I hope it doesn't become a target but I feel my HSA will be taken away

[RB TexLa]

I pay about 4 times to my health savings account over what I pay in premiums each month for my high deductible insurance plan. The reason for the individual mandate is we all pay in through premiums to help lower the cost. I pay very little to the insurance company. With my plan I use as little health care as I can. It's my money in the HSA and I'm not giving it to a doctor. They don't deserve to have it, I do.

I feel at some point, with the ACA upheld enough people will say me and the rest of us who have HSA's aren't paying enough to the insurance companies. They'll look at the fact that my premiums are half of what someone in my same demographic class pay for full coverage and they'll think that isn't fair. As it stands, whatever I save and don't spend on medical costs I get tax free at age 65. I'm no longer counting on that.

[EC]

1. No,

as I recall there are improvements to HSAs as far as being able to save more and take more out without penalties. The exchanges will also have catastrophic policies, so yours will likely qualify. You'll be fine.

[Honeycombe8]

30. I read they are likely to be changed. OP should read this.....

The reason HSAs are likely to be changed is because of the 80% rule. The ACA requires ins. cos. to pay 80% (or is it 85%?) of its premiums in claims. If it doesn't, it has to refund premiums to get to the 80% level.

HSAs....insurance companies love HSAs because they get money for, basically, nothing. YOU put money in an account (that a banking institution charges you a FEE to maintain), then YOU must pay for healthcare up to a large deductible. And remember, not everything counts toward that deductible.

In essence, you are paying for only catastrophic coverage. That's okay, but the ins. companies' premiums don't reflect the paltry claims that the company will have to pay.

As for the premiums YOU pay, the ins. company is getting paid premiums. If YOU aren't the one paying them, then it's your employer? Insurance coverage isn't free. Insurance coverage for catastrophic care is far from free or almost free.

Doesn't your employer kick into your account a sizeable amount of money? They do that because the LAW requires it. I think they get a tax deduction for that.

I looked at HSAs, and worked out whether it would be a good thing. I did that for two different plans, different scenarios. I couldn't get an HSA to save me any more money than maybe $400 a year....and it wasn't worth it for all the paper tracking and stuff you have to do. And it was possible I wouldn't save that $400.

So HSAs will probably survive, but will be required to be adjusted. That's a good thing. You probably didn't know you were buying a policy where the company was spending most of its premium on admin costs and keeping it as profit, instead of going toward claims.

IF you have one of the good HSAs, where the deductible is only $1,000, then your HSA may not be changed. But the two offered to me had much higher deductibles, even though a $1,000 deductible qualifies to be an HSA.

[joshcryer]

2. Nah, you should be fine.

It's good that you're healthy, I wish you the best of luck, because that HSA isn't going to do squat for you if the hammer comes down hard.

[SickOfTheOnePct]

4. Why not?

The OP has a policy, the HSA will cover the deductible.

[joshcryer]

8. Key is "hammer comes down hard..." The caps on HSAs...

...can be low if I recall correctly. You could wind up needing years of medical coverage and it will run out.

[SickOfTheOnePct]

10. There are contribution caps, but I don't believe there are caps on the accounts

You can have as much in an HSA as you want. And the contribution caps are pretty generous.

[joshcryer]

11. Yeah, but they will only cover up to like $2-3 million or something.

[SickOfTheOnePct]

12. Are you talking about the high deductible plans only covering $2-$3 million? n/t

[joshcryer]

14. Yes.

[unblock]

16. the hsa contribution limit for 2012 if $6,250 for family, $3,100 for individuals.

with an extra $1,000 allowed if age 55 or over.

http://www.hsacenter.com/2012limits.html

there's no limit on how much you can accumulate in an hsa, but not many will reach into the millions when you can only contribute a few thousand per year.

[SickOfTheOnePct]

18. But you don't need it to be in the millions

After the deductible, there is still an insurance plan that pays much if not most of the cost.

[unblock]

3. fear not. hsa's are of the greatest benefit to fairly well-off people, so it won't go away.

yes, that's quite cynical, but that's the way it is these days.

hsa are a form of partial self-insurance, which is something that is prudent only for those with the resources to stomach paying the super-sized deductible. moreover, the deduction is worth more for those in the higher tax brackets, and of greatest benefit for those who can contribute the maximum each year.

these are the people who are also able to contribute meaningfully to political campaigns, and their benefits will not be taken away anytime soon.

beyond that, i SERIOUSLY doubt they'll change the rules for contributions already made. any change would no doubt apply only to FUTURE contributions.

[joshcryer]

5. Yeah, Bush made them policy.

A test pad for privatizing social security, imo.

[seabeyond]

6. i get what you are saying. personally i think it is bullshit insurance

we have this plan and i hate it. we pay cash for everything out of our hsa account and never even get close to our deductible.

i am very hesitant using medical for check ups and other stuff cause it is me paying cash.

i dont get the rave about this type of insurance.

hate it.

[RB TexLa]

7. I pay out of pocket when I've had to. I don't want to pull anything out of the HSA.

[unblock]

13. well the idea is that it's cheaper if you don't eat up the deductible because the premiums are lower

but the premiums are still mighty expensive in my experience.

in your case it sounds like you are indeed saving money, which is great, but at the cost of refusing health care that perhaps you shouldn't be refusing.

that's the problem i see with high-deductible plans. it gets people to skimp on the relatively cheap stuff, which often heads off the rather more expensive problem down the road. but the cheap test up front is out of pocket and the expensive fix later on is covered once the deductible is met. so the incentive to save are on the wrong parts.


personally, i have an hsa and i'm always hitting the $5,700(!) deductible, basically due to my migraines alone (200-250 a year, and zomig ain't cheap). it's almost a toss-up between this plan and the "traditional" plan, but once i hit my very high deductible, there's zero co-pay for office visits and procedures. so anything other than meds is completely free. THAT makes it worthwhile.

[Lydia Leftcoast]

9. You should be fine--it's a great deal for affluent people

not so much for anyone else.

[DisgustipatedinCA]

17. Not quite. I'm not affluent, & I'm in my employer's HSA

The saving grace for me is that the employer puts money in the account quarterly, and I've got a deduction set up from my pay to cover the rest of the deductible over the course of the year. So it's working out forme ok--but it sure wouldn't if I had to pay the annual $5K deductible on my own.

[Lydia Leftcoast]

20. That's not an HSA, which is for self-employed people or those who have no medical benefits

at work. The trouble with an HSA is that 1) you have to have a high deductible insurance policy, but if the deductible is too high, it doesn't qualify, and 2) if the deductible isn't all that high, the premiums will be sky high, especially if you're over 50. Even if you can afford both the deductible and the premiums, all you're doing is prepaying your deductible.

It's the Republicans' idea of a good deal.

If your employer pays for it, it's an FSA, a flexible spending account.

[emmadoggy]

21. No, that's not true.

As I understand, certain insurance plans (usually high deductible) qualify you to have an HSA account. These can be from employer offered insurance or privately purchased. I know this because my husband's employer only offers high-deductible plans now and we qualify for an HSA account. They actually opened the accounts for all employees on the insurance and deposited $500 to get everyone started (we are on our own now). It is NOT an FSA.

[Lydia Leftcoast]

29. Not if your deductible is too high

Both policies I've had since moving to Minneapolis (the only ones I can afford) have had *too high a deductible* to qualify for an HSA. If I bought a plan that had a low enough deductible to qualify, my premiums would be unaffordable, AND I'd be expected to put aside extra money each month. Not a good deal for someone who is self-employed, not wealthy, and over 50.

[emmadoggy]

31. That may well be.

I don't know what qualifies as "too high" a deductible to qualify for an HSA. And I'm not really debating the merits of an HSA. I'm simply saying that HSA's can be offered through employer insurance and that the OP is not likely incorrect in saying the account is an HSA. We have one as well. We are not REQUIRED to put money into it though. It is optional.

And I agree with you that an HSA is simply pre-saving to pay your deductible. The problem for us is that you can never get enough money in there before you need it to pay deductible expenses and then you are back to starting over again. Unless you can go a couple years with no medical expenses and get the account built up, it is hard to make it work the way it is supposed to. At least for us. We don't have that kind of expendable income to set aside, which is why we are making payments to the clinic and hospital for our deductible expenses instead of into our HSA.

The whole situation just sucks.

[Lydia Leftcoast]

32. $5000 is too high a deductible (in more ways than one!)

The deductible on the HSA-eligible account has to be equal to or less than the amount of money you put aside each month.

[DisgustipatedinCA]

24. It's a health savings account. I have piles of paperwork that say so.

[RB TexLa]

25. Employers can offer HSA as well

And pay part of the premium for the qualified high deductible plan.

[SickOfTheOnePct]

27. Incorrect

My employer offers an high deductible plan with HSA. They pay part of the premiums and deposit money into the HSA.

If it's still offered once both of my daughters are out of college, I'm taking it.

[meaculpa2011]

26. I had a high-deductible plan...

back in the 90s. The difference between my monthly premium and a comprehensive premium was huge. Buying the comprehensive plan was the equivalent of pre-paying my deductibles and co-pays to the insurance company whether I accessed healthcare or not. For the three years that I had the plan I saved more than $18,000 in premiums. When we added up our out-of-pocket expenses for the same period it came to just under $4,000 so we were $14,000 to the good and we still had protection against bankruptcy in case of serious illness.

BTW: My daughter had to be hospitalized a few days after we returned from Guatemala with her. The hospital submitted the bill to our insurance company. They paid $4,000 and the hospital billed us for the remaining $2,000.

Then the insurance cartel sent their lobbyists to the state legislature and got them to "mandate" comprehensive healthcare insurance. In the six years after "reform" my premiums went from $780 per month to $1,400 per month. I was paying $196 for my "crummy" high-deductible plan. Under my new comprehensive plan none of the expenses for my daughter's illness would have been covered because of an adoption exclusion and waiting period.

It was for my own good.

[aikoaiko]

15. Maybe, FSA limits get rolled back to 2500 in 2013 if I understand the law correctly.

Its where I get caught up in the new law. My wife and kid have a lot of medical bills even with insurance. I put away 6k on my FSA every year and spent every sent.

I estimate the change will mean I have 800 dollars less to spend on medical expenses.

[SickOfTheOnePct]

19. Yeah, that part stinks

I'm a big fan of the FSAs - makes it much easier to save for the big ticket items like braces, restorative dental work, contact lenses, etc.

[nadinbrzezinski]

22. As long as you have a plan at least at bronze level

Or any f the other eligible things, yiu're fine.

[morningfog]

23. Who is "they" that will tell you you aren't paying enough to insurance companies?

[knockknock]

28. Only HSAs for large companies survive under ACA - indiv. HSAs are toast

See or [link:http://www.hsacoalition.org/wp-content/uploads/2012/02/Report-ABAImpactofMedicalLossRatioRequirements.pdf|