Premiums are about $200 a month, and last year we paid out of pocket $177. This year I started an HSA, because I knew my daughter was getting her tonsils out. She will hit her $5000 deductible (her dad has to pay half, so that does factor into making the HDHP even more affordable for me, at least until she turns 18).

Nonetheless, it’s a steal. To get anything close to a more traditional plan would be more than double the premiums. Last year I would have paid 3600 more in premiums to save a hundred dollars. The two year average (this year and last year) would mean I’d still pay out $2200 more. Now if another kid gets sick– maybe it will take an extra year to average out, but I still get the tax deduction.

BTW American Chartered Bank out of Chicagoland doesn’t charge any fees for their HSA. None. Yes, the interest rate stinks, but I’m not out-earning $3.50/month in fees this year for sure.

http://www.alliantcreditunion.org/services/rates/

Incidentally, you also have to be able to become a member of the credit union, but they have VERY broad membership requirements. I’m aloud in because my wife is a member of our local pta. So long as you are a member of a PTA anywhere in the country, you can get in.

Don’t forget to take into account the fact that CA is one of the few states that taxes HSAs. I’m still moving back to CA anyway, despite taxing HSA, despite state tax, despite increase in Human healthcare premium. I’m bored out of my mind in NV and have missed living in CA. Sometimes having quality of life as a priority has a high price.

BTW, I really enjoy your ponderings and advice. You’re the same age as my oldest son.

I’ve always been incredibly healthy, never even had the flu, so that’s why at age 53, when I moved to NV, I went with a high-deductible healthcare plan at $250/month premium. Then at age 54 I was diagnosed with breast cancer. Had double mastectomy, chemo, radiation, the works. I spent the $5k deductible out of pocket two years in a row, and the rest of my bills totaled close to $250k, which Humana covered at 100% (after deductible).

I’m moving from NV to CA in a few months, and just because it’s CA, Humana is increasing my premium from $250 to $430/month, with the exact same coverage.

So I’m proof that even if you take great care of yourself, you never know what can happen. I’m glad I had the insurance.

BTW, free market plans are not as good if you have a family because the deductibles are much higher. The best plan we could find for us (a family of three) has a $10k deductible and costs $225/mo. We could get a deductible of only $6k for twice the cost. I’d love to have a HDHP where the family deductible was $3000 just like the employer’s plan, but I haven’t seen one at any cost.

I won’t get so sick following my lifestyle, so I won’t have to submit to surgery in case of a disease. Only if I happen to be hurt badly, like by bullet, knife or something sharp.

In any case, I thought I would chime in on your last point. Yes, you can use your HSA as an IRA when you reach the appropriate age. You don’t need to convert it, it just behaves like an IRA (you can take money out and pay the regular tax on it, just like an IRA, with no penalties for withdrawal.) Another little perk is that if you pay for any health care expenses over all the years up to that point out of your regular money, you can “reimburse” yourself in retirement by taking those dollars out of the HSA first (the ones you saved all the receipts for) without paying tax at all.

As a health professional I, too, believe in a proactive approach to health hence why I do my best to live a healthy lifestyle. Too often, a health providers practice is dictated by the patient’s health insurance company and/or health system in which s/he is employed (lots of pts to see in a short period of time, preventive care not supported by the system, etc.). The other issue is that it is very difficult to motivate patients to modify their lifestyle to healthy living. Many patients are content with “a pill for every ill”. It is easier than taking the fat out of meals and exercising.

On another note, a healthy lifestyle can not prevent catastrophe. I have taken care of self-employed professionals without health insurance diagnosed with a terminal illness or involved in severe accidents resulting in them wiping out their assets. The number one cause of bankruptcy in this country is medical bills. Health insurance (or a much improved health system) is very important to have, if available.

On top of that, the 3k contribution is done pre-tax, so, lessens my tax burden a bit.

Obama made the cap limits go away, so that takes that off the table.

I also like the discount pricing we get too.

Once my HAS gets to about 10k, then ill start investing it – we can only use JP Morgan Chase, but, better than nothing.

The main problem with healthcare, as many have said, is that is is reactive and not proactive. We should get discounts for healthy living, regular weight maintenance, non-smoking, regular exercise (which can be tested with treadmills in the docs office and checking pusles, etc), and mandatory twice a year checks. There’s nothing wrong with eating a double cheeseburger if you run it off later.

The HDHP I found (also at ehealthinsurance.com) for my family is actually better coverage (lower out of pocket max per year) and less than half the price. I suggested to my employer to keep paying me the value of the old premium – $800/month – and I could pay the HDHP myself & save the difference in our HSA. After about a year we would have the deductible covered.

The Patient Protection and Affordable Care Act (health care reform) prohibits group health plans from establishing any lifetime or annual limits on “essential health benefits”. Future regulations will define “essential health benefits”, but will at least include the following categories:

ambulatory patient services;

· emergency services;

· hospitalization;

· maternity and newborn care;

· mental health and substance use disorder services, including behavioral health treatment;

· prescription drugs;

· rehabilitative and habilitative services and devices;

· laboratory services;

· preventive and wellness services and chronic disease management; and

· pediatric services, including oral and vision care.

This is effective September 23, 2010.