I had to choose my healthcare coverage for next year

[Horse with no Name]

and my employer (who is a healthcare corporation)has a *new* choice.
It is a healthcare savings account. You deposit your money in it each month and the employer matches it. You can use it anywhere.
However, there is no catastrophic coverage and it's limits are confined to the contributions.
It reminds me of what the Republicans have been wanting...

[NMDemDist2]

1. yeah and chances are if you don't use it, you'll just be throwing that

$$$ away

[Horse with no Name]

5. Yep.

Sounds like *someone* is making money on it. The HORRORS of it.
But the real incendiary part is that if these people who choose this coverage get cancer or something equally as catastrophic...then you have someone who works full time (since benes are only for FT employees)who won't qualify for Medicaid. So they will either be saddled with insurmountable debt or just be left to die.
That's the part they don't tell you about.

[SharonAnn]

30. Health Savings Account is different from a Health Spending Account

The old Health Spending Account meant that you had to use it all in one calendar year. It was also interesting about not letting you spend on anything before you started work at a job (even though it was in the same calendar year) and no drugs you bought from another country (like Canada).

A Health Savings Account is one you can build on for life. I think they were originally intended to go with a ctastrophic insuranc epolicy. For example, cardiac bypass surgery and treatment would cost in the hundreds of thousands of dollars. Even a "simple" broken leg or appendectomy could be in the $50,000 range.

So, basically you're "screwn" if you have a need for significant medical care.

[Nickster]

2. Have you seen the "donut hole" plan yet? My employer offers a plan that

sounds strangely similar to Medicare-D.

[Gormy Cuss]

3. Nice to have ownership over your health care costs, isn't it?

Yes, I'm being sarcastic.

What genius decided that employees wanted a plan without catastrophic coverage? It used to be that catastrophic coverage was cheap -- I know because I had opted for catastrophic only insurance for several years when I was self employed.


Edited again to reflect your clarification that it's an option to a health insurance plan.

[Robbien]

4. Isn't the heathcare savings account an option in addition to the hmo/ppos

In other words, can you have insurance coverage plus the healthcare savings account? That is the way my former healthcare employer ran the program, which is the only way it really works IMHO.

[Horse with no Name]

6. Yes it is in addition.

Our health insurance costs have doubled since last year, so I guess they threw this out there for someone so that they can just have *something*.

[NV Whino]

11. After digging around a while

I learned that this money, going directly from your paycheck to the special account, is not taxed. As long as it is used for medical expenses it is not taxed. If you withdraw it for anything other than medical, it will be taxed. If you withdraw it before you are 65, there will be a penalty as well.

[Norquist Nemesis]

15. Wow. Meanwhile, just exactly who is making money on it?

It's not the depositor.

[NV Whino]

31. Given the fact that you have to have a "special" account

authorized by the health organization, the health organization probably benefits. And the bank, of course.

[Horse with no Name]

8. I misunderstood your post

See my additional post but, we have a healthcare spending account--which is putting pre-tax money in an account that is in addition to our healthplan.
However, the Healthcare Savings Account is completely different. It is an either/or to the insurance.

[Phoebe Loosinhouse]

13. There are 2 things with similar names being discussed

A Health Savings Account, as I understand it, it kind of like a high-deductable healthcare policy. You put your money into it, usually in some type of mutual fund. If you have any health expenses, you pay directly out of this fund until you hit the maximum. If you don't have any healthcare expenses, you get to keep the money and can contribute more money into it the next year. It was explained to me as "use it or don't lose it". It's actually not a bad idea and I heard it is in fact a very good way to go for someone who is pretty healthy and does not anticipate high medical costs. After you hit the maximum, your actual health insurance kicks in , just like with any plan.

There is another program with a similar name that you do use in conjuction with your usual healthcare. You put pre-tax dollars aside in a special account to pay for what you think your out-of-pocket healthcare costs will be for things like: co-pays, OTC medications, glasses, contacts, antacids, bandages, etc. In this case though, you HAVE to spend the money put aside in that calendar year, and if you don't - you lose it.

[SoCalDem]

17. Reminds me of earthquake insurance

Insured pays the FIRST $30 K out of pocket BEFORE the Quake insurance even kicks in.. (at least that's what it was the last time we dared to even look into it.)

Modern Insurance, making you FEEL insured, without actually insuring you :)

[Phoebe Loosinhouse]

20. The plan I actually examined had a deductable of $3000 for an

individual or 6,000 for a family. You are definitely playing the "How lucky do I feel?" game.

I agree that ALL current US healthcare is an illusion. It has been pointed out that a high percentage of bankruptcies declared due to medical expenses are filed by people WITH insurance. Maximum of 1 Mil? You can hit that pretty fast in this day and age and then you are through. Sick, no money, no insurance (and uninsurable) and probably no job either.

[Gormy Cuss]

19. the other is an HCRA health care reimbursement account AKA Flexible Spending Account

As to the former, I'd always thought that HSAs had to be tied to a high deductible plan which would provide coverage for catastrophic but the OP wrote that that was not the case at this employer. Curious.

[npincus]

7. what shit.

One f*cking BRIEF emergency room visit, and you're in the hole for 4 digits (before the decimal point). Whatta bunch of fucking bullshit. My Caesarian section childbirth cost more than $35,000. Got that in a healthcare savings account?

[CountAllVotes]

12. yep, just have ONE thing go wrong

and they will want at least $10,000.00 minimum.

Good f'n luck.

:kick:

[npincus]

14. health care and business do not mix.

It should be in the American Constitution.

My daughter banged her nose last month- we took her to the emergency room. She had 3 x-rays and a brief exam (all fine). The bills so far total more than $1,000 (covered by insurance, thank G-d). And that was minor.

What a fucking joke. I think Bill Gates and those in the top 1% earning class can afford the "Healthcare Savings Acount" option.

[SoCalDem]

22. In 1977, I got a bill from the hospital informing me that

our insurance had been declined, and would I please send them a check for $447,000.00 ...NOT AN ERROR.. That was the amount of the hospital bill..

I about fainted..and then I laughed..and then I cried a bit..and then I laughed again.

The next day (our mail came late) I called them and found out that a clerk had transposed two numbers in my husband's social security number , and then I relaxed..

We had an 80/20 policy, but luckily hospital care over a certain amount was 100%.

For about 8 years running, we always paid hospitals/doctors/etc MORE than what we paid for rent every month..

Looking back, I really don't know how we paid all that and did not go around holding up 7-11's in our spare time :)

[npincus]

24. hoy f*cking shit

...and you didn't have a heart attack! Jesus!

Well, good for you. I went unisured for a long time, and was really careful crossing streets.

Some country we live in!


:)

[Nickster]

21. Ahh, you're not looking at it as a Republican would. "I need to shelter

several thousands of dollars from taxes....what to do....what to do?....."

[Xenotime]

9. We just need to nationalize healthcare...

Hopefully we can get that in place in the next 2 years.

[npincus]

10. New Name For America's Healthcare System:

"Drop Dead Incorporated"..... ka ching, ka ching, ka ching.

[NMDemDist2]

16. that *would* be hilarious

if it wasn't so freaking tragic

:cry:

[SoCalDem]

18. and their new motto

"Modern Insurance, making you FEEL insured, because that's all that really matters"

[windbreeze]

29. almost hilarious.....if....

I didn't know someone it is currently happening too...the state of our medical care in this country truly needs to be overhauled and quickly...if you think it's bad when you work....wait until you retire, it is much harder attempting to pay high premiums/copays and still live/eat on that fixed income...
windbreeze

[valerief]

23. Some people keep working well beyond 65 for health coverage.

With this, some can retire and know that there's untaxed money that can be used on medical expense. College professors benefit from this.

[haele]

25. There are different types of HSA's -

Ours is a "use it or lose it" - renewable every year. It's basically a "Christmas Club" type of account; any money left over in the account will be refunded to you and taxed (and fee'd) as an investment disbursal, even though the "interest" you accrue on it is only 2% a quarter. You're supposed to use all of it - or turn it over to whatever medical/dental facility you are using to cover costs after the deductible for the rest of the year.
We've got a maximum amount we can put into it (Ours is around $250 a payday).

The primary problem with any HSA is the question of whether or not you can afford it. In our situation, even maxed out, the HSA provided by my employer wouldn't cover all our current ongoing medical bills - we can't use it for pharmacy items or regular doctor's visits and tests, which is the majority of our ongoing costs.
It might really help with our dental, however, we can only use it for the upcoming dental cost we accrue over the year we put into the account, not for the last year's dental bills - or medical bills we would still be paying off. If next year, we have very little in the manner of covered medical bills (i.e. - special lab tests or specialist visits, emergency room visits, root canals, etc), we've just put money we can spend on our normal medical bills in an untouchable savings account until the end of the year and when we get it back, we have to pay both maximum tax and fees.

My opinion - if you don't really have the money to put into one in the first place, there's no real advantage of having it unless you know you can take the risk that you will need to use the HSA over the year.
Even my wealthy mother-in-law who works for a charitable hospital organization is cautious about people who live paycheck to paycheck investing in an HSA - she's seen too many applicants to her charity who have HSA's and still have problems meeting some basic medical bills that their HSA won't disburse to.

The one good thing I can see about an HSA in our particular case is if we decide we're going to get the kidlet braces, we will go ahead and get the account for that year to get a tax break, start the procedure as soon as the HSA kicks in (January) and not worry too much about budgeting that year's payments to the Orthodontist. We'd just have to worry about the $100 or so a paycheck shortfall in available funds for the rest of our bills.

Haele

[Horse with no Name]

26. These are two separate things

One allows you to put pre-tax dollars into an account to use for Lasik, prescriptions, co-pays, some over the counter meds, etc.
The other is being used as an ALTERNATIVE to health insurance.
The caveat is that the money is considered a "premium" and you can't carry it over from year to year.
It would be the same if you didn't use your health insurance but paid premiums.
This is just a cheap version that the employer matches the funds. At the end of the year, if you didn't use it, the employer keeps whatever is left.

[RB TexLa]

28. That is a flexible spending account

It's not an HSA. There are two types of FSAs one for un-reimbursed medical expenses and the other for child/elder care. They are simply allowing you to hold out pre-tax dollars to pay for these things. It is a great program, especially for people that use day care as they reduce the cost by their marginal bracket.

The caps are for the employers protection. Say you choose the $250 deduction per pay period, assume that is a 26 per year pay cycle, you have up to $6500 you can be reimbursed. If you have something done the second week of the benefit year that you pay $6500 for you can turn that in and get $6500 from your employer, the premise being that you are then going to have the remaining $6250 held out of your next 25 checks, but if you don't come back to work for them they are $6250 in the hole. This is made up over time by people not using the total amount they have held out over time, a hundred here and hundred there. The smaller the company the lower the max they will let you hold out will usually be as a couple of people falling in this situation can put them in a big hole.

[Lydia Leftcoast]

27. HSA's are a ripoff unless you're rich

As a self-employed person, I looked into the ones offered by the three main insurance companies that operate in the Twin Cities.

I have lousy coverage with a high deductible and high premiums as it is, but if I were to sign up for an HSA, I would

1) Pay higher premiums per month
2) Deposit $200 every month into a savings account that could only be used for medical expenses

In other words, my monthly outlay would double before I got any care at all.

The PR about these things blathers on about tax advantages, but when affording the upfront payments is a problem, tax advantages are little comfort.

[VOX]

32. Boy, are you ever right on, LL...

This open enrollment period just past, my employer offered an HSA *without* any matching $$$. So, I'm supposed to shell our more bucks each month into a debit card-only account that I may (or may not) use later on? What on Earth is the point of that???? The potential tax savings are minimal to this married indentured servant. :grr: