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Re: Anyone using HSAs?
Old 11-30-2005, 10:47 AM   #21
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Re: Anyone using HSAs?

Quote:
Originally Posted by justin
Two questions I think you all can help me with.

1. If we have a high deductible plan through work, and can start an HSA at work, can we start an HSA at a private bank, like HSABank? In other words, opt out of the HSA account through the job, and pick our own independent provider for HSA?

2. I was concerned with paying the retail rate at medical service providers with the high deductible plan instead of the insurance co's negotiated rate. The negotiated rates are typically 50% or so of the retail rate in my experience. Is it generally the case that you, as the high-deductible plan insured, pay only the negotiated rate, by paying retail and then getting reimbursed, or by paying the negotiated rate up front? The high deductible plan may be what I am looking for, since I don't mind self-insuring for the first couple thousand dollars.

Help please?!

Here is the latest from the feds on HSAs: http://www.treas.gov/offices/public-...hsa-basics.pdf

According to this publication, the account is owned by the individual, not the employer and the individual decides which company will hold the account.

One advantage to having such a plan is that even as you chew through your deductable, this is transparent to medical providers and thus you get the insurance company negotiated rates.
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Re: Anyone using HSAs?
Old 11-30-2005, 10:59 AM   #22
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Re: Anyone using HSAs?

Martha,

Let's say I have a $1200 deductible for my high deductible plan. I have a procedure done that is $1200 retail. The negotiated insurance rate that I'll pay is $600. Have I met my deductible for the year, or do I have $600 left on my deductible before the plan starts to pay? In other words, is the amount allocated to meeting the deductible the amount I actually pay ($600), or the amount that I am charged ($1200) before the ins. co. applies the negotiated rate?
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Re: Anyone using HSAs?
Old 11-30-2005, 11:06 AM   #23
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Re: Anyone using HSAs?

The amount you actually pay.
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Re: Anyone using HSAs?
Old 11-30-2005, 12:46 PM   #24
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Re: Anyone using HSAs?

I have heard some individual stories on this board about exclusions but how bad is it going through the underwriting for an individual plan? Is it a case that they really stretch to find things to exclude or is just the major stuff that they hit? Somebody recently said to expect a 20% or so increase in the online estimates of insurance costs. *
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Re: Anyone using HSAs?
Old 11-30-2005, 01:52 PM   #25
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Re: Anyone using HSAs?

I researched HSAs about a year ago. I started out thinking they would be ideal for DW and I. We already had chosen a high deductible health insurance policy and the opportunity to save for future medical expenses tax deferred seemed like a great deal. Here's what I found instead.

High deductible isn't good enough. The policy has to be specifically designed to meet federal HSA standards. My insurer, Humana, developed policies to match the federal requirements, but that meant they offered coverage that was different (and more expensive) than my current coverage. So I would have to pay higher premiums to take advantage of an HSA. Then there were the investment choices I could find for the HSAs. The vast majority of HSA plans offered pathetic mm interest rates and high fees which negated almost any savings advantage. There was one company that offered Vanguard funds, but their fees were astronomical. When I ran all the numbers, it was a wash at best.

I intend to shop HSAs again soon (things change sometimes). But my first HSA shopping experience was pretty disapointing.
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Re: Anyone using HSAs?
Old 11-30-2005, 02:56 PM   #26
 
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Re: Anyone using HSAs?

SG,

Things may have changed since you last researched it.

At Blue Cross, the HSA plan that I switched to was similar to the other high deductible plan, and cost less ($162/month vs. $203/month).* Of course, the complexity of the plans muddies the water so much that you can't really compare them (different deductibles, other differences).

Looking at Saturna (HSA Custodian), I could invest in their short term bond fund, which has an expense ratio of .3% (see related post), and there are no other fees whatsoever.

I just spoke with someone at Sterling HSA, and for them there would be a $20 annual fee, and no other fees to invest in, for example, a Vanguard mutual fund.* No, they didn't give me all the numbers.* There would be a $35 setup fee, a $2.50 per month fee, and a .5% expense.* So, to invest $4,000 in a Vanguard mutual fund, the total for the first year would be $85.

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Re: Anyone using HSAs?
Old 11-30-2005, 08:15 PM   #27
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Re: Anyone using HSAs?

Quote:
Originally Posted by maddythebeagle
I have heard some individual stories on this board about exclusions but how bad is it going through the underwriting for an individual plan? Is it a case that they really stretch to find things to exclude or is just the major stuff that they hit?
Looks like no one else is going to respond, so...

Example: Three years ago had dime-size pre-cancerous spot removed from skin. Coverage excludes any form of tumor or malignancy of the skin until the 5th anniversary of having the spot removed.

Example: Congenital kidney cyst. No change in size or any indication of problems in initial 57 years of living :. Coverage excludes any benign disease or disorder of the urinary system for the life of the policy.

Hope that gives you an idea of what takes place in the underworld underwriting.



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Re: Anyone using HSAs?
Old 11-30-2005, 08:24 PM   #28
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Re: Anyone using HSAs?

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Originally Posted by TromboneAl
SG,

Things may have changed since you last researched it.


Thanks, Al. It is on my list of things to re-visit before the end of the year. (I don't have too much time left.) I'll check out those leads.
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Re: Anyone using HSAs?
Old 11-30-2005, 08:39 PM   #29
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Re: Anyone using HSAs?

Quote:
Originally Posted by maddythebeagle
I have heard some individual stories on this board about exclusions but how bad is it going through the underwriting for an individual plan? Is it a case that they really stretch to find things to exclude or is just the major stuff that they hit? Somebody recently said to expect a 20% or so increase in the online estimates of insurance costs. *
When I was applying, I filled out the forms and questionaires. Because of the horror stories I'd heard, I applied for insurance from 3 different companies at once. It researched about a dozen and ended up with these three as approximately comparable.

Two years earlier I had orthoscopic hernia surgery. That was the only item that came up on the 149 question survey for both my wife and myself. This is about as routine as it gets. One insurance company (BCBS) only offered coverage with an exclusion. I asked how long the exclusion would apply and they told me that I could ask them to review the exclusion in two years . . . no promises. I asked if there was a rate reduction since I wouldn't be getting as much insurance. They laughed.

One insurance company (Golden Rule) sat on the application for over two months without doing anything. Finally, about a week before the deadline I had given them when I needed the insurance, they called and offered to sell me a really expensive temporary policy for a few months to give them time to consider my application.
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Re: Anyone using HSAs?
Old 11-30-2005, 09:09 PM   #30
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Re: Anyone using HSAs?

Quote:
Originally Posted by ((^+^)) SG
One insurance company (Golden Rule) sat on the application for over two months without doing anything. Finally, about a week before the deadline I had given them when I needed the insurance, they called and offered to sell me a really expensive temporary policy for a few months to give them time to consider my application.
Pretty sleazy.
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Re: Anyone using HSAs?
Old 12-01-2005, 01:52 PM   #31
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Re: Anyone using HSAs?

Quote:
Originally Posted by ((^+^)) SG
One insurance company (Golden Rule) sat on the application for over two months without doing anything.* Finally, about a week before the deadline I had given them when I needed the insurance, they called and offered to sell me a really expensive temporary policy for a few months to give them time to consider my application.
Apparently they have the gold and thus feel entitled to make the rules... preferably when you don't have enough time left to ask anyone else for gold!
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