Saturday, August 23, 2008

HSAs Suck

Over 2 years ago my company went to an HSA (Health Savings Account) for insurance. We're such a small company that getting affordable coverage is quite hard. They figured this was the best way to go. For those of you who aren't familiar with HSAs I'll sum it up for you: You pay a monthly premium that says, "I have insurance." That money doesn't go anywhere but to the insurance company. You keep nothing of it. You then pay over and above that to put money into your account for medical use. You have a wide variety of things you can use the money on from doctor's visits to buying OTC meds at the grocery store. You have no co-pays and pay for everything at cost. However, most doctors have a contract of some sort with the insurance company. Let's say they usually charge $150 for an office call. They'll submit that claim to the insurance and receive a letter back stating that they can only charge $90 due to their contract. You then receive a bill in the mail for the $90 that you have to pay. The idea is that you pay it with your HSA account, of course if you even have that in the account. HSAs have a high ass deductible...something like $3,000 per person per year. $5,000 per family per year. So basically what you want to do is put enough money into the account to at least cover your deductible. Of course financially you can only afford to put a certain amount away and with ongoing medical expenses it's darn near impossible to put enough money into the account to even cover your deductible. And since you don't have a co-pay you pay whatever the pharmacy wants to sell your medication for. For instance, I'm on birth control (no surprise) and I have to pay whatever they sell it for. I get no "breaks." Thankfully I found a company that has off brand birth control prescriptions. At $54 for a 90 day supply it's a heck of a lot more than a payment of $25 for 90 day supply. At the same time it's better than paying $100 per month for a pack, and given my coverage that's what I'd have to pay if I hadn't found this company. The "good" thing about HSAs are that they cover wellness visits 100%. Like when I go in for my annual exam and pap I pay nothing. But those circumstances are few and far between in the scheme of things. The point of HSAs is that you take hold of your insurance spending and price things around to see what's best before acting. That's all well and good but most doctor's can't give you that information until they see you and submit a claim to the insurance. Also the "good" thing is that it's "your" money. It's a form of retirement fund that you can cash out at a certain age. So given that, you try not to spend it because you want to save as much of it as possible. At least that's my thinking.

So that's the hell of HSAs in a nutshell. Hopefully I didn't lose too many of you. So that leaves me where I am. I personally have medical situations which I haven't addressed because I can't afford them. Of course anytime I bring them up my co-workers will say, "you need to take responsibility of your medical problems. You're young now, but could have some serious medical issues that you're not having treat." And the best thing....they say, "The doctor will just bill you." Now why in the hell would I want to have a bill hanging over my head. The bottom line is that it's a catch 22. I treat my problems and have huge bills or I just deal with the discomfort. In addition, anytime I go into the doctor 9 times out of 10 I don't feel like my issues are addressed and if they are it means it will cost A LOT more money.

I've had a nagging abdominal pain for the past 2 years. It's on and off so it's hard to catch it when it's going on. I went to the doctor and he couldn't palpate a thing. He ordered an ultrasound and a urinalysis with culture and sensitivity. I had the urinalysis performed and never received a call back. Finally, I called and come to find out it was negative. Yeah, would've been nice to get a phone call. And as for the ultrasound they couldn't get me in for a month. By the time the appointment came around I didn't have the symptoms. In addition, at $500+ a pop I couldn't see myself having it performed, especially since I had no symptoms at the time. So I'm back at square one. I have the abdominal pain on and off and it hasn't been dealt with.

Another situation...As everyone knows I've been on an anti-depressant. It took 3 medications to get me to be able to even handle the one I ended up on. I thought things were going great until recently I was having severe memory lose and having trouble connecting my thoughts. In the profession I'm in, this is unacceptable. So that coupled with the monthly fee of $30 for the medication I decided to wean myself off of it. So in another situation I'm back to square one. Now most people would say, "go to your doctor and see what they say." That's all well and good but every time I step foot in the door it costs me $90+ dollars. And given that this time the medication worked, but didn't, he'll recommend me going to another doctor to speak to someone for a more confirmed diagnosis. What does that mean? More money. I'll be put on another medication which means, more money. Money that I really don't have. Yes, I have money in our HSA but at this point it doesn't even cover our deductible so Heaven forbid anything seriously wrong would happen. I try to keep David's other lose knee far from my mind. At any moment it could go and we wouldn't be able to afford to fix it due to our shitty insurance.

And at this point I cannot put any additional money into it than I'm already providing. I'm already paying $150 twice a month to cover David's premium and for money to be placed into the HSA. Add onto that taxes and my placing money into my IRA I have approximately $350 taken out twice a month. That doesn't leave us with much.

The situation is utterly ridiculous. In my opinion it'd almost be best not to even have insurance. If I didn't have insurance I wouldn't go to the doctor. I have insurance now and don;t go to the doctor, but am losing money on the situation. The thing is, this is nothing new to those dealing with HSAs. Anywhere you look you see problems with the current state of the US health insurance problem. And I don't see the problems being addressed anytime soon.

I was hoping our situation would soon change since David got the job with the school system. It looks like he'll have awesome coverage. As for me, according to the school system, if my job offers insurance I have to take it as my primary. I can then add David's insurance as my secondary. So whatever my primary doesn't cover the secondary will. But given I have an HSA, technically it "covers everything," even though it doesn't cover shit, a secondary insurance will probably be a waste of money. So before doing my research it looks like the HSA's going to screw the pooch again. Big surprise. Only time and research will tell, but in our current state it doesn't take much to reduce me to tears just looking at it, seeing that more than likely my situation won't change.


Jan said...

Just take a deep breath. Things will work out. They always do.

Anonymous said...

Hey, I just got a new job 3 months ago. My wife and I are just surfing around the web trying to learn about an HSA to cover us and our kids. Found your blog both informative and quite entertaining! We can identify with your struggles and appreciate your sharing. We wish you the best. Thanks.
- J&L from Steubenville

Anonymous said...

I have an HSA. And at the moment, I'm feeling the burn. Wishing I'd gone PPO or something else. I didn't realize they don't put the full amount from your employer in at the beginning of the year. No, they slice it up into 24 bite size pieces and put it in your account that way. Nice. Now I can't get sick. If I do, I can try home remedies, or I can die quietly at home. If an ambulance shows up, I probably better wear one of those bracelets saying, "no transport" or something in case I'm unconscious and can't tell them not to take me. Hubby lost his job about a half year ago. Figured this would save us some money. Now I've got diabetes, he does too, he had to replace a DME equipment and now we can't fix our dental needs either because that too is pulled from the HSA. HSAs suck. I guess that's why they call it the "don't get sick" health plan. =( I'm so frustrated, I'm in tears.