Hoping for some quick validation on HDHPs...

Basically I'll have a deductible with a HDHP until I hit a family max in my case that's $5,600 for the family.
At that point I am responsible for 10% of fees moving forward
Cost per paycheck for family coverage is $96.50 (paid twice a month)

With a HDHP I get a HSA which is basically an account I submit deposits into and withdraw as needed to cover expenses. I can contribute up to $6,370 and my company contributes $2,380.

Net is I should max out the HSA since when I turn 65 I can use those tax free investments for anything - not just healthcare.

And I can also enroll in a Limited FSA which I'll also be doing.

Did I say all of this correct? This sounds like the way to go as long as I have the necessary cash flow... Agree

Thank you for all the feedback.

Do I really need to fund a FSA if I have a HDHP?

HDHP + HSA is a no brainer. At my last two employers the deductible was actually about the same as the PPO plan with cheaper premiums, free money from employer, option to invest your contributions, incredible tax treatment, etc. it's so far superior to anything else it's not even debatable.

I would show people that it made zero sense to go with PPO but most people have it in their head that the coverage is less with the HDCP + HSA when it's not. They simply don't believe it even when the election paperwork explicitly tells them this. It's kind of wild.

fulshearAg96 said:

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Do I really need to fund a FSA if I have a HDHP?

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I did the LPFSA (in addition to the HSA) the years my kid needed braces/ortho work to get the tax break (we were on a basic dental plan that didn't cover any ortho). But I haven't found it particularly worth the effort aside from that one exception.

I put $500/year for tax savings into my LPFSA, because $500 rolls over if not used. Between $37 here for flouride, an extra $48 there for bitewings, and $25 for the eye pressure test we end up using it most years anyway. Then I use it heavily the years we have big ortho spend.

RightWingConspirator said:

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I always select the HDHP to get the HSA - the most powerful savings/investment tool there is. Don't over think it. Get the HSA.

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would you say this if there was a cost to the plan with HSA?

My employer just changed their plans and we're in open enrollment.

Typical plan is no cost to me, but plan with HSA is ~$750 a year. Wondering if there's a analysis to do here based on my anticipated contributions. Obviously if I contributed nothing, it wouldn't make sense to pay for it.

if the plans were about equal I'd do it, just the initial tax savings on contributions should be multiple times the cost, then tax free growth

mosdefn14 said:

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Wow your plan is cheap. Thank your employer.

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I noticed the same thing. Also, that is a nice employer lump sum into the HSA.

I'm a healthy Type 1 Diabetic for the last 42 years. I did an analysis of the typical frequency of my doctor visits plus all of my pharma costs and I still came out ahead on the HDHP. If you're going to go to the doctor often, or if you have health issues that necessitate medical intervention, it's not as much of a no-brainer. In my case, the $400/month in cost for a PPO is wasted money given the one time per year I see the doctor. My pharma is fairly expensive but I still come out ahead.

I fully fund the HSA every year. This year I think you can fund with ~$8500 or so (if memory serves). The only "cost" with my employer is the contribution. We also never touch the HSA. I rolled my HSA over to a Fidelity HSA which allows me to pick whatever investments I choose, even individual stocks. My account is sitting at about $90k now. I could pull the entire amount out given actual medical expenses for dental, medical, etc. but I just don't ever touch it.

My HDHP with my employer costs me some $15/month or so. I'd go this route even if I came out slightly behind relative to PPO just for the HSA.

62strat said:

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RightWingConspirator said:

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I always select the HDHP to get the HSA - the most powerful savings/investment tool there is. Don't over think it. Get the HSA.

---

would you say this if there was a cost to the plan with HSA?

My employer just changed their plans and we're in open enrollment.

Typical plan is no cost to me, but plan with HSA is ~$750 a year. Wondering if there's an analysis to do here based on my anticipated contributions. Obviously if I contributed nothing, it wouldn't make sense to pay for it.

---

This is so odd to me. My employer WANTS us on the HDHP. When I first selected it 10 years ago, it was completely free - for me and my dependent. Then I starting having to pay for my dependent. Then I started having to pay for both of us.

Next year, the monthly premium is going up from about $75/month to almost $120. I'll be paying more in premiums than my company puts in the HSA ($1000), which used to be the selling point. But it's still significantly cheaper than the other option.

One piece of advice I'd give anyone transitioning to an HDHP is you have to stay on top of your costs. I've only had 2 years out of 10 where we hit our deductible.

But medical billing staff see you haven't hit your deductible and mistakenly think that's your goal (NO, it's not!). When I questioned a bill from a doctor's office once, the admin literally said "But you haven't hit your deductible, yet!" I had to explain to her I wasn't trying to hit my deductible.

I have to watch bills like a hawk. And if possible, I NEVER pay anything on the date of service and tell them to bill me later.

In many ways. It's made me a more educated consumer, and I think we could all stand to learn more about (what a racket) medical billing is. But if you or a loved one has a really serious medical problem (like cancer), I could see where you might not want to take on this extra responsibility.

I'm 42 and have never contributed to an HSA, I feel so far behind in this space. I am starting to contribute to it this year after our company finally offering it. I have saved well in all other areas of life, but this one. Lessons learned I guess.

Thanks again for all the feedback!

In retrospect, as an early retiree not eligible for Medicare, the HSA is critical. I never planned on using it period, but I can now see scenarios where we likely will over the next 14 years as a backup. We have $100k to lean on there and I see it getting tapped in some capacity.

Very thankful for it.

TXTransplant said:

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62strat said:

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RightWingConspirator said:

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I always select the HDHP to get the HSA - the most powerful savings/investment tool there is. Don't over think it. Get the HSA.

---

would you say this if there was a cost to the plan with HSA?

My employer just changed their plans and we're in open enrollment.

Typical plan is no cost to me, but plan with HSA is ~$750 a year. Wondering if there's an analysis to do here based on my anticipated contributions. Obviously if I contributed nothing, it wouldn't make sense to pay for it.

---

This is so odd to me. My employer WANTS us on the HDHP. When I first selected it 10 years ago, it was completely free - for me and my dependent. Then I starting having to pay for my dependent. Then I started having to pay for both of us.

Next year, the monthly premium is going up from about $75/month to almost $120. I'll be paying more in premiums than my company puts in the HSA ($1000), which used to be the selling point. But it's still significantly cheaper than the other option.

One piece of advice I'd give anyone transitioning to an HDHP is you have to stay on top of your costs. I've only had 2 years out of 10 where we hit our deductible.

But medical billing staff see you haven't hit your deductible and mistakenly think that's your goal (NO, it's not!). When I questioned a bill from a doctor's office once, the admin literally said "But you haven't hit your deductible, yet!" I had to explain to her I wasn't trying to hit my deductible.

I have to watch bills like a hawk. And if possible, I NEVER pay anything on the date of service and tell them to bill me later.

In many ways. It's made me a more educated consumer, and I think we could all stand to learn more about (what a racket) medical billing is. But if you or a loved one has a really serious medical problem (like cancer), I could see where you might not want to take on this extra responsibility.

---

I should have added, my wife has had an HDHP with HSA through employer for several years now, and they contribute $100 a month, while we've slowly increased our contribution, up to $200 or so a month now I think.


Looking at our plan options, it seems the HDHP with the hsa is really not much of an hdhp. The deduct is $3500 (compared to $3k the typical plan offers), and after deductible it pays 100%, so that's your OOP max.

It's like they picked the most expensive HDHP so the deductibles didn't have sticker shock.. but the premiums aren't as low as they should be?

This is United healthcare.

Also my max contribution is only $4400.. not a ton.

62strat said:

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TXTransplant said:

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62strat said:

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RightWingConspirator said:

---

I always select the HDHP to get the HSA - the most powerful savings/investment tool there is. Don't over think it. Get the HSA.

---

would you say this if there was a cost to the plan with HSA?

My employer just changed their plans and we're in open enrollment.

Typical plan is no cost to me, but plan with HSA is ~$750 a year. Wondering if there's an analysis to do here based on my anticipated contributions. Obviously if I contributed nothing, it wouldn't make sense to pay for it.

---

This is so odd to me. My employer WANTS us on the HDHP. When I first selected it 10 years ago, it was completely free - for me and my dependent. Then I starting having to pay for my dependent. Then I started having to pay for both of us.

Next year, the monthly premium is going up from about $75/month to almost $120. I'll be paying more in premiums than my company puts in the HSA ($1000), which used to be the selling point. But it's still significantly cheaper than the other option.

One piece of advice I'd give anyone transitioning to an HDHP is you have to stay on top of your costs. I've only had 2 years out of 10 where we hit our deductible.

But medical billing staff see you haven't hit your deductible and mistakenly think that's your goal (NO, it's not!). When I questioned a bill from a doctor's office once, the admin literally said "But you haven't hit your deductible, yet!" I had to explain to her I wasn't trying to hit my deductible.

I have to watch bills like a hawk. And if possible, I NEVER pay anything on the date of service and tell them to bill me later.

In many ways. It's made me a more educated consumer, and I think we could all stand to learn more about (what a racket) medical billing is. But if you or a loved one has a really serious medical problem (like cancer), I could see where you might not want to take on this extra responsibility.

---

I should have added, my wife has had an HDHP with HSA through employer for several years now, and they contribute $100 a month, while we've slowly increased our contribution, up to $200 or so a month now I think.


Looking at our plan options, it seems the HDHP with the hsa is really not much of an hdhp. The deduct is $3500 (compared to $3k the typical plan offers), and after deductible it pays 100%, so that's your OOP max.

It's like they picked the most expensive HDHP so the deductibles didn't have sticker shock.. but the premiums aren't as low as they should be?

This is United healthcare.

Also my max contribution is only $4400.. not a ton.

---

So that's a good thing. To my point above on the deductibles being mostly aligned. All the more reason to go with HDHP + HSA because of the added benefits of the HDHP. Coverage should be the same. When these first came out, there was a large gap in deductible in that you would be paying OOP much more for an HDHP. Not really the case anymore.

YouBet said:

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62strat said:

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TXTransplant said:

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62strat said:

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RightWingConspirator said:

---

I always select the HDHP to get the HSA - the most powerful savings/investment tool there is. Don't over think it. Get the HSA.

---

would you say this if there was a cost to the plan with HSA?

My employer just changed their plans and we're in open enrollment.

Typical plan is no cost to me, but plan with HSA is ~$750 a year. Wondering if there's an analysis to do here based on my anticipated contributions. Obviously if I contributed nothing, it wouldn't make sense to pay for it.

---

This is so odd to me. My employer WANTS us on the HDHP. When I first selected it 10 years ago, it was completely free - for me and my dependent. Then I starting having to pay for my dependent. Then I started having to pay for both of us.

Next year, the monthly premium is going up from about $75/month to almost $120. I'll be paying more in premiums than my company puts in the HSA ($1000), which used to be the selling point. But it's still significantly cheaper than the other option.

One piece of advice I'd give anyone transitioning to an HDHP is you have to stay on top of your costs. I've only had 2 years out of 10 where we hit our deductible.

But medical billing staff see you haven't hit your deductible and mistakenly think that's your goal (NO, it's not!). When I questioned a bill from a doctor's office once, the admin literally said "But you haven't hit your deductible, yet!" I had to explain to her I wasn't trying to hit my deductible.

I have to watch bills like a hawk. And if possible, I NEVER pay anything on the date of service and tell them to bill me later.

In many ways. It's made me a more educated consumer, and I think we could all stand to learn more about (what a racket) medical billing is. But if you or a loved one has a really serious medical problem (like cancer), I could see where you might not want to take on this extra responsibility.

---

I should have added, my wife has had an HDHP with HSA through employer for several years now, and they contribute $100 a month, while we've slowly increased our contribution, up to $200 or so a month now I think.


Looking at our plan options, it seems the HDHP with the hsa is really not much of an hdhp. The deduct is $3500 (compared to $3k the typical plan offers), and after deductible it pays 100%, so that's your OOP max.

It's like they picked the most expensive HDHP so the deductibles didn't have sticker shock.. but the premiums aren't as low as they should be?

This is United healthcare.

Also my max contribution is only $4400.. not a ton.

---

So that's a good thing. To my point above on the deductibles being mostly aligned. All the more reason to go with HDHP + HSA because of the added benefits of the HDHP. Coverage should be the same. When these first came out, there was a large gap in deductible in that you would be paying OOP much more for an HDHP. Not really the case anymore.

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so what is the added benefit? I'm paying $750 a year more for it? i'd rather have a $5k deductible and not be paying more.

And the family premiums; the cheaper plan is $1100 a month, whereas HDHP is $1725 a month.. that's a huge increase to have a higher deductible.

It makes zero sense to me.

62strat said:

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YouBet said:

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62strat said:

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TXTransplant said:

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62strat said:

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RightWingConspirator said:

---

I always select the HDHP to get the HSA - the most powerful savings/investment tool there is. Don't over think it. Get the HSA.

---

would you say this if there was a cost to the plan with HSA?

My employer just changed their plans and we're in open enrollment.

Typical plan is no cost to me, but plan with HSA is ~$750 a year. Wondering if there's an analysis to do here based on my anticipated contributions. Obviously if I contributed nothing, it wouldn't make sense to pay for it.

---

This is so odd to me. My employer WANTS us on the HDHP. When I first selected it 10 years ago, it was completely free - for me and my dependent. Then I starting having to pay for my dependent. Then I started having to pay for both of us.

Next year, the monthly premium is going up from about $75/month to almost $120. I'll be paying more in premiums than my company puts in the HSA ($1000), which used to be the selling point. But it's still significantly cheaper than the other option.

One piece of advice I'd give anyone transitioning to an HDHP is you have to stay on top of your costs. I've only had 2 years out of 10 where we hit our deductible.

But medical billing staff see you haven't hit your deductible and mistakenly think that's your goal (NO, it's not!). When I questioned a bill from a doctor's office once, the admin literally said "But you haven't hit your deductible, yet!" I had to explain to her I wasn't trying to hit my deductible.

I have to watch bills like a hawk. And if possible, I NEVER pay anything on the date of service and tell them to bill me later.

In many ways. It's made me a more educated consumer, and I think we could all stand to learn more about (what a racket) medical billing is. But if you or a loved one has a really serious medical problem (like cancer), I could see where you might not want to take on this extra responsibility.

---

I should have added, my wife has had an HDHP with HSA through employer for several years now, and they contribute $100 a month, while we've slowly increased our contribution, up to $200 or so a month now I think.


Looking at our plan options, it seems the HDHP with the hsa is really not much of an hdhp. The deduct is $3500 (compared to $3k the typical plan offers), and after deductible it pays 100%, so that's your OOP max.

It's like they picked the most expensive HDHP so the deductibles didn't have sticker shock.. but the premiums aren't as low as they should be?

This is United healthcare.

Also my max contribution is only $4400.. not a ton.

---

So that's a good thing. To my point above on the deductibles being mostly aligned. All the more reason to go with HDHP + HSA because of the added benefits of the HDHP. Coverage should be the same. When these first came out, there was a large gap in deductible in that you would be paying OOP much more for an HDHP. Not really the case anymore.

---

so what is the added benefit? I'm paying $750 a year more for it? i'd rather have a $5k deductible and not be paying more.

And the family premiums; the cheaper plan is $1100 a month, whereas HDHP is $1725 a month.. that's a huge increase to have a higher deductible.

It makes zero sense to me.

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I wasn't aware your premium was that much higher which doesn't make any sense now that I see it. I think they have mis-labeled this plan?

HDHP + HSA should be cheaper premium and higher deductible. In my last two gigs, the premiums were way cheaper and the deductibles the same in one and $500 apart in the other. Made zero sense to go with the PPO.

fulshearAg96 said:

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Do I really need to fund a FSA if I have a HDHP?

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I don't understand the question??

You fund an FSA if you know you can use the funds.. has nothing to do with HDHP.

I read the question as "Do I really need a (LP)FSA if I have an HSA (that comes with the HDHP)?"

The nice thing about the HSA is you "set it and forget it" - meaning you don't have to worry about spending any of the funds in a specific time period and can treat it as a long-term savings account.

You do have to pay attention to LPFSA spend - which is why I only used it in years when I knew I was going to have a big expense not covered by our insurance.

Max contributions for the LPFSA are increasing to $3400 for 2026, and the max rollover will be $680. If the tax savings is worth it to you, and you know you'll be spending that on dental and/or vision, might as well go for it.

TXTransplant said:

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I read the question as "Do I really need a (LP)FSA if I have an HSA (that comes with the HDHP)?"

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Even still.. fsa and hsa are two very different things, and having one doesn't replace/negate the other.

I'd say you should use an FSA if you have daycare or other known medical expenses, whether you have an HSA or not.

I maxed out FSA for daycare for 5-6 years. Having an HSA would have had no bearing on that.

I would say, if you can only fund one of them, then HSA is the way to go. Then try and pay your bills with cash and let the hsa grow.

The LPFSA that is allowed when you are on an HDHP has very strict limitations. The funds can only be used on specific things, like dental and vision expenses. The limits are specifically because people with an LPFSA should also have an HSA. So, you really have to understand what the funds can be used for. I think that's the point of the discussion.

Dependent care FSA is an entirely different thing, that is (as you noted) unrelated.

Being in a HDHP means your premiums should be cheaper so how do you go from 1100 to a hdhp that is higher?

YouBet said:

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62strat said:

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YouBet said:

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62strat said:

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TXTransplant said:

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62strat said:

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RightWingConspirator said:

---

I always select the HDHP to get the HSA - the most powerful savings/investment tool there is. Don't over think it. Get the HSA.

---

would you say this if there was a cost to the plan with HSA?

My employer just changed their plans and we're in open enrollment.

Typical plan is no cost to me, but plan with HSA is ~$750 a year. Wondering if there's an analysis to do here based on my anticipated contributions. Obviously if I contributed nothing, it wouldn't make sense to pay for it.

---

This is so odd to me. My employer WANTS us on the HDHP. When I first selected it 10 years ago, it was completely free - for me and my dependent. Then I starting having to pay for my dependent. Then I started having to pay for both of us.

Next year, the monthly premium is going up from about $75/month to almost $120. I'll be paying more in premiums than my company puts in the HSA ($1000), which used to be the selling point. But it's still significantly cheaper than the other option.

One piece of advice I'd give anyone transitioning to an HDHP is you have to stay on top of your costs. I've only had 2 years out of 10 where we hit our deductible.

But medical billing staff see you haven't hit your deductible and mistakenly think that's your goal (NO, it's not!). When I questioned a bill from a doctor's office once, the admin literally said "But you haven't hit your deductible, yet!" I had to explain to her I wasn't trying to hit my deductible.

I have to watch bills like a hawk. And if possible, I NEVER pay anything on the date of service and tell them to bill me later.

In many ways. It's made me a more educated consumer, and I think we could all stand to learn more about (what a racket) medical billing is. But if you or a loved one has a really serious medical problem (like cancer), I could see where you might not want to take on this extra responsibility.

---

I should have added, my wife has had an HDHP with HSA through employer for several years now, and they contribute $100 a month, while we've slowly increased our contribution, up to $200 or so a month now I think.


Looking at our plan options, it seems the HDHP with the hsa is really not much of an hdhp. The deduct is $3500 (compared to $3k the typical plan offers), and after deductible it pays 100%, so that's your OOP max.

It's like they picked the most expensive HDHP so the deductibles didn't have sticker shock.. but the premiums aren't as low as they should be?

This is United healthcare.

Also my max contribution is only $4400.. not a ton.

---

So that's a good thing. To my point above on the deductibles being mostly aligned. All the more reason to go with HDHP + HSA because of the added benefits of the HDHP. Coverage should be the same. When these first came out, there was a large gap in deductible in that you would be paying OOP much more for an HDHP. Not really the case anymore.

---

so what is the added benefit? I'm paying $750 a year more for it? i'd rather have a $5k deductible and not be paying more.

And the family premiums; the cheaper plan is $1100 a month, whereas HDHP is $1725 a month.. that's a huge increase to have a higher deductible.

It makes zero sense to me.

---

I wasn't aware your premium was that much higher which doesn't make any sense now that I see it. I think they have mis-labeled this plan?

HDHP + HSA should be cheaper premium and higher deductible. In my last two gigs, the premiums were way cheaper and the deductibles the same in one and $500 apart in the other. Made zero sense to go with the PPO.

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I agree, the pricing is backwards on these options.

I wonder if the difference has something to do with that stipulation on the middle option is that you use certain doctors and the Surest app to "find the lowest prices".

Our HDHP plan has the exact same providers as the next plan up (our most expensive plan that does limit who you can see is being phased out).

We are BCBS, so it covers just about all providers. The difference is, you pay for all services that basically aren't preventative out of pocket instead of having a higher premiums, lower deductible, and a fixed co-pay.

Maybe on your HDHP, OOP costs aren't guaranteed by in-network negotiated rates?

My company is self-insured, so they have a vested interest in employees paying more of our medical expenses.

Otherwise, it does not make sense that an HDHP would have a lower deductible and lower OOP costs.

It's also so weird that it says the HDHP is best for expensive medications. The opposite is true. HDHPs typically only cover very basic, preventative meds. This is a big reason people at my company don't want to switch. However, you do have the freedom to use things like Good RX to keep prescription costs down if you are on the HDHP.

Ugh - edited this so many times because that info is so counterintuitive!

I seriously think that insurance guide was printed in error.

Very perplexing.

Yea something seems off

Here is the comparison.