, completing a health profile, signing up for on-line health programs,etc. Under our high deductible plan,all well visits are covered and I generally wind up with a test and visit or two out of pocket around $500-750 total. This little bonus $ generally covers those ooo expenses.

Personally, I would never complete an online "health profile" or sign up for online "health programs." Way to collect personal data that can be used against me later.

Okay, then you can do the other options like go for your annual physical, get a mammogram or sign up to be reminded to "eat fish" or "get a good night's rest " . The point is that these are really simple $ you can earn and are often not advertised well by companies. But it can be a significant amount of $ into your account.

max_weisenfeld said:

Tom_R said:

max,

Don't let the perfect be an impediment to the good.

Ain't no system gonna be perfect. Somebody will be left out.

TomR

that's a lame excuse not to try

I don't recall making any excuse.

I also don't recall suggesting that we shouldn't try to make health care better. Have at it. Run for Congress. Run for President!

I do recall that I wrote that there ain't no system gonna be perfect.

If you have a suggestion for a system that would be perfect; please tell us what your system is.

TomR

Something to read before signing up for a workplace wellness plan:

https://mobile.nytimes.com/2017/03/10/health/workplace-wellness-programs-health-genetic-data.html

kthnry said:

Something to read before signing up for a workplace wellness plan:

https://mobile.nytimes.com/2017/03/10/health/workplace-wellness-programs-health-genetic-data.html

The health of the American public will cascade downwards due to the removal of EPA regulations. More cancer, emphysema, etc.

Which means business now needs to keep a closer eye on their employees health so they won't be a burdensome expense.

Welcome to the dystopian era.

from kthnry's link: "the rules under the antidiscrimination laws would not apply if someone
volunteered personal health information under a wellness program."

wow. imo, this is a big deal.

Maybe it's time to separate insurance from employment.

you think?? I do not understand why big and small businesses are not wildly in favor of this.

As a side note, yesterday on NPR there was a very well-done report on the advantages of ACA for start-ups: the founder was comfortable leaving his corporate job to start new company, and was able to find employees who would work for him without employer insurance, both because of ACA.

why why why did they not broadcast this BEFORE the election?? And why don't Dems make a point of it, with or without NPR??

the Dems did a terrible job of explaining the ACA. And, as I recall, they treated Obama like he was radioactive during the 2010 midterms. No wonder support for the ACS has been lukewarm on both sides. Nobody really understands it except for the people who need it.

I don't understand how you can build up a nest egg in your HSA. Aren't HSA accounts "use it or lose it"? I'm pretty sure mine always have been.

Rivoli said:

I don't understand how you can build up a nest egg in your HSA. Aren't HSA accounts "use it or lose it"? I'm pretty sure mine always have been.

That would be the flexible spending account which allows you to set aside around $2500 in pretax earnings or something for qualified medical expenses. The HSA can keep growing although eventually I think you have to start using in on medical expenses.

the FSA is use it or lose it and is a far inferior product to the HSA. The HSA is more like a lady by-term savings account and can build over time.

you can accumulate funds in an hsa. but if withdraws are not for medical reasons, then income tax applies and perhaps 10% penalty.

Looks to me like an HSA is a pretty nice deal if you have enough money to max out your HSA contributions while paying for annual out of pocket expenses from your other income.

http://www.bankrate.com/finance/insurance/health-savings-account-rules-and-regulations.aspx

.

Rivoli said:

I don't understand how you can build up a nest egg in your HSA. Aren't HSA accounts "use it or lose it"? I'm pretty sure mine always have been.

No. You are thinking of a Flexible Spending Account.

A Health Savings Account is a different animal. Not everyone is eligible, as the rules stand today, to have an HSA. It can be paired only with certain types of insurance policies.