Code Red on Health Savings Accounts

[ourbluenation]

I'm posting this here cuz I think it will get lost in the other forum. I really would love to hear what my fellow DU's think of HSA's. I'll soon have this as an option at work. Thx.

Code Red on health savings accounts

Heads up, Americans. The Bush administration is now greasing the skids for employers to drop your health coverage. This is a biggie.

Radical change was not the headline when the president unfurled his latest proposals for health savings accounts. It was presented mainly as a sensible-sounding way for people without medical insurance to buy it with pre-tax dollars, the same way companies do.

George Bush's new HSA is actually a rocket-powered tax shelter dressed up as a sweet little program to help the uninsured. It would also undermine the traditional health coverage now offered by employers. (More on that in a minute.) And in case anyone still cares about deficits, it would cost the Treasury $156 billion in lost tax revenues over 10 years — more than wiping out any savings Bush hopes to achieve with his cuts in projected Medicare spending.

An HSA lets people put pre-tax earnings into a tax-advantaged account to be tapped for medical expenses. They must also buy a high-deductible health insurance policy to pay for big-ticket medical needs.

Bush's HSA proposal is a wedding cake of tax credits piled on top of tax deductions. And unprecedented in the annals of tax breaks, this one would tax neither the earnings going into the accounts nor the withdrawals coming out. This is unlike 401(k) plans, where people contribute pre-tax dollars into accounts but pay taxes on the money they withdraw.
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Read more here...

http://seattletimes.nwsource.com/html/opinion/2002797585_harrop12.html

[European Socialist]

1. For the wealthy and the healthy--typical GOP winner take all. nt

[Mel]

2. I think it stinks

It's just another way for the rich to shelter their money tax free.

I have this type of insurance I don't go to the Doctor unless it's broke. The deductible is high and the out of pocket is higher than any I've ever had before, it's by far the worst insurance (if you can call it that) I've ever had.

The point behind the corporate thinking where I work at is that it will make us better consumers of health care that we abuse it. That's bunk! I don't even like going to the Doctor and if I over go to a Doctor don't you think he/she may check into my mental health to see if I have some issues that need to be addressed? If I'm obsessed with seeing a Doctor all the time you think my insurance would cover my mental health?
Oh, hell no, they don't want to cover that now do they.

You know, I called the insurance company and asked about a regular thing that people have checked every year. I asked am I/you being overcharged for this it seems awfully high? I was told the going price is the same everywhere in my area. I did this before I found out how corporate thought we abused health care (code for they don't want to pay)

I say we should start going to the steps of the media, hospitals, congress you name it and protest by (fake) dying on their steps with posters of the different diseases illnesses that we die of for lack of Universal Health Coverage.

[REACTIVATED IN CT]

3. They only make sense if you otherwise would have to pay a lot

for your medical insurance premium. Usually that is the case for self employed people. But if your company charges you say half of the cost of the premium for your family coverage, it may make sense for you.

It also depends on how old you are. You can't be in an HSA if you are over 65, so if you are close to that age, say 60-62, it probably doesn't make sense either.

What you are doing with an HSA is gambling that you will have low medical bills so that what you are putting in the HSA will accumulate. For that scenario to make sense, you have to be saving money on what you otherwise would have paid for medical insurance premiums.

If your employer is funding the HSA - or matching your contribution - it might also make sense to participate.

I was a Benefits Administrator for many years and have read extensively on this subject. My last employer offered an HSA and not many people took it - only the self-employed who had younger healthy family members.

FYI - the underlying insurance coverage will cover preventive care

[Mel]

4. the underlying insurance coverage will cover preventive care

that's true for my insurance but it's a lot less that they pay now (more out of pocket) and that hurts when you make very little money to start with and you don't have the extra cash to put into the HSA. It does not help people that earn what I consider mine to be and that's a low wage for (Raleigh, N.C.) $7.50 per hour.

[Serial Mom]

6. Partially incorrect ... the insurance company will deny

FYI - the underlying insurance coverage will cover preventive care


any chance they get. It depends on the "coding" - part of my yearly physical, totally preventative, was blood work. My clinic coded the blood work, separated out for the draw, equipment, lab tests, of which the insurance company turned down the charges for the draw and equipment used. After a long discussion with a "customer service rep" who I DO NOT fault for taking the job and sounded like she was 20, couldn't do anything but put it through again only to get turned down again. I then called a supervisor who said my clinic is coding it incorrectly and will not be paid until they a "conform".

So I called my clinic, they code that way for their accounting purposes - they would not change it to be coded "preventative" which the insurance company wanted. So it cost me about $45 more out of my pocket.

Two months later I had my "preventative" colonoscopy and of course, nothing was coded correctly for the insurance company. And to that explanation they said it couldn't have been "preventative" since they found polyps and tested them, so they wouldn't have paid for it anyway. Try arguing that logic - I tried for 3 months, but lost - that "preventative" test cost me almost $3,000 all totaled!

Again, it is dubya helping rich corporations get richer, helping the OVERPAID CEO get bonuses by improving the bottom line at the expense of the little guy. SSDD!

[REACTIVATED IN CT]

8. What is the deductible on your HDHP insurance?

The underlying High Deductible Health Plan ? If it is less than $3,000 the colonoscopy should be covered in part.

The HSA/HDHP was a good choice for about a dozen execs at my prior employer. Their medical ins. premiums were $18,000 a year for family coverage. THe HDHP cost them half that and they could put about $5000 into the HSA. For someone in that situation, they can make sense. Yes, they were the higher paid employees.

They are by all means not suitable for the majority of working class Americans

[Serial Mom]

12. Deductible was $4,000 family

and yes, I know and even our "broker" said it should have been covered.

But as mentioned in my post above, insurance companies try to weasel out of paying with a reason that the insured has no control over. This coding issue has been the biggest headache for me.

I am NOT a highly paid employee, but our company went with the HSA to reduce premiums by about $400/month, and then turned around and adds about $150 a month into each of our HSAs (which helps offset the high deductible). A company that recognizes a savings and then passed some of that onto us - but this is 2nd year of this type of insurance and already the amount they put into our HSAs has dropped (partially because the premium for this high deductible insurance went up 23% over last year!).

[REACTIVATED IN CT]

15. Do you have an insurance ombudsman in your state?

Here in CT we can complain to the insurance commissioner on these types of matters. I always recommend a cc to them on any letter to a CT insurer !

[Lydia Leftcoast]

13. In my case, the HSA option has only $20 cheaper premiums than

the traditional plan--and the deductible is more than twice as high.

[REACTIVATED IN CT]

16. Then its certainly not a good choice !

IMO, there are a very narrow set of circumstances when an HSA makes sense

[area51]

5. Health Savings Accounts...

... are a way for the republinazis to cull the American population of the working poor, & to get rid of the middle class. :mad: :nuke:

[MiniMe]

7. Sucks unless its just a flex spending account

I have one at work and I love it. I still get full medical, but you can set aside part of your salary pre-tax for expenses that insurance doesn't pay. You can deduct the co-pays for prescriptions and Dr's appointments, dental work, contact lenses and lens solution, eye glasses, etc. The flex spending plan as a SUPPLEMENT to regular insurance is great in my opinion, because you pay for things with pre-tax dollars.

In my opinion, a Health Spending Account in place of traditional insurance just sucks. It only works if you are healthy.

[mainer]

9. I agree it's great as a SUPPLEMENT to regular insurance

We have health insurance with a high ($5000) deductible, because it's the most affordable. But it doesn't pay for things like hearing aids or eyeglasses. And I had surgery last year that cost nearly $5,000, which we had to pay out of pocket, from after-tax dollars. I wish we'd had an HSA then. We have one now, and have already used it to replace an old hearing aid.

[mwooldri]

11. I agree too....

I have one at work, but because of the cuts in healthcare, it doesn't matter how much I put aside in health care costs each year, I still incur more than I put aside each year in healthcare costs. Already we're at over $2,400 - that's what I set aside for the whole of 2006 and my wife thought we wouldn't spend that much. Two dentists visists and a long hospital stay later and we're already at that point. And we have reasonably good health and dental insurance anyway (90% with a $1,000 year cap per person on health, and 80/20 on major dental stuff).

Flex spending plan as an alternative to regular insurance? Forgetabout it. But as a supplement it works OK.

To be honest, I'd trade in our whole health system for the British National Health Service any day of the week. No doctor or hospital copays, $10 a prescription and if you have to have many then you get a certificate for multiple refills - something like $70 for three months of unlimited refills for your needs. NHS dentistry however has withered away, and the only thing you tend to get on the NHS when it comes to vision is your eyeglass exam (if you're lucky). However the private sector's costs have come down in these areas so it's affordable but still expensive.

Mark.

[SmokingJacket]

10. Tell me where an individual can buy affordable health insurance...

My husband and I have been mostly self-employed for ten years, and we buy our own high-deductible coverage, which now costs about as much as a regular policy did back when we started -- it's hugely expensive and we have NEVER met the deductible -- they're taking our money and have given not one penny back. But we have to keep it just in case something happens.

AND companies have been phasing out these policies. I don't think we could find one in our state today; we were grandfathered in.

We use money from our regular savings account for medical care -- I don't think we'd save much if the account were tax-free. We never go to the doctor, by the way.

People are going to be SCREWED.

[Ilsa]

14. A minor detail, but sometimes the school system wants a doctor's

excuse for the kids if they've been sick for too long. I'm "in trouble" with the school because my son was out for three days in a row, and I didn't take him to the doctor. I listened to his lungs (I'm a nurse) and he was clear, and just had the snots and a cough and very low grade fever a couple of times (but you have to be fever-free for 24 hours to go back to school). They want a doctor's note. I called the doctor's office and requested one, but they never returned my call. Yeah, they want us to blow $70 on a visit that was unnecessary, when we already pay thousands for docs for our autistic son. On top of that, the doc's office was full of kids with strep and rotovirus that I wanted to keep my kid away from.