HSA goals and Universal Healthcare in the US

[RDamien]

I did a quick search and didnt find anything already discussing this. I've just now started an HSA at age 38. I was wondering if there are any estimates on what I can expect to spend on healthcare after retirement? I understand they would need to be averages and highly subjective based on general health and unknowable variables. But still the point is to plan ahead, so would a rule of thumb be to just max the HSA and assume it will be used at some point or another?

Assuming the general wisdom is simply max it, how does universal healthcare fit into that equation?

Clearly there is at least a chance the US will move to something resembling the Western European style socialized healthcare systems. If not now, then possibly down the road. 20 years from now if the US has a fully socialized system and I have 100k in my HSA ... ?

I'm probably over thinking it!

[Martha]

I think that it is still impossible to predict what will happen with health care financing in the US. I also think that an HSA is a great idea for a young and healthy person.

Costs of healthcare after you retire are all over the board. Are you talking early retirement? Or are you talking after Medicare age retirement? A Fidelity Investments "study" found that a typical couple retiring in 2008 will spend $225,000 on prescriptions, deductibles and Medicare premiums. That assumes the man lives 17 years and the woman 20.

Pre-Medicare is going to vary a lot, depending on where you live and your health. Private insurance is relatively inexpensive if you are young and healthy. In contrast, it can be impossible to get or you can be priced out of the market if you have health problems. For example, my spouse and I pay about $15,000-$16,000 for health care premiums, deductibles and other costs, with insurance through a risk pool.

[RDamien]

Thanks Martha that helps. In initially thinking about it the HSA is a no brainer for me. I will be maxing it regardless. In looking at the full picture though, the only downside is it can "only" be used for medical expenses.

I assumed that would never be a problem since I would likely spend at least what I could save in the HSA on healthcare over my life (God willing!), but with all the talk of Universal Healthcare and single payer systems ... well it just made me pause a moment and consider how it will play out.

[ziggy29]

I think it's unknowable. There are too many variables including currently out of control cost increases and the possibility that the government will completely change the landscape.

But for what it's worth, I started my HSA in the start of 2008 and (including the employer match) it's over $7,000 today. Once I have at least two years of out of pocket maximums (currently a total $8,000 for $4K a year) in cash, I'll start looking at investing the rest of it in something like a balanced fund.

Depending on how the universal health care initiatives play out, I'd still think you could use the HSA for any copays or deductibles that remain, or for OTC medical supplies and OTC medicines, and dental/vision care. And I'd assume you could still withdraw it for any reason without penalty after age 65. I don't see anything more sinister than that (i.e. I don't think any "universal" plan would confiscate the account balance).

[Notmuchlonger]

I would guess your HSA would be safe. However, you will be paying substantially higher taxes down the road.