My numbers are similar. We were quoted a similar prce for a PPO with a similar deductible. We went to a high-deductible plan with a deductible of about $5600. The insurance cost a little over $500 a month. So monthly savings about $600 compared to the PPO. We put that savings into the HSA. Some years we spend the deductible, some years we don’t.

It helped us, and out health picture sounds a little more complicated than what you described.

My practice has patients with catastrophic insurance, they always put aside money for smaller medical expenses within the deductible. Now they get a tax break for doing the same thing.

I looked at the price of a typical PPO policy, and one with the big $5600 deductible for a family. The savings was about $6000 annually. So I buy the high-deductible policy, use the savings to fund the HSA, and I actually come out a little bit ahead. It’s a no-brainer.

We have health issues, but not always significant enough to hit the deductible limit. So some years we come out ahead, some years we break even compared to a typical PPO.

If someone had ongoing major chronic health problems, a HSA would be a wash financially compared to traditional coverage.

We’ve had HSA coverage for our family and our practice employees, it works just fine.

I don’t know what’s the big problem with HSA’s, it’s no different from wanting cheaper auto insurance with a high deductible, and using the savings to cover that high deductible.

I found a PPO plan with a major insurance company, $250 deductible, for “X” dollars a year. I found a HDHP insurance compatible with a HSA from the same company. The deductible is the $5,650 allowed for family HSA’s. The cost is “X”, minus six thousand. So the price difference was a little bit better than the increased deductible.

So for the same price, I get insurance, where a lot of the money spent, I get to keep.

Some years I spend it all, some years I save.

For someone with chronic illness who really does spend more than the deductible every single year…..it’s a wash financially.

So fine, not everybody does better with HSA’s. Some people just break even.

For my family, and for my employees, it was a net gain overall.

Employees who leave, now have savings that can be used to pay premium. Surely you’ve run into patients between jobs, uninsured because they can’t afford the big premium hit for a regular PPO with no money coming in. Now the departing employee has savings to pay premium and keep at least catastrophic insurance between jobs, and some routine care along the way.

I don’t know why it’s such a big deal for a practice to figure out what to do with a patient with a HSA. It’s no different from someone with regular PPO insurance and a deductible. Just a higher deductible.

I’ve been using it for years, sometimes we hit deductible, sometimes we don’t. When we don’t hit deductible, we carry over the savings to next year.

My only regret is we couldn’t open one twenty years ago. By now, we’d have saved enough to cover our deductible out of dividends.

For a lot of people, I don’t think the fear is HSA’s won’t work. I think the fear is HSA’s WILL work.

Mona Lori, Principal
http://www.outofpocket.com

My take is here.

PPOs are much better alternatives. A co-insurance of 20% instead of copayments with a reasonable, but not high deductible, would spread out the expenses for all treatments, not just initial ones.

And….I WORK for the ‘evil insurance’ company. I can’t imagine, without a LOT of education, that HSAs will work well for the general public.

If you want to decrease unnessary spending, you need to look at ALL the factors. The MDs and public who defraud the companies, the people who think that they “deserve” treatment for everything (antibiotics for a cold, for example), the families who demand all treatment for the 95 year old who is dying (let’s put a pacemaker in him/her…no, let’s do a cardiac transplant! We can’t let him/her die!!)

OK. Sorry, Kev. I’ll get off my soapbox. But, as a person frustrated with the high cost of medical care, too, I tend to rant. I think doctors are underpaid by insurance companies, but it’s not only because the companies want to make money. There are lots of factors that many people don’t consider.

A diabetic who loses 20-30 pounds can often cut back on his/her medicines. More diabetics would challenge their doctors to use generic medicines for their treatment.

Your brother?