I know this post is like a decade late and very boring, but I gotta post it anyway

Basically, with employer-sponsored health insurance the employer pays half and the employee (you) pays half. The cost of your insurance goes way down if you have a high deductible, and a deductible is basically what you’d have to pay before the insurance actually pays anything. So ‘high-deductible’ means you have to pay a lot before insurance pays anything, and it’s a lot cheaper to buy that insurance cause the insurers often just don’t pay anything ever. If it’s $5,000 before insurance pays a dime, often times you have to just pay as though you had no insurance. This is obviously bad, but it’s also cheap so like maybe you just luck out an never get sick or injured, right…?

Anyway, HSAs. Yeah, it’s called “Health Savings Account”. It’s marketed as a tax-advantaged, investor-y, bougie-“we’re comfortable” lifestyle way to really feel like a keen insider. Picture this: what if health insurance was individualized in the same way 401k and retirement stuff was, and you could “call your broker” at your “health savings account” to tell them to invest your tax-free “medical dollars” in the latest gizmo or whatever. Just deeply bad for solidarity and also very weird. And this is how basically everyone thinks about HSAs. A “tax-loophole” for the rich that I can also use because “I’m actually very financially savvy, just like the rich, who got where they are because of a weird hyper-individualized investment thing rather than any underlying systemic basis of societal organization”.

And you’re probably thinking: “But I already hate the suburban petite-bourgeois and their annoying mannerisms for reasons that are way less boring and meaningless.” Well you’re right, but also: high deductible plans are a requirement of HSAs so the employer’s half decreases significantly. Your employer doesn’t contribute to the HSA (they technically could, but if you’re reading this post they don’t [incredibly silly losing battle available there for libs]), so hopefully you do at least up to your deductible, but it’s pretty likely that’s not possible even if you had the money (no one does) because you literally aren’t allowed to due to contribution limits. (if people did have the money it would probably be better to get different / better / additional health insurance anyway.) But importantly and I guess obviously: nobody contributes to their HSA. It’s basically the chance for each person to individually manage an insurance fund for only themselves, which is almost exactly the same as paying out of pocket, the main difference being the additional bank account and a make-work program for MBAs. I’ve talked to almost a dozen office workers about this and they mostly have no idea what I am saying at all or say “yeah, I added money in onboarding, but I canceled it once I realized it came out of my pay.”

There’s no non-scam option btw if that wasn’t clear. And, yeah, obviously all health insurance is a scam, but this is a different scam run by a slightly different set of people (there’s def overlap though don’t get me wrong). The office job benefits world is basically a choice between varying levels of high-deductible plans + HSA (ie. $1.5k, $3k, $5k…) with maybe one ridiculously expensive low-deductible plan.

Anyway, thoughts? I needed to get this rant out, I guess. Maybe I just missed the discourse on this because I was a child at the time lol.

No one could explain was a deductible was to me until my late 20s. Probably because it makes no sense. I ALREADY paid you mfs, youre saying I still have to pay??

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31 points

I guess a deductible is incentive to stop you from walking into the surgery place and saying:

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definitely, because otherwise I would be getting elective wisdom teeth extractions every week

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20 points

It’s absolute nonsense. I recently just figured out what the difference between a deductible, out of pocket maximum, and coinsurance was. This shit is so horribly complicated for no fucking reason. Hells, even after learning all of that, I still have no idea if my insurance is good or not.

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This shit is so horribly complicated for no fucking reason. Hells, even after learning all of that, I still have no idea if my insurance is good or not.

No for no reason. They have to get as much money from you as possible while trying to limit how much you’re willing to use it because its impossible to know what you are going to be charged. And doctors and dentists will tell you that insurance covers things and then a month later send you bills.

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5 points
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And doctors and dentists will tell you that insurance covers things and then a month later send you bills.

I went to the doctors and my insurance paid for the visit. Cool. Expected since it was in network. Then a month later I get a letter saying I owe the clinic like $100 + $30 late fees because ooh sorry silly me I should’ve expected this random ass bill despite DESPITE signing a “no surprise billing” contract and no one and no app or receptionist explained I was going to pay again??

???

Turns out that in addition to the clinic visit, I also have to pay the specific doctor for his service??? Like a fucking tip??

Fucking annoying

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3 points
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I found a YouTube link in your comment. Here are links to the same video on alternative frontends that protect your privacy:

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I couldnt even figure out if my insurance was available in my state, so after a frustrating phone call with my mom I just chose not to buy any health insurance. Dental was cheap tho, thank god, otherwise I would have paid out the ass for my wisdom teeth extraction

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5 points

Pretty much yes. My current job offered me the choice between an HSA or a PPO, and once I read the terms of each the HSA came out looking so bad I wondered why they bothered offering the choice at all - but the monthly payment for the HSA is less, so I guess there’s my answer.

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4 points

My place pushes that HSA hard. They have it automatically checked and highlight it as “Recomnended for your personal circumstances” and have a little section where they try to make it look great.

PPO is the way for most people to go

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3 points
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8 points
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what if health insurance was individualized in the same way 401k and retirement stuff was, and you could “call your broker” at your “health savings account” to tell them to invest your tax-free “medical dollars” in the latest gizmo or whatever.

Lmao. No way. You’re kidding right? HSAs are literally just investment accounts, but it’s just branded as being health related?

The cost of your insurance goes way down if you have a high deductible, and a deductible is basically what you’d have to pay before the insurance actually pays anything

I don’t get this shit at all lol. My health insurance pays like 85% of clinic visit fees. I’ve called them on multiple occasions and asked about my deductible. Apparently if I meet it, they’ll start paying 80% of my bills? But they literally already do! What exactly is the benefit here? Do they mean they’ll pay 80% of hospital procedures or some shit?

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4 points

Yes. Which is a fuckton of money if you need surgery or something. 20% of a hundred thousand dollar procedure is more than I could afford.

If you are a very young homebody who is otherwise healthy, and you have decent future prospects for moneymaking, it might be worth your while to build up an HSA over time. Put it in S&P 500 and don’t fuck with it and by the time you’re old, you’ve got mad loot. Assuming wall street still exists in 50 years.

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2 points
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