posted
So, after almost 6 years of college, two degrees, and four years of experience, I finally have a job that provides health insurance. 'Tis a happy day...
I know the basics of health insurance, particularly PPO's since that's what I had through BC/BS. Anyways, both choices are offered through my new job are with United Heath Care, so networks aren't a huge issue (at least not a determining factor). For what it matters, my company will contribute $1,100 a year into the HSA if I choose that path.
My question is who has some experience with Insurance plans that incorporate an HSA (not FSA)? I'm a fairly healthy and single adult, I've been to the doctor's office three times in the past four years, so what I know about HSAs make them sound promising. But, they're different so on some level they're intimidating. Cheaper, but seemingly less of a financial safety net if some illness or injury gets out of hand.
Has anyone here had a good experience with them? Horror stories regarding them? Really good links comparing and contrasting them with less of a hidden agenda than the ones I've found so far?
Thanks for the help for a health insurance noob.
Posts: 1368 | Registered: Sep 2002
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posted
Do NOT use UHC's FSA, as it SUCKS. A lot of FSA's now use a credit card they send, with your amount allowed loaded on it. That way you just charge your stuff....glasses, doctor's appointments, whatever...on the card. No up front money at all
UHC's FSA require you to pay 100% up front, then they send you a check.
I have a HIA with my PPO at work, and it is great.
Posts: 15082 | Registered: Jul 2001
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posted
If you're young, healthy, and have only preventative health care to worry about, an HSA should be fine.
If you have any sort of chronic health condition (diabetes, mental illness, asthma, etc), an HSA will end up costing you much more. In fact, an HSA would be practically useless.
If the difference in price between the HSA and the PPO isn't a big one, the PPO is the 'safer' option. I worked for a health insurance company and pretty much every employee would/does say that HSA's are worthless unless you've got a ridiculous amount of cash in your bank account.
If you want more information (an explanation of how each thing works, etc), just ask. Posts: 14745 | Registered: Dec 1999
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posted
I agree with mackillian, but also would add that you should be okay with slightly more risk if you sign up for the HSA. Even if you are generally healthy, there is a chance you could get seriously ill, and then you would have to face the higher deductible.
But if you are healthy, young, and are okay with a little risk if it gets you lower premiums, then an HSA is an okay path to take.
Posts: 34 | Registered: Jan 2008
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My company just switched to a HSA this year. I hate the concept of it. I have a family of six and my wife has had health issues the past few years. This could prove to be very expensive for us. I also have a medication I take that will now cost me over $2400/year. That is over 1/3 of the total money that will be contributed (by both me and my company) into my HSA. I am going to stop taking that medication when I run out to try to save money. That's not a good thing.
Medical benifits is one of the reasons I chose my current company. Now they go and change them up on me. If it gets too expensive, I will change compnaies.
You are young and pretty healthy, you could be safe in taking the HSA, but if ANYTHING happens, the $1100 will go very fast when you have to pay the entire contracted amount. My wife just went to the doctor and the contracted amount for that doctor visit was $85. The other thing, you are probably not going to stay with this company until you retire. HSA's can only be transferred or used in the future if you are at a company that also has a HSA.
If I were you in your situation, I would take the PPO. If fact, I would ALWAYS take a PPO over a HSA. Heck, I would even take a HMO over an HSA.
Posts: 1766 | Registered: Feb 2006
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My insurance assumes everything is a preexisting condition so if you don't have a certificate of prior coverage, they don't pay. Or you can use them for over a year and after a year they will start to pay. Would HSA's provide a certificate of prior coverage?
Posts: 1001 | Registered: Mar 2006
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Um, if your HSA is administered by UHC, don't opt for that. I'm not kidding.
And I entirely agree with brojack about always choosing pretty much anything other than an HSA (or FSA, for that matter). Brojack really just paid out the entire issue with HSAs—the money is limited and if you have a chronic health condition, need to take prescription medications on a daily basis, have a family, or have anything catastrophic happen to you, you are completely screwed with an HSA. The money will run out and you will then be screwed.
While an HMO (or PPO or EPO) has hoops and hurdles to get through, in the end, they will cover you much more thoroughly money-wise. If you play the game (I mean, getting referrals when you have to, etc), the coverage is actually fairly good.
People (not on this thread) talk about the 'freedom' that an HSA offers in terms of choosing your own providers. However, what they don't mention is that there's no point in being able to choose your own provider when you can't afford to see them. More and more companies are opting to offer only HSAs for health coverage because they're cheaper on their end. Don't be fooled. Unless you are young, healthy, single, and low-risk, an HSA is a horrible health plan and can financially cripple people, or deny them the proper health care (like having to stop taking a prescription because the HSA money has run out).
...I should stop now. I could go on and on about the state of health care today. But I've seen the HSA trend from the inside (I used to work for a subsidiary of UHC). The company I worked for stopped offering the HMO option for healthcare when UHC took over. When they presented the HSA-only options to the employees and tried to frame it as a fantastic choice, it didn't go down well at all. Why? Because we all worked in the industry and we could easily tell good coverage from bad.
Posts: 14745 | Registered: Dec 1999
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posted
Everything that your insurance company does now will continue under a HSA.
A HSA is a checking account that both you and your company can contribute to and rather than paying a copay and a percentage of medical costs, you pay the full contracted rated with the entity. So, where I used to pay $15 in copay for a doctor visit and the insurance paying the remaining $70, I pay the full $85. My company will put a total of $3250 over the course of this year and I can put in another $2600. This gives me about $5800 for medical bills this year. My company has set an out of pocket maximum of $8000 for a family per year and if I hit that, then I go back to a regular PPO style of payments with copays and such. Unlike a FSA, HSA can be rolled over from one year to another and I can take it with me if I leave, but only if I go to a company with a HSA. I can also chose to invest this money similar to a 401K, but I haven't looked into that at all.
I don't like this concept, but for now I have no choice. I think it is a way to get people to stop using medical services. I have had to give up two prescriptions that I need (one blood pressure and one horomone replacement) because I can't afford my medicine and my wife's.
Posts: 1766 | Registered: Feb 2006
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Architraz Warden, You make it sound as if you are choosing between and HSA and a PPO. Its my understanding that you can't qualify for an HSA unless you have a PPO. Companies will often offer a choice between a PPO with low deductable and an HSA combined with high deductable PPO.
If you are really just looking at an HSA, don't do it because you will have no safety net if you have an accident or an major medical problem.
If instead you are looking at an HSA and a high deductible PPO, then there are circumstance where the latter can work out in your favor.
Posts: 12591 | Registered: Jan 2000
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posted
All of the above comments could be footnoted in an essey on why we need a whole new approach to paying for medical care. But, right now no one is even talking about a single payer system, even though all these problems would be addressed by such a system. There is no rational advantage to linking health care payment to employement. It is a worn out relic of the wartime labor board from WWII. When they put artificial wage celings on employment, health insurance was cobbled together to provide an discriminator or recruting incentive. The only arguement for continuing with our present system is that it is our present system. (and the Republicans would have you believe that anything else a communist plot) You young guys with these problems need to remember how it feels to have to deal with them now. Then when someone finally had the courage and opportunity to change the system, you will help them do it.
Posts: 1167 | Registered: Oct 2005
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quote:Originally posted by Artemisia Tridentata: All of the above comments could be footnoted in an essey on why we need a whole new approach to paying for medical care. But, right now no one is even talking about a single payer system, even though all these problems would be addressed by such a system. There is no rational advantage to linking health care payment to employement. It is a worn out relic of the wartime labor board from WWII. When they put artificial wage celings on employment, health insurance was cobbled together to provide an discriminator or recruting incentive. The only arguement for continuing with our present system is that it is our present system. (and the Republicans would have you believe that anything else a communist plot) You young guys with these problems need to remember how it feels to have to deal with them now. Then when someone finally had the courage and opportunity to change the system, you will help them do it.
posted
I have never been a fan of centralized healthcare. I work for NASA and I see how the government spends the money it gets and how difficult it is to get through the bureaucracy, but at this point, I am ready for something else.
Posts: 1766 | Registered: Feb 2006
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I'm a Human Resources Dude who has been wrestling with administering insurance plans for lots of years. We provide our employees with the best plan in 17 counties. (possibly the whole state) But, to do that we have negoiated discounts and other advantages with medical service providers. Any costs that we don't have to pay get passed on to those who don't have the same aggressive administration. The federales go one step further. They just don't pay the full bill. So, the rest of the world takes up the slack. We have a Union, with whom we work out co-pays, deductables, and out-of-pocket limits. And we have Government contracts that let us pass much of our health cost inflation to our customers. Other businesses without those constraints/opportunities have (or think they have) to pass the inflation on to their employees. I realize that the world isn't fair. But, there has to be a better way. Oh! And I'm not a commie. But, I probably am an old conservative Socialist if you scratch of the patina.
Posts: 1167 | Registered: Oct 2005
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posted
I make my living working with folks who have had the unexpected happen to them. Spinal cord injuries, brain injuries, accidents leading to amputations, and so many other things happen to young, healthy people with no significant medical history. And you would be astounded at the cost - not just the initial hospitalization, but the rehabilitation hospital, months of outpatient therapy, wheelchairs costing $5,000-30,000, hospital bed rental, prosthetic limbs, bathroom equipment, splints, and so much more.
If your insurance will not pay for the above, you're frighteningly underinsured. However, at this point, I hate pretty much every insurance company I've come across. I don't have any recommendations, except to get as much insurance as you can afford.
Posts: 23 | Registered: Jul 2001
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quote:Originally posted by The Rabbit: Architraz Warden, You make it sound as if you are choosing between and HSA and a PPO. Its my understanding that you can't qualify for an HSA unless you have a PPO. Companies will often offer a choice between a PPO with low deductable and an HSA combined with high deductable PPO.
If you are really just looking at an HSA, don't do it because you will have no safety net if you have an accident or an major medical problem.
If instead you are looking at an HSA and a high deductible PPO, then there are circumstance where the latter can work out in your favor.
You are correct, there is an overarching insurance plan behind the HSA (iPlan through UHC). I think I had that tidbit in there when I first wrote this, then took it out when I mentioned it was through UHC. The deductible is a year's contributions (for 1,100 in my case).
The kicker here is that I wouldn't be paying for a premium for either plan, so I was looking for a general feel for the popularity of insurance with an HSA account... It, uh, seems to have the popularity of a root canal.
On the upside, it makes my gut feeling much more appealing to go with the PPO.
Thanks all. This thread may now devolve into a debate on the sad and perplexing state of the medical insurance in this country.
Posts: 1368 | Registered: Sep 2002
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posted
I have a HIA along with my PPO, and it is great. The company put in something like $1200, and it gets used towards my deductibles in my PPO plan. After the money in it runs out I have to pay the rest of the deductible and my PPO kicks in.
In conjunction, it isn't bad. Some plans are worse than others though. I could have picked the other option, which was a lot higher amount in a HSA, but the coverage after sucked.
I picked the PPO with a HIA as a middle ground, and it has worked well.
The only thing that sucks is that I pay up front, and the HIA reimburses me, at least for a lot of things. It should all come from there rather than from me, IMO. That's the whole POINT of having insurance.
Posts: 15082 | Registered: Jul 2001
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posted
It sounds like you've already made your choice, but I just wanted to voice the other side. I have a high deductible plan ($2500) with an HSA that I'm quite happy with. It isn't a straight comparison of PPO versus HSA, there are a lot of factor to consider. What is your deductible? What is the cost share after the deductible is reached? What will you have to contribute for the different plans? What are your employer's incentives for being part of various plans?
For me, the PPO with HSA costs me $20 a month versus the $120 for the low deductible PPO. So I choose to pay the $20 and put $100 in my HSA every month. My company deposited $1000 in to the HSA in January. Once I hit the deductible, there is no copay- all medical expenses will be fully funded. Taking in to consideration the medical expenses I have, within another year I will easily have $2500 in my account. At that point, I'm essentially fully covered in case something goes horribly wrong while paying far less a month than I would be for a PPO. Even if something went wrong right now, I would not have to pay more than $2,500, whereas on a PPO with 20% coinsurance, I could be paying quite a bit more.
quote:HSA's can only be transferred or used in the future if you are at a company that also has a HSA.
This isn't correct. The account is yours just like your regular savings and checking accounts. Your employer is only involved in that it pays the admin fees. If you're willing to pay the admin fees for the account (usually around $5 a month), you can hold on to it indefinitely.
My suggestion would be to look at ALL of the parameters to the two options. HSA's sometimes are the better option- especially for young, healthy people.
Posts: 1947 | Registered: Aug 2002
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