Health Insurance Open Season......

[jorswift]

Federal employee. It is open season time.
Have always had BCBS, but with monthly premium rates raising 11% last year and another 17% this year. It may be time to ditch it. Family of 3; spouse and kiddo (16). I am looking into a HSA/HRA plan through MHBP. Much cheaper monthly premiums and the added benefit of the HSA. They throw a yearly amount of 2400 into the HSA to start, deductible of 4k, so out of pocket is essentially $1600 before plan benefits hit. You can put up to $8750 into the HSA which rolls over and is tax free money from my pay. We are generally healthy folks, just the normal Dr appointments every 3-4 months and some monthly RXs. However, I had an elected hand surgery and daughter had an injury surgery from a sport. Last year out-of-pocket was about $2500 -3k plus premiums.

2026 BCBS yearly premium - $9278.36
2026 MHBP - $5799.04

I like the idea of rolling over the HSA every year, getting $2400 per year and being able to possibly invest the HSA.

I do not like the unknown and paying for everything out of pocket until the deductible hits. I like a fixed price. But I know I would be saving $3479.36 per year just switching to this plan, thus adding $2400 from the plan I would be essentially gaining $5879 just by switching. Then add in my FSA, that I have been using and that is another $1500. Total $7379.36 towards the HSA.


Anyone have real world experience on HSA? Hate it, like it, got burned with it? Advise?

 

[PathFinder]

Interested to hear what others think, we just went through the same thought process.
For our family of 7, BCBS is 4800 per year for premiums alone. In a couple years, we could get to where our HSA would balance risk pretty well. And it would only go up from there. Pretty hard to flush money down the insurance toilet with that math. It comes down to risk mitigation for individual situations, but that's the way we're headed.

Sent from my Pixel 10 using Tapatalk

 

[ODB]

My wife has an HSA. Like you I was kind sketchy with the pay out of pocket, but after a few years we’ve got plenty saved up in it so it takes the pressure off. She likes it.

I have a standard insurance plan that luckily went from United to BCBS this year and is actually less. We had to go to war with United for some simple dentistry and it really pissed me off.

 

[atmat]

To clarify, you’re deductible is not $1600 — it’s really more like $1200 if you fill the HSA more and pay with that, as you’ll get the tax savings.

My family of 5 has always been on an HDHP with HSA. The first year or two seen scary. But ultimately there’s enough in there to cover our OOP max now, so there’s very minimal risk.

HSAs are also the only triple tax advantaged account in the US, which is nice.

 

[180ls1]

It's a great idea. You have to commit to the long run though as you can really take it in the shorts any one year(s). Over a decade or more with diligent investing you should come out ahead, compound that over several decades and you're likely killing it.

 

[Marbles]

In the plans available to me, there is a very narrow window where a low deductible plan can be cheaper. Add one to two years of not hitting your max out of pocket and there is no scenario were the low deductible plan can be cheaper.

HSAs can also be used to cover various other expenses, such as dental.

You would have to math out you total cost if no services are used for each plan, then figure out max out of pocket for each plan (no difference on mine). Then figure out the cost at which the low deductible pulls ahead.

Example
HD costs $4K in premiums, but you get $2.5k in the HSA, so it costs you $1.5K per year just to be insured.

LD costs $8K a year just to be insured. Then has a $500 deductible with 20% coinsurance.

So, the LD plan costs more until you spend $7K (premium difference+ LD deductible).

But, if you max out your HSA contribution and your top income is in the 22% bracket, you effectively get an additional $1300 as you would have had to pay that in taxes on the ~$6K you contributed.

Now you have to spend $8.3K before the LD plan pulls ahead. But, due to max out of pocket being $10K, the HD plan can never cost more than $11.5K in a year ($10K~ if HSA contribution is maxed out).

The LD plan on the other hand also has a max out of pocket of $10K, so add in premiums and it can cost me up to $18K in a year.

You have a catastrophe that bridges plan years (say MVC putting 2 family members in the ICU on December 28th), the LD plan actually leaves you more exposed financially with no way to reduce that exposure over time. On the other hand, with two or three good years, if you max out the HSA, you have no true exposure.