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Lauren Sprieser HSA Article

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  • Lauren Sprieser HSA Article

    Loved the latest article by Lauren Sprieser on HSAs. While I think there's lots of discussions on how to make our sport safer, there's fewer discussions on how to deal with accidents when they do happen. Especially since the American health system is still incredibly expensive and can be hard to navigate, it's worth talking about some of the practical details.

    I'm really thankful that my big horse-related injury (fractured vertebra) happened while I was still on my parent's health insurance, and stopped riding altogether when I wasn't insured in the past.

    My SO plays hockey (we apparently love the expensive high-risk sports) and after a major injury he discovered that his insurance plan covered a fraction of what he expected. He's now had an HSA for a few years, and can use it for everything from orthopedic cushions to contacts to major medical bills. Another nice thing is USA Hockey (their main national governing body) automatically provides additional insurance coverage for any member injured during an event or practice session- which ultimately covered his ambulance ride.
    "Things turn out best for the people who make the best of the way things turn out." ~John Wooden

    Phoenix Animal Rescue

  • #2
    HSA - Health Savings Account (for those who may not know or be from US)
    Direct link to article - https://www.chronofhorse.com/article/a-psa-get-an-hsa

    She also brings up IRA's which I definitely agree with. I don't like HSAs (at least through my job) and PPO is cheaper and thank goodness they started offering that plan last year so I could switch over. However, for those who don't have the health insurance available HSA isn't a bad idea. My employer doesn't put enough into my 401k so I have a separate IRA and a vested account with the state from my previous employer. I am a big believer in squirreling away money and it baffles me that there are so many people around my age or younger that don't.

    Comment


    • #3
      With the high deductible plan an HSA is pretty much necessary.

      Comment


      • #4
        For some reason I can no longer read the COTH blogs or articles on my computer (although they show up fine on my phone.) But even without reading the article I would certainly support the idea of health savings accounts. Many employers will match contributions which is essentially free money - and unlike FSAs, that money is yours to keep and portable if you change jobs, etc.
        **********
        We move pretty fast for some rabid garden snails.
        -PaulaEdwina

        Comment


        • #5
          DH and I have had a MSA for years. We had a flexible spending account before that. So I am pretty conversant with the ins and outs of spending accounts, high deductible plans, etc. When my former employer started offering a high deductible option, my boss was all excited about the lower premium. I tried in vain to get her to understand that she either 1) should take the difference in premiums and put into the MSA or 2) keep on with her HMO even if it was more expensive monthly as she could at least predict her medical spending. So of course she went on the high deductible with practically nothing in the MSA. Predictably, she had to have surgery and was floored by how much they expected her to pay up front.

          Sigh, all I could say was sigh. I thought I showed remarkable restraint by not saying "I told you so" but it was tempting.

          Good advice for all in Lauren's blog. Now you just have to whack people over the head to follow it!

          Comment


          • #6
            Originally posted by Libby2563

            I have good insurance through my employer and still find my HSA very useful. I see several providers who are out of network (physical therapist, dentist, very expensive Lyme specialist) and use the HSA for whatever is not reimbursed by health insurance, as well as our prescriptions. It definitely doesn't have to be an either/or thing.
            I think you are confusing a medical spending account (MSA or FSA) with a true HSA. An HSA is only available (per IRS regulation) to those enrolled in a high deductible health plan (there's a modest monthly premium but a big fat deductible). The idea of an HSA is that you sock money away in anticipation of meeting that high deductible. Employers can match funds if they like, or anyone else can fund it, too.

            Comment


            • #7
              Originally posted by TMares View Post

              I think you are confusing a medical spending account (MSA or FSA) with a true HSA. An HSA is only available (per IRS regulation) to those enrolled in a high deductible health plan (there's a modest monthly premium but a big fat deductible). The idea of an HSA is that you sock money away in anticipation of meeting that high deductible. Employers can match funds if they like, or anyone else can fund it, too.
              Oops you’re right, mine is an FSA! Thanks for catching that. I’ll delete my previous post to avoid confusing other people in addition to myself.
              Building and Managing the Small Horse Farm: http://thesmallhorsefarm.blogspot.com

              Comment


              • #8
                Originally posted by Libby2563

                I have good insurance through my employer and still find my HSA very useful. I see several providers who are out of network (physical therapist, dentist, very expensive Lyme specialist) and use the HSA for whatever is not reimbursed by health insurance, as well as our prescriptions. It definitely doesn't have to be an either/or thing.
                My employer is an HSA or a PPO. My PPO covers everything I need and I save much more with it than I do with the employer HSA (in terms of up front cost of insurance vs deductibles, cost of dr, and cost of medications)... I do not use outside providers and have never needed to (and I've had to get a lot of procedures done and have worked with specialists that are in network, thankfully a lot of places are). My insurance is actually pretty great, which isn't the case for everyone, and I don't qualify for an outside HSA due to deductibles. Barely, but I don't qualify.

                Comment


                • #9
                  I don't have an HSA per se. At my last job, though they offered one, the fact that I have Medicare excluded me. I was still paying my share for employer funded health insurance, with Medicare as a secondary provider. My present job does not offer health insurance, but does give me pre-tax dollars to cover my Medicare supplement and prescription plan. I am still working full time, hoping to retire I about three years. I opted to take my SS payments when I was in my late sixties (I'm 74), and basically have it deposited directly to my savings account. That savings account is pretty healthy now, and I try to avoid dipping into it as much as possible, but it's there in an emergency.

                  Comment


                  • #10
                    I had an HSA for a while while self employed and I hated it with the passion of the burning sun.

                    The first thing is, they are potentially a nice tax vehicle for someone with cash flow and who is already maxed on on IRAs, and who does not currently have any medical expenses.

                    But let's talk some disadvantages:
                    • IME, an HSA-enabled plan is more expensive than the same plan with the same benefits that is not HSA eligible. As far as I can tell, this is because the insurance company is skimming out some of your tax savings.
                    • There is a monthly fee for these accounts that also eats into your tax savings. It's larger than a regular checking account, though still small if you're maxed out into contributions and accumulate the account for a while. But, if you spend down the money at all, or just leave it too long, it can actually end up closing the account on you.
                    • The amount you can stash does not increase when you have dependents on your plan.
                    • If you change away from an HSA plan, you cannot continue contributing to it, so the balance will decrease from fees faster than it will increase with interest in the current environment.
                    • The account is separate per policyholder, and because of the way my small employer group was set up, that meant that my spouse and I had separate accounts, each accumulating fees. It also meant I couldn't use his account's debit card to pick up his prescriptions.
                    • If you have the cash flow to put a lump sum at the beginning of the year, or you have the cash flow to let the money accumulate tax free while you pay your actual medical bills out of your regular cash, this doesn't matter, but the extra overhead in these accounts meant I sometimes had to wait up to 5 days for a deposit to settle before it was available. My family had some expensive prescriptions at that time, and I had a client that was not always quick to pay.
                    • I cried in the parking lot of the bank and the pharmacy in tremendous frustration more than once that year.
                    • It makes your taxes more complicated in a way that will eat your time or add to your tax preparation bill.
                    • An HSA and its connected plan, at the end of the day, is not always a better buy than health insurance with either a plain ordinary savings account or a lower deductible.

                    Banks may be offering some better deals and processes these days, and as I said, if you're in a position where someone will give you money to put in it, like parents, or if you don't have to spend it, then yes, this can be a neat bit of niche loophole for you. But if you don't have the $3550 to drop into it every January, then it might not actually be all that great.
                    If you are allergic to a thing, it is best not to put that thing in your mouth, particularly if the thing is cats. - Lemony Snicket

                    Comment


                    • #11
                      Originally posted by poltroon View Post
                      I had an HSA for a while while self employed and I hated it with the passion of the burning sun.

                      The first thing is, they are potentially a nice tax vehicle for someone with cash flow and who is already maxed on on IRAs, and who does not currently have any medical expenses.

                      But let's talk some disadvantages:
                      • IME, an HSA-enabled plan is more expensive than the same plan with the same benefits that is not HSA eligible. As far as I can tell, this is because the insurance company is skimming out some of your tax savings.
                      • There is a monthly fee for these accounts that also eats into your tax savings. It's larger than a regular checking account, though still small if you're maxed out into contributions and accumulate the account for a while. But, if you spend down the money at all, or just leave it too long, it can actually end up closing the account on you.
                      • The amount you can stash does not increase when you have dependents on your plan.
                      • If you change away from an HSA plan, you cannot continue contributing to it, so the balance will decrease from fees faster than it will increase with interest in the current environment.
                      • The account is separate per policyholder, and because of the way my small employer group was set up, that meant that my spouse and I had separate accounts, each accumulating fees. It also meant I couldn't use his account's debit card to pick up his prescriptions.
                      • If you have the cash flow to put a lump sum at the beginning of the year, or you have the cash flow to let the money accumulate tax free while you pay your actual medical bills out of your regular cash, this doesn't matter, but the extra overhead in these accounts meant I sometimes had to wait up to 5 days for a deposit to settle before it was available. My family had some expensive prescriptions at that time, and I had a client that was not always quick to pay.
                      • I cried in the parking lot of the bank and the pharmacy in tremendous frustration more than once that year.
                      • It makes your taxes more complicated in a way that will eat your time or add to your tax preparation bill.
                      • An HSA and its connected plan, at the end of the day, is not always a better buy than health insurance with either a plain ordinary savings account or a lower deductible.

                      Banks may be offering some better deals and processes these days, and as I said, if you're in a position where someone will give you money to put in it, like parents, or if you don't have to spend it, then yes, this can be a neat bit of niche loophole for you. But if you don't have the $3550 to drop into it every January, then it might not actually be all that great.
                      Interesting post.
                      I can not think of how your first item would work. The plan we have requires us to pay the first large amount of expenses. How is a plan the same as that but not HSA eligible?

                      The account I have does not charge fees once you get over a minimum amount, which was pretty close to the maximum one year contribution for a single person. After that there are no fee deductions so my account collects interest and is not shrinking on its own.

                      I have used my spouse's account debit card to pick up his prescriptions. His account is even at a different bank than mine (different employer).

                      My account is single person but from what has been presented at open enrollment time the amount you can contribute for a family is far more than a person can contribute if they are single. Now, if there are only the two of you and you both have an account, you can not pretend your spouse is not contributing to theirs. The amount you can stash is controlled by the amount of your policy deduction level. Those are the same for two people as they are for a family as far as I know.



                      Comment


                      • #12
                        Originally posted by poltroon View Post


                        The first thing is, they are potentially a nice tax vehicle for someone with cash flow and who is already maxed on on IRAs, and who does not currently have any medical expenses.

                        But let's talk some disadvantages:
                        • IME, an HSA-enabled plan is more expensive than the same plan with the same benefits that is not HSA eligible. As far as I can tell, this is because the insurance company is skimming out some of your tax savings.
                          J- Not possible. Eligibility for HSA is based on your deductible. If one plan in NOT eligible for HSA, it must have a smaller deductible.
                        • There is a monthly fee for these accounts that also eats into your tax savings. It's larger than a regular checking account, though still small if you're maxed out into contributions and accumulate the account for a while. But, if you spend down the money at all, or just leave it too long, it can actually end up closing the account on you.
                          J- I guess it depends on the bank, but my fees have been negligable.
                        • The amount you can stash does not increase when you have dependents on your plan.
                          J- Yes it does. I can contribute twice as much if I include my husband (who does not have his own heatlth insurance since he is self employed)
                        • If you change away from an HSA plan, you cannot continue contributing to it, so the balance will decrease from fees faster than it will increase with interest in the current environment.
                          J- you can continue to use it for medical expenses, or withdraw it without penalty if you are over 65. You can also roll it over into a different HSA (I have done this twice)
                        • The account is separate per policyholder, and because of the way my small employer group was set up, that meant that my spouse and I had separate accounts, each accumulating fees. It also meant I couldn't use his account's debit card to pick up his prescriptions.
                          J- That has to do with YOUR employer, and nothing to do with HSAs in general.
                        • If you have the cash flow to put a lump sum at the beginning of the year, or you have the cash flow to let the money accumulate tax free while you pay your actual medical bills out of your regular cash, this doesn't matter, but the extra overhead in these accounts meant I sometimes had to wait up to 5 days for a deposit to settle before it was available. My family had some expensive prescriptions at that time, and I had a client that was not always quick to pay.
                          J- I am confused. you refer to you "employer". If you have an employer it should not matter how quickly the client pays.
                        • I cried in the parking lot of the bank and the pharmacy in tremendous frustration more than once that year.
                          J- I am sorry you were frustrated.
                        • It makes your taxes more complicated in a way that will eat your time or add to your tax preparation bill.
                          J- I had one extra piec of paper I had to enter in one place on the tax return. No more than 5 extra minutes.
                        • An HSA and its connected plan, at the end of the day, is not always a better buy than health insurance with either a plain ordinary savings account or a lower deductible.
                          J- Not always, but it often is.

                        Banks may be offering some better deals and processes these days, and as I said, if you're in a position where someone will give you money to put in it, like parents, or if you don't have to spend it, then yes, this can be a neat bit of niche loophole for you. But if you don't have the $3550 to drop into it every January, then it might not actually be all that great.
                        J- Mine goes in with each paycheck. I had expensive (but luckily successful) brain surgery earlier this year, and the HSA took away a LOT of the stress.

                        Janet

                        chief feeder and mucker for Music, Belle and Tiara. Someone else is now feeding and mucking for Chief and Brain (both foxhunting now). Spy is gone. April 15, 1982 to Jan 10, 2019.

                        Comment


                        • #13
                          Originally posted by trubandloki View Post

                          Interesting post...

                          ... The amount you can stash is controlled by the amount of your policy deduction level. Those are the same for two people as they are for a family as far as I know.
                          I don't believe that is correct. The annual amount you can put into an HSA is determined by IRS rules. If you have a qualified high deductible plan, you can put in $3500 for an individual or $7000 for a family, (assuming that your spouse is part of your family coverage). If you are both over age 55, you can put in an additional $1000 for each of you (which could bring your contribution to as high as $9000 if its family/spousal coverage.) Those limits are scheduled to increase slightly for 2020.

                          We have been fortunate that DH's employer contributes something to his HSA and we have tried to max out our contribution of the rest each year. It sure came in handy when DH totally blew apart his rotator cuff this spring.

                          The nice thing about an HSA is it is pretax when put into the account and not taxed when taken our for medical use. So no tax on that money. That adds up over the years. With an IRA or 401K, you will eventually be forced to take minimum distributions that will be taxed, like it or not.

                          One way to save a tiny bit of taxes is something I haven't seen talked about much. Just learned about it a few month ago as DH & I were doing some pre-retirement financial planning. You can make a one time direct rollover from a traditional IRA into your HSA. There are a few rules; must be direct rollover and you must continue to have a qualifying high deductible health insurance plan with HSA for at least one year after making the rollover. Amounts are subject to the same limits as apply to the HSA.

                          If you learn the fine points, an HSA is a good tool. Totally agree with Lauren Sprieser on the benefits of funding both an HSA and an IRA. It takes self discipline, but the pay off at retirement age can be sweet. So glad I sacrificed during my 40+ years of work & self employment to now be able to enjoy retirement without feeling I'll have to live with a very tight belt forever, nor will my kids have to sacrifice or struggle to see that mom and dad are taken care of.




                          Last edited by fjordmom; Dec. 3, 2019, 06:15 PM. Reason: Edited to clarify a point

                          Comment


                          • #14
                            I've had two different HSAs through two different employers at two points in my life. At my most current job, I opted for PPO over HSA. While I like the HSA in theory, the insurance coverage it is packaged with by your employer matters a great deal.

                            First HSA experience was great because my employer matched my contribution up to a $100 a month. The insurance that was packaged with this HSA was fair in coverage and price - I had no issues with billing and their web portal was terrific.

                            Second HSA experience was horrid because 0 matching contribution, and the insurance it was packaged with was worthless. Cash clients actually were billed less than I was and I payed through the roof for very basic things. I would get invoices 11 months after the doctor visit occurred with no description for the line item which led to multiple billing disputes. Their web portal was outdated and customer service was sub par. I know this is a reflection of the insurance company more than the actual HSA, but many HSAs are packaged with cut-rate high deductible health (HDHP) insurance plans and this one really burned me,

                            At current job I had many options and I choose a PPO. I like the network it is in, and don't have to deal with so much billing on my own. After a nasty riding spill that I fortunately was uninjured from, I chose to pay a little more a month so I'm not stuck with a HDHP and I know the % of what insurance will cover after that lower deductible is met. Horseback riding comes with inherent dangers, so I don't want cut-rate insurance if I do sustain a costly injury.

                            As poltroon pointed out, I am still paying monthly fees on my two old HSA accounts, so I use them for contacts,dental work, glasses and to pay co-pays. One has so little left in it that the fees will eat the amount long before I retire, so its best to use it up now.

                            Comment


                            • #15
                              Originally posted by Janet View Post
                              J- Mine goes in with each paycheck. I had expensive (but luckily successful) brain surgery earlier this year, and the HSA took away a LOT of the stress.
                              I simply cannot imagine going through a terrifying nf situation like needing brain surgery, and having the added stress of worrying how to pay for it. I feel for all of you and am grateful to live in a country with universal healthcare.

                              Some questions about the HSA - does the money grow tax free or are you taxed on gains? If there a reason an HSA is preferable to opening a regular savings account or investment account and making regular contributions that you earmark for health emergencies?

                              Comment


                              • #16
                                The growth in the HSA is tax free, as long as you use it for medical expenses.
                                Janet

                                chief feeder and mucker for Music, Belle and Tiara. Someone else is now feeding and mucking for Chief and Brain (both foxhunting now). Spy is gone. April 15, 1982 to Jan 10, 2019.

                                Comment


                                • #17
                                  poltroon

                                  I think a lot of the difficulties you experienced were because you were a one-person shop - so you were the employer and employee, right? So I think many of your complaints have to do with the administrative/financial headaches of being both. I can assure you that being part of a group plan masks a lot of those problems. So my husband's employer drops in some $$ at the beginning of the year and they take a deduction out of each of his checks until we reach the federal maximum. We answer one additional question in Turbo Tax when I do the taxes. So I am not discounting any of your issues, just saying the majority of people do not experience them. On the other hand, as I mentioned above, if someone does go into a high deductible situation, you have to do it with eyes wide open.

                                  My husband is going to retire in 2020 and we'll be going on to Medicare. The MSA goes away. As the queen of benefits, I have already decided that we will go on the HMO version of Medicare and damn the costs, just so that we don't get caught short with a big bill. Kind of the exact opposite of what we do now.

                                  I have often thought that these insurance approaches, while very good on paper, are often waaaaay too complicated for the average person to understand, select from, and live with.

                                  Comment


                                  • #18
                                    Originally posted by Janet View Post
                                    The growth in the HSA is tax free, as long as you use it for medical expenses.
                                    Which including Medicare premiums ( but not supplemental policies).

                                    I plan to use my HSA to pay premiums when I go on Medicare. It's a way to beef up my IRA.
                                    ~ ~ ~ ~
                                    Seems like the devil already has enough advocates.

                                    Comment


                                    • #19
                                      I love my HSA and have been fortunate to not incur much in medical bills but have been stashing away the annual max contributions and have been investing those - all tax free! With the huge increase in the markets, i have a nice amount set aside for when I do need it for medical bills, or let it grow until retirement.

                                      Comment


                                      • #20
                                        I think it is a good thing to discuss and hopefully people will look in to them (and health insurance policies, in general,if not offered by employment).

                                        I just can't get in to her blogs. Even one that I think is a fantastic topic, always comes off *to me* as self glorifying or self promoting or a plug for someone. JMO.
                                        Come to the dark side, we have cookies

                                        Comment

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