Jay and I are in Vail, Colorado this week, getting his knee fixed at the Steadman|Hawkins clinic at Vail Valley Medical Center. The surgery on Monday went great – far better than we had expected. His physical therapy is going very well too – they’re seeing him twice a day this week and I’m going to all the appointments with him so that we’ll be able to do the exercises at home between visits to a physical therapist in Westminster.
Before the surgery, we met with an insurance/billing specialist who reminded us that we had only met $1200 of the deductible on our health insurance policy so far this year (the MRI that Jay had on his knee a few weeks ago), and that we would need to pay another $1800 by the time this is all said and done. Our deductible is $3000 – somewhat high, but it feels comfortable to us because the trade-off is that it helps keep our premiums reasonable every month. We switched to an HSA-qualified health insurance policy about a year ago, and have been adding a little money to the HSA every month. We know we’re getting a great deal on our premiums, so we’ve tried hard to put the savings into the HSA each month, reminding ourselves that the high deductible health insurance policy is only useful if you’re actually able to come up with the money for the deductible in the event of a claim.
Joe Paduda had an interesting article at Managed Care Matters this week, discussing the pitfalls of high deductible health insurance plans when the HSAs aren’t being funded. All too often we talk with clients who focus on the lower premiums that come with HSA-qualified plans, without really thinking about how they would pay the deductible. Most people do not have $3000 or $5000 just sitting around. Commitment to funding an HSA is a good way to gradually build up the money necessary to pay a deductible, but a lot of people don’t see the importance of the HSA. Instead they get the high deductible health insurance policy, pay the premiums each month, and hope that they don’t have to meet the deductible any time soon. For some, this is a genuine choice to spend the money elsewhere, but for others, the premiums are all they can manage – there’s nothing left over to fund the HSA.
The government has been pushing HSAs hard for the last few years – touting them as the answer to our broken health insurance system. For people who are willing and able to fund the HSA and also pay the premiums for the health insurance, HSAs do provide a tax advantage and a peace of mind that comes with knowing that if you need to meet your deductible, the money is there. But this is certainly not everybody. Some people can’t afford to fund an HSA; some people just don’t want to. For them, a health crisis would be accompanied by a financial setback as they scramble to come up with the money to meet their deductible – which seems so much higher when you actually have to pay it than it did when you applied for the health insurance.