Who leverages an HSA?

[DSM Turbos]

Based on the topic around investing, who here uses an HSA?

I have always used a PPO plan at work, but with a recent job change, the HSA actually looks like it will save me thousands of dollars a year vs the PPO they offer. Which leads me down the path of HSAs.

If you have an HSA, do you contribute to your HSA over your 401k? Seems the common suggestion is fund your 401k up to your company match, then match your HSA after that, then move back to the 401k.

Pretty wild you can use save all your medical expenses for 20+ years, as long as you have the receipts, you can reimburse yourself 20 years later, and use the HSA funds during that time to invest and grow.

 

[justjeepin86]

Based on the topic around investing, who here uses an HSA?

I have always used a PPO plan at work, but with a recent job change, the HSA actually looks like it will save me thousands of dollars a year vs the PPO they offer. Which leads me down the path of HSAs.

If you have an HSA, do you contribute to your HSA over your 401k? Seems the common suggestion is fund your 401k up to your company match, then match your HSA after that, then move back to the 401k.

Pretty wild you can use save all your medical expenses for 20+ years, as long as you have the receipts, you can reimburse yourself 20 years later, and use the HSA funds during that time to invest and grow.

I gave an hsa, but don't leverage it for anything. I need to though.

Edit,
I do think it sucks that you can't use it for health insurance premiums after retirement. That would be killer.

 

[kaiser715]

I've had an HSA health policy for maybe the past 10 years. Wish I'd started earlier, when it could build up before starting need it more -- one or the other of us has emptied it every year.

For those not familiar, 2025 contribution limits are $4300 per individual, $8550 family. Plus $1000 catch-up if you are over 55.

I like the HSA just because it's simple. Pay for everything until you hit your policy deductible, then insurance pays 100%. It just hurts when you go to the doc and get a bill for 300 bucks. By May 5th I'll have mine maxed out for the year ($8300 deductible).

 

[TARider]

I'm a fan. It's that much less of my pay being taxed and once you reach a certain balance you get investment options.

 

[LBarr2002]

I made a bad decision on High Deductible HSA plan 10 years ago when we had our first child. That kept me from looking at it again for a while but a few years ago I calculated it out vs PPO. If you hit your out of pocket max and burn the whole HSA it comes out a little more expensive, but any other scenario HDHP w HSA wins. I've been doing it for 3 or 4 years now fully funding HSA and he have hit our Deductible every year but not out of pocket max.

 

[DSM Turbos]

I made a bad decision on High Deductible HSA plan 10 years ago when we had our first child. That kept me from looking at it again for a while but a few years ago I calculated it out vs PPO. If you hit your out of pocket max and burn the whole HSA it comes out a little more expensive, but any other scenario HDHP w HSA wins. I've been doing it for 3 or 4 years now fully funding HSA and he have hit our Deductible every year but not out of pocket max.

Ours comes out like 2k cheaper if you hit the max out of pocket on the hdpd. It’s seems odd. I have never seen a place like that, but I have done the math a ton. The initial couple of months might suck for out of pocket but it shouldn’t be too bad.


My goal would be to fund the FSA but pay out of pocket, and not pay myself back for a long time and let the money grow instead since there are no time limits.

 

[LBarr2002]

My goal would be to fund the FSA but pay out of pocket, and not pay myself back for a long time and let the money grow instead since there are no time limits.

If you can do that, absolutely. It hasn't worked out for us. My wife keeps saying she wants to do that and put more in the kids 529 and and and but I keep asking her where all this extra is coming from.

We started this year with a $4000 ER visit on new years day, so we'll hit deductible soon.

 

[VortecJeep]

I expect to hit the federal limit on my 401k this year, most years I either hit it or come just under. Sometimes that hurts now, but I’ll be glad I did when I’m 60 or so.

I also max out my HSA contributions each year.

I have my HSA set up to have a few thousand in “cash” that I can use anytime with the HSA debit card, then the rest gets invested. It’s all automated; every paycheck when the contribution is made, if cash is below a set amount, it goes there. If cash is above the set amount, it goes into the investment portion.

 

[jeepinmatt]

I made a bad decision on High Deductible HSA plan 10 years ago when we had our first child. That kept me from looking at it again for a while but a few years ago I calculated it out vs PPO. If you hit your out of pocket max and burn the whole HSA it comes out a little more expensive, but any other scenario HDHP w HSA wins. I've been doing it for 3 or 4 years now fully funding HSA and he have hit our Deductible every year but not out of pocket max.

Ours comes out like 2k cheaper if you hit the max out of pocket on the hdpd. It’s seems odd. I have never seen a place like that, but I have done the math a ton. The initial couple of months might suck for out of pocket but it shouldn’t be too bad.


My goal would be to fund the FSA but pay out of pocket, and not pay myself back for a long time and let the money grow instead since there are no time limits.

At previous jobs, the HSA always came out cheapest in nearly every scenario, especially when considering max out of pocket. Keep in mind that even if the max OOP is similar, the monthly premium on the HSA is typically much cheaper than PPO.

 

[DSM Turbos]

At previous jobs, the HSA always came out cheapest in nearly every scenario, especially when considering max out of pocket. Keep in mind that even if the max OOP is similar, the monthly premium on the HSA is typically much cheaper than PPO.

Here is the math for the new job (for the family) for in network

	PPO	HDHP
Monthly Premium	$665.60	$345.10
Deductible	$500 person / $1,500 family	$3,300
Out of Pocket Max	$6,000	$5,500
Copay	preventative care 0/primary care $20/specialist $40	preventative care 0 / everything else 10% copay
HSA	0	Employer contributes 2,000 (assuming you also put in 2k)

I'll easily hit the deductible, potentially even the Out of Pocket Max.

Just in Premium + deductible + HSA you are looking, the PPO is $9,487.20 for the year, and HDPD is $5,441.2. There is never a scenario when the PPO is cheaper based on this (that I can find). Even if you hit the OOO Max for the HDPD you are still only looking at $7,641.20 for the year with HDPD which still doesn't even hit the premium cost alone of the PPO.

I guess I don't know why anybody would go with the PPO in this scenario (maybe it would work out for the PPO if only 1 family member really uses a lot of insurance and the rest stay below the deductible? / have no costs)

Bonus points are the HSA savings you can do towards retirement, etc.

 

[kaiser715]

Here is the math for the new job (for the family) for in network

	PPO	HDHP
Monthly Premium	$665.60	$345.10
Deductible	$500 person / $1,500 family	$3,300
Out of Pocket Max	$6,000	$5,500
Copay	preventative care 0/primary care $20/specialist $40	preventative care 0 / everything else 10% copay
HSA	0	Employer contributes 2,000 (assuming you also put in 2k)

I'll easily hit the deductible, potentially even the Out of Pocket Max.

Just in Premium + deductible + HSA you are looking, the PPO is $9,487.20 for the year, and HDPD is $5,441.2. There is never a scenario when the PPO is cheaper based on this (that I can find). Even if you hit the OOO Max for the HDPD you are still only looking at $7,641.20 for the year with HDPD which still doesn't even hit the premium cost alone of the PPO.

I guess I don't know why anybody would go with the PPO in this scenario (maybe it would work out for the PPO if only 1 family member really uses a lot of insurance and the rest stay below the deductible? / have no costs)

Bonus points are the HSA savings you can do towards retirement, etc.

That really shows the value of having an employer, vs working for yourself (which I always did) or early retired (which I am now).

I'm paying, just for myself, around 1100 a month premium, plus 8300 a year (deductible and max OOP). That's about 21,500 a year. For one person.

 

[DSM Turbos]

That really shows the value of having an employer, vs working for yourself (which I always did) or early retired (which I am now).

I'm paying, just for myself, around 1100 a month premium, plus 8300 a year (deductible and max OOP). That's about 21,500 a year. For one person.

This is what they show as the total cost (including employer) for semi monthly (from left to right is employee only, employee + spouse, employee + children, family). So the individual they are saying is 1300-1600 per month total cost.

 

[jeepinmatt]

We have a $1500 deductible PPO plan, and the company pays for the employee 100%, and dependents 50%, and it’s still over $700/month. If I were paying all of it, it would be nearly $2000/month!

 

[RatLabGuy]

That really shows the value of having an employer, vs working for yourself (which I always did) or early retired (which I am now).

I'm paying, just for myself, around 1100 a month premium, plus 8300 a year (deductible and max OOP). That's about 21,500 a year. For one person.

This just shows how employers are using healthcare benefits etc as an extra enticement for emplyment in lieu of salary (cash)

 

[VortecJeep]

This just shows how employers are using healthcare benefits etc as an extra enticement for emplyment in lieu of salary (cash)

Yep, you have to look at the total package, not just an hourly rate or salary.
My employer also provides a good chunk of “seed money” in our HSA at the beginning of each year to try to entice employees to use the high deductible plan instead of the PPO. With that seed money they give us, plus the credits I earn for not using tobacco and for working out, the high deductible plan ends up basically costing me nothing in premiums for the year.

 

[Andy J.]

I agree with all of this. All in with vision and dental, my portion of premiums are $427 per month with a $3k deductible and $8500 max OoP. IIRC, my employer pays 70% of the premiums. I max our HSA, but we tend to use all of it every year on medical expenses.

 

[benXJ]

This just shows how employers are using healthcare benefits etc as an extra enticement for emplyment in lieu of salary (cash)

gov't meddling at it again!

and maxing 401s and HSAs?!

and still have $ for jeeps?!

I gotta get a job like y'all!

 

[RatLabGuy]

gov't meddling at it again!

How is thsi gov't meddling?

We're literally talking about employers doing what they want bc the gov't doesn't.

 

[RatLabGuy]

I agree with all of this. All in with vision and dental, my portion of premiums are $427 per month with a $3k deductible and $8500 max OoP. IIRC, my employer pays 70% of the premiums. I max our HSA, but we tend to use all of it every year on medical expenses.

Careful w/ vision insurance if its a seperate add-on plan, like Davis Vision etc. If you sit down and do the math of what they cover vs what you pay for the premiums its very common for it to not pan out even if you use all of the benefits annually. Unlike dental and most other health things vision care costs (that are covered under most plans, which is only optometry, not opthalmology) are extremely predictable... either you need glasses or you don't, and the cost of the exams and glasses are known ahead of time. It isn't the gamble like dental where you may suddenly need a root canal or whatever.

If your employer is paying part if the premium then the math may pan out.

 

[jeepinmatt]

How is thsi gov't meddling?

We're literally talking about employers doing what they want bc the gov't doesn't.

I mean it’s literally a regulated industry at both the state and federal level, with tax advantages depending on which plan you gamble with, and then they created a whole in between layer with Obamacare, all for a transaction between you and your healthcare provider, but other than that, no, it’s not at all government meddling…

 

[JSJJ388]

we've had one for years. We put 3500 in it per year and the company matches 1k. I do this regardless of 401k and other investments. It's just the better option imo.

 

[shawn]

, it would be nearly $2000/month!

That's nothing. The plan at my old employer for family was about $3,600 a month.

 

[skyhighZJ]

I have the 20yr investment plan. Health, dental, vision. Free. Upgraded plan is $300/ yr for wife and I no OOP, pick your Dr., free scripts. Haven’t had any complaints.

 

[benXJ]

How is thsi gov't meddling?

We're literally talking about employers doing what they want bc the gov't doesn't.

The shift towards employers offering health insurance instead of pay increases primarily took off during and after World War II, particularly in the 1940s. This was driven by government policies like wage freezes designed to combat inflation during the war, which limited employers' ability to raise wages. As a result, employers began offering health insurance as a non-wage benefit to attract and retain workers. The Internal Revenue Service (IRS) further encouraged this practice in 1943 by making employer-sponsored health insurance tax-free for both employers and employees.

 

[DSM Turbos]

gov't meddling at it again!

and maxing 401s and HSAs?!

and still have $ for jeeps?!

I gotta get a job like y'all!

I’m have no jeep anymore

Careful w/ vision insurance if its a seperate add-on plan, like Davis Vision etc. If you sit down and do the math of what they cover vs what you pay for the premiums its very common for it to not pan out even if you use all of the benefits annually. Unlike dental and most other health things vision care costs (that are covered under most plans, which is only optometry, not opthalmology) are extremely predictable... either you need glasses or you don't, and the cost of the exams and glasses are known ahead of time. It isn't the gamble like dental where you may suddenly need a root canal or whatever.

If your employer is paying part if the premium then the math may pan out.

For the entire family my vision insurance is 9 a month, pretty cheap.