>$1000 per hour for nothing

[pioneer98]

We have twins that are 4 years old now. They were born quite premature and only weighed 4 lbs at birth. They have always been small for their age, even now. We are a bit concerned and are trying to make sure they are eating right. The thing is, other than being small, they are healthy and are doing fine developmentally. Our doctor was concerned and referred us to a University of Iowa doctor. All the guy did is ask several questions, then tell us we need to schedule x-rays and blood work. We were there maybe 50 minutes tops.

We got separate bills for each kid. Each bill had 1 line item on it for "Consultation". It cost $576 and then our insurance got about a 20% discount, so our cost is $463 per child. So for 50 minutes of visiting, where no treatments or tests or anything were done, they are asking for $926. We have the money in an HSA, but I'm not paying it. It's just outrageous. I guess someone has to pay for that new Children's hospital.

[lukethedrifter]

OTOH a primary care doc might get $20 to see you for a regular visit.

[IMADreamer]

I'd definitely argue it. Let them know you are dissatisfied and see what happens. Worst case scenario you still owe the same amount. Best case maybe you get a two for one deal.

[cardsfansince82]

Was the doctor out of network? It seems to me based on stories I hear that people with HSAs end up paying way more if they need any kind of care. A lot of coworkers do the HSA plan and it doesn't make much sense to me. I have an older style plan that has copays for everything and it seems like a much better deal. I had 3 X-rays on my wrist last month and was kind of dreading the bill. The hospital billed my insurance like $700, insurance adjusted it down to $300 and my out of pocket was $40.

[Swirls]

Was the doctor out of network? It seems to me based on stories I hear that people with HSAs end up paying way more if they need any kind of care. A lot of coworkers do the HSA plan and it doesn't make much sense to me. I have an older style plan that has copays for everything and it seems like a much better deal. I had 3 X-rays on my wrist last month and was kind of dreading the bill. The hospital billed my insurance like $700, insurance adjusted it down to $300 and my out of pocket was $40.

HSAs make a lot of sense if you are generally healthy and don't regularly see a doctor. My insurance premiums for a family plan (just my wife and me) run me about $15/paycheck. The caveat to that is we also have a $2750 deductible. 90%/10% coinsurance after that up to a $5500/year out-of-pocket maximum.

We regularly contribute $1k or so each year to our HSA, so we have enough in it to cover our deductible if something bad happens (although this year we're likely going to use it all up between me getting my wisdom teeth pulled and now my wife going to PT to fix her IT band in her knee).

We've generally been healthy, so even though we have the choice of going with a more traditional healthcare plan of a $250 deductible and $1500/year max out-of-pocket, we choose not to. That plan runs $100/paycheck, which would mean we would basically end up paying our HSA deductible each year in insurance premiums whether or not we ever visited a doctor. Why not put that money in an HSA instead as pre-tax income (and therefore only end up really paying like $2k-ish instead of $2750).

If you tend to visit the doctor a lot, or if you know you are going to have a bunch of medical expenses in a particular year (such as having a baby or long term physical therapy), going with a traditional plan makes more sense. Or even better would be a traditional plan with an FSA (maybe you want to have elective surgery, which normally wouldn't be covered by health insurance).

[tlombard]

I was beginning to think that I'm the only one using an HSA! I went to it this year and think it is the right decision. I haven't been to the doctor in years and don't foresee any health issues in the near future. I am taking a gamble that I don't have any issues this year. If I can make it through this year then I'll be looking really good though. Since the premiums are cheaper with the HSA, I made up the difference in my portion with additional contributions to my HSA account so that if I come out of this year healthy I'll have more in my HSA than my out of pocket max for next year and that should keep building which will put me better off in the long run... I think.

[Swirls]

I was beginning to think that I'm the only one using an HSA! I went to it this year and think it is the right decision. I haven't been to the doctor in years and don't foresee any health issues in the near future. I am taking a gamble that I don't have any issues this year. If I can make it through this year then I'll be looking really good though. Since the premiums are cheaper with the HSA, I made up the difference in my portion with additional contributions to my HSA account so that if I come out of this year healthy I'll have more in my HSA than my out of pocket max for next year and that should keep building which will put me better off in the long run... I think.

Yup, I've used one every year since like 2011 I think.

I had enough in mine for my max out of pocket, but then I gambled and spent it all on Lasik a few years ago. The gamble paid off as I never needed a doctor for the next few years. I built it back up, then got married, and once I switched to the family plan my deductible/max out of pocket both doubled. So now we have enough for our deductible but not much more. And like I said earlier, we'll probably use it all this year. If not for her PT, then for me possibly considering getting some form of orthodontia now that my wisdom teeth are out (I had braces as a teenager to correct my overbite, but my wisdom teeth shifted all my teeth around and brought the overbite back).

[tlombard]

I never even considered Lasik or anything like that as ways to use mine. I am probably going to hold off on that for another year or so to build up the HSA but I do need new glasses and I guess that I could use a little of the HSA to pay for that. I put off the decision until the last minute and never really researched what I can and can't do with the HSA but I'm learning I can use it for a lot more than I thought at first.

[Swirls]

I never even considered Lasik or anything like that as ways to use mine. I am probably going to hold off on that for another year or so to build up the HSA but I do need new glasses and I guess that I could use a little of the HSA to pay for that. I put off the decision until the last minute and never really researched what I can and can't do with the HSA but I'm learning I can use it for a lot more than I thought at first.

Yeah, there are a ton of uses for it. Hell, getting a massage or a quick back cracking from a chiropractor are both eligible expenses.

Plus the nice thing is that it's a savings account in your name only and not tied at all to your employment. If you leave and go someplace else, you still have that money you can spend on medical expenses. And when you turn 65 (I think that's the magic number), you can withdraw from it for any expense you want penalty-free. The base interest it earns is pretty much negligible (I think mine yields 0.01%), but my HSA Bank gives you the option of investing your HSA money into Vanguard mutual funds, so I've found mine has a really good annual yield (between 10%-15%) provided I don't spend any of it.

Also some employers put in seed money every year to their employees' HSA accounts. Mine automatically adds $500/year for a single plan or $1000/year for a family plan. So even if you don't contribute a dime to your own plan, the company themselves invests in it for you.

[go birds]

I'm confused as to why having an HSA impacts health insurance.

We're talking about Health Savings Accounts right?