Health accounts heal pocketbooks (Government Finally Gets One Right!!! My Title)

How 'bout around a hundred sixty bucks a month for someone age 40 to 49... available from several providers?

Nope, I got a quote of seventy bucks a month from a provider a few years ago, I actually paid a few months premium before realizing that I was dishing out over 800 a year for practically nothing. The coverage was so poor, about the only people who could get a dime back on it were those who padded their expenses up with chiropractors, massage therapy, naturopaths, etc.

The thing is, I don't believe in quack medicine, and I don't waste money on someone to hold my hand. WA state requires insurers to cover all this pablum, so the potential expense for them is reflected in our health insurance rates. I suppose if someone made a frightfully high deductable, say $5,000, that might make premiums dirt cheap (all they're taking a chance on here is an accident or a heart attack), and I'd think about paying 35-40 dollars for a piece of paper that made my HSA contributions tax deductable.

By the way, I saw on NBC news tonight, here in WA, there is a network of providers who do a cash-only business, no insurance hassles, no paperwork, no billing, just cash and carry. Fifty bucks an appointment is what it costs, sounds like a plan to me. They showed a couple who started getting racked for $700 a month in insurance premiums, who went to catastrophic coverage only, and pay out of their own pocket for the little stuff. Of course, there was some insurance whore pooh-poohing the whole concept.

I'm not sure what the difference is, we have several plans where I work and they are all essentially 100% tax deductible. We have the new HSA plan available this year, but all other plans are paid with untaxed dollars through our section 125 accounts. Besides premiums, we pay deductible and copay amounts with a charge card that is tied to the account, so there's no hassle with paperwork to get reimbursements. The only thing I don't like about the section 125 plan is that you have to plan ahead to make best use of the funds, and work around the calendar with the elective stuff (do things like buy new glasses or stock up on supplies in December with leftover money, or wait for January to do that root canal if you are short).

Would be better to be able to just pay as you go, and there's really no logical reason that bona-fide health care expenses shouldn't be tax deductible from the first dollar without resorting to such gimmicks. Health costs are going out of control because of an unhealthy interaction between insurance industry practices and government regulation. People having more flexibility and control would do wonders to lower costs. Congress oughta just do that (but then it makes too much sense I guess).

>> Of course, there was some insurance whore pooh-poohing the whole concept.

Predictable. But that's the sort of coverage that would make the most economic sense for darn near anybody. If that sort of thinking were near universal though, lower deductible coverage for folks with known heath problems would go through the roof - and there might need to be some sort of partial subsidy worked out for some of the poorer working class who have unusually high expenses. And I'd go for that. It would be less expensive and more efficient than a single payer scheme.

True story: I'm with Blue Cross in FL. In 1988 we were paying $4000 for 80/20 family of 5 with maybe a $500 deductible. We went for some 4 years getting only occasional "benefits". As we were all basically healthy at year end I went with a $5000 deductible dropping the annual to ~ $2300. Turns out there's a rider that says that anything over $2500 deductible allows the hospital, lab, etc. to charge you anything they choose - NOT THE BLUE CROSS NEGOTIATED "ALLOWED AMOUNT" - until of course you've met the deductible - at which point the negotiated (much lower rates) kicks in because BC/BS would then have to kick in at the 80/20 rate.

Ping anyone on this post you choose but to all - be careful with a high deductible.

Oh - almost forgot - my wife has been recently diagnosed with Type II (adult onset diabetes) and BC/BS says we're stuck with our high deductible and cannot change even with "medical underwriting" - medical exam to qualify.

And the kicker - other insurance companies will treat her as having a "pre-existing" condition and exclude coverage for her. Just be careful with high deductibles. I'd be happy to respond to any FReepmail with the rider's ID.

I'm an ex-lawyer (CA), now in FL, and reading this rider you wouldn't have a clue as to its meaning 'til they "'splained it to you". :-(

Oops - in the first paragraph - policies with a $2500 deductible or larger are all subject to the rider. Sorry.

All fixed now. ;-)

I'm in my second 40 years of the miserable health insurance business. I have NEVER trusted the Blues Brothers contracts and administration, as they have never had to abide by the same rules as actual insurance department regulated insurance companies!

It should be obvious why they have survived where most commercial insurers have pulled back or out of the market place. The Blues Brothers are techincally not "insurance" at all, but nothing but a contract for pre-payment for services, just like HMO's which are also technically not "insurance" and thus, in most states not regulated as stringently.

Therefore... They get away with crap like you described and complaining to your state insurance department for consumer protection does no good. In CA they are regulated by the department of corporations who don't even know how "insurance" is supposed to act. Also, the Blues Brothers are NOT a "national" outfit, but a loose association of independent outfits, operating differently in each state.

They advertise so heavily that due to competitive pressures I've had to use one of the Blues Brothers here in CA that has voluntarily submitted to insurance department regulation in some areas, but they still don't comply with some of the mandated provisions in their contracts that "insurance" companies must to protect consumers! This allows them to have more "competitive" rates that fool consumers all the time.

Trust but verify. Insurance, or especially pre-payment for service organizations are not some sanctified "belief system," but merely contracts put together by your clever colleagues. It's STILL "caveat emptor" unless you are willing to trust an experienced, competent Broker who reminds you that the cheapest is certainly NOT always best, which you knew already, right?

"According to Dr. Edward Langston, a family physician in Lafayette, Ind., if spending comes from a patient's personal account, he will likely be more responsible with his health care. Langston said Health Savings Accounts are the first step toward successfully controlling medical spending."

Last year, I was told that I needed two dental crowns and an implant for one of the crowns.

Nothing was an emergency so we scheduled the pre implant surgery last year to use the rest of the my wife's health deduction (cafeteria plan) for 2003. Then she opted for her max in 2004. So I had the implant finalized and the two crowns made and installed this year. That depleted my wife's account.

On my last visit my dentist informed me that I needed two more crowns. I told him that I would wait until Jan of 2005 because my wife's current cafeteria plan was tapped out. He looked a little irritated at first, and I explained the tax advantages for us. He said, "Sure, you should be okay until then!"

By the way, I saw on NBC news tonight, here in WA, there is a network of providers who do a cash-only business, no insurance hassles, no paperwork, no billing, just cash and carry. Fifty bucks an appointment is what it costs, sounds like a plan to me. They showed a couple who started getting racked for $700 a month in insurance premiums, who went to catastrophic coverage only, and pay out of their own pocket for the little stuff."

Congratulations!!! That is exactly the principal concept of the Bush signed HSA law with additional tax incentives!!! You couldn't possibly have illustrated it better!

Some of the "insurance whores" you impugn include many Brokers who are good and decent conservatives who have hated the system that has become overburdened by the leftist legislated mandates, especially in your state, that have exploded the cost of health insurance!!!

We are the ones that have had to face the irritation and wrath of clients who got the rate increase notices and were justifiably "Mad As Hell!" Legislators make terrible designers of coverage contracts because they don't have to deal with their "unintended consequences," which are intended by leftist legislators to cripple the system so we'll all have to go to Hillary Care!!!

Which is why I put in the title of this thread:(Government Finally Gets One Right!!!)

The great thing about the new HSA, as opposed to your wife's "cafeteria plan" is that there's no "use it, or lose it" provision to be careful about in calculating what expense may pop up during the coming year.

The only thing one needs to be concerned about is funding enough for the high deductible and you can take a chance and calculate that over 2, or even 3 years, instead of just 1, if you wish. Whatever you fund is deductible in that tax year!

Whatever you fund, if unused, just accumulates from year to year, like an IRA and can even be used to pay for Long Term Care Insurance premiums with fully tax deducted dollars now, or in the future!!!

You don't even need to buy a dental plan, unless you want to trade dollars with an insurer, because you can do exactly as you reported from your account. With some set-ups for HSA I've seen, you get a "Debit Card" with your HSA bank account and after you dicker with the Dentist on the price, you just swipe the card in his machine and it's taken care of!!!

Even over the counter medicines at the Pharmacy... same deal. Just make sure it's stuff on the IRS list of legitimate stuff that has normally been legitimate under itemized deductions on your tax return! No deductible, No hassel, No paperwork (the bank statement is your record)... Super!!! It's hard to believe government approves of something so practicle!!!

"The great thing about the new HSA, as opposed to your wife's "cafeteria plan" is that there's no "use it, or lose it" provision to be careful about in calculating what expense may pop up during the coming year."

Actually, that hasn't been a problem the past few years. The problem has been that the limit on her cafeteria plan has been too low.

Since, she may retire next year, are there any plans for old retired Freepers like me re the HSA's?

Ironically, this dentist is one of the reasons why we have utilized my wife's cafeteria plan. When I retired, our not very great Dental insurance plan would have gone up to about $1,000 per year, and its coverage was not good.

His suggestion/advice was to put that $1,000 per year in a savings account or one of the cafeteria plans versus sending the money to a not great dental insurance plan. We did and it has worked out well for us.

I'm thing about talking to him about the Chinese method. We will just pay him so much per month for dental care, and he will not charge us except his cost for a crown.

Family practioners have done this for a few years in the Seattle are. Their patients pay them a flat rate /month or year. Then, they are treated with no costs with the exception of lab tests and other services not done in the offices. Of course any hospitalization, surgery and such are not covered.

Take a look at my reply above about the "Blues Brothers" not being technically "insurance," but rather a contract for pre-payment for "services!"

Yes! Anyone can make an agreement/contract with any service provider for pre-payment of "services" without ANY 3rd party such as an HMO or PPO or the "Blues Brothers!"

Most people don't do it because they don't want to be "bothered!" They want the "convenience" of joining an organization and spreading their risk amongst many thousands of "subscribers" (not policyholders as with "insurance" that is more carefully regulated!)

HSA's are available to EVERYONE that is covered by a HDIP (High Deductible Insurance Plan) Medicare's deductible isn't high enough so that pretty much rules out those over age 65, unless they are still covered primarily by a retirement health plan with Medicare as "secondary" coverage!

BUT... The employer provided retirement health plan must be a HDIP and none of those exist yet, to my knowledge.

Some of the "insurance whores" you impugn include many Brokers who are good and decent conservatives who have hated the system that has become overburdened by the leftist legislated mandates, especially in your state, that have exploded the cost of health insurance!!!

Sorry, I should have clarified, the "insurance whore" I was speaking of is a Dr. Bob Blendon, professor of health policy at Harvard University, who stated that only 5 to 10 percent of Americans could benefit from such a system as the SimpleCare plan. Somebody who sits around contemplating his navel in an ultraliberal think tank is not going to lead us out of the chaos, and I'm surprised that NBC News did not go to someone who deals on the front line of health insurance, such as one of the honest brokers that you mention.

Of course, you realize that health insurance is being taken over by a large group of hucksters that have moved in, and unless the decent people you speak of find a way to kick them out, soon enough, they'll be considered on a par with used car dealers. Perhaps you can recommend someone dirt cheap to purchase catastrophic insurance from here in WA, I'd be interested. The HSA is a great boon to us all, it makes sure that middlemen get cut out of the deal.

By the way, I emailed SimpleCare, and suggested that they take things one step further. Perhaps the contract between a SimpleCare provider and a SimpleCare patient should include mandatory arbitration, so we can cut the ambulance chasers out of the mix, too. When I need a prescription, I want to see a doctor, not sue a doctor.

Excellent reply! You are so absolutely correct!!!

Sorry, my license is only good in CA and my only experience with WA is having one of my clients move to WA at about the time in the mid 1990's that your legislature went more berserk than even CA's about mandating benefits into health insurance that were never actuarily designed to ever be a risk to be covered by said "insurance."

So the national "insurance" company I had them with in CA naturally decided to not renew that policy in WA that had gone beyond the pale as far as the rest of the states were concerned.

That "Simple Care" concept is a good one, except that I'm not sure it's truly an actual "insurance" policy against a mega-claim, is it? I'll have to go back and read your previous comment/description of it on the thread, I guess. Your suggestion to them sounds terrific!!!

If anyone has been whoring around this and the Workers Compensation Insurance issue, it's been the Litigators and Allegators, making allegations like Consumerist Activists, but who are really Socialist Activists that collude with the Media Activists, passing themselves off as supposed Journalists!!!

Yes, you are absolutely correct again about the "Hucksters!" Unfortunately, in a free society with a free market system, the legitimate brokerage community comes off as a "Special Interest," or a bunch of "Lobbyists" whenever we organize to make it hard for these creeps to do business!!! We begin to be likened to "Unionists" feathering our own nest, which is probably true!

That's exactly why "Caveat Emptor" cannot be done away with through government! The buyer MUST beware AND be aware which he/she will become when paying for the routine expenses out of their tax free accumulation account in an HSA, prior to meeting their high deductible. Now it'll be part of their "Nest Egg" involved in paying the small bills and they'll "Pay Attention" instead of ignoring the basic problem of what's been feeding the inflation in healthcare costs for the past 30 years!!! (third party payors)

Insurors actually love competing for covering a quantifiable, measurable risk that has a lower frequency of occurance! They hate the administrative cost of constant first-dollar claims. They want the time to earn a return on premiums before they are paid out in claims again based on a stable risk pattern. HSA's are one of those rare "Win/Win Propositions!" You might call it a synergistic solution in the making.

One may criticize President Bush and the House Republicans for the Medicare Prescription Drug Benefit, but the HSA part of that bill has real redeeming social value for the entire medical system in the United States!!!

My employer offers the option of an HSA plan. They contribute $1000 annually to the HSA. Beyond that, the employee has to pay $500 out of pocket before 80/20 coverage kicks in. Sounded like a good plan until I found out when you leave the company, they keep any accumulated balance. I shop around and economize to build up the HSA balance and they keep it in the end? Wasn't much of an incentive to me.

That is NOT offically an "HSA!" That is another animal that is technically and legally not a true HSA! One of the biggest features of the new HSA is portablity when you leave the company. You can even pay COBRA premiums with your fund, or other temporary health coverage while on unemployment!!!

There are hardly ANY employers who have had time to set up a true HSA as of yet, because it's so new.

Thanks for the info.
If the company ever offers a real HSA I will sign up.

...your legislature went more berserk than even CA's about mandating benefits into health insurance that were never actuarily designed to ever be a risk to be covered by said "insurance."

Well, for that, we can thank the Naderist Deborah Senn, who as Insurance Commissioner made it her mission to ramrod these socialized medicine bennies through the legislature. She actually ran for the US Senate, and was narrowly defeated in the Rat primary by Maria Cantwell, who won the election over RINO Slade Gorton. Now, Cantwell is a bought and paid for subsidiary of Hillary, and I really don't know which one of them would have been worse.

That "Simple Care" concept is a good one, except that I'm not sure it's truly an actual "insurance" policy against a mega-claim, is it?

No, its just an association of providers and patients. The cost for patients is $29 per year for an individual, and $39 for a family. They charge prospective providers even more, about $150 for an initial listing, and a third of that for an annual renewal. This covers the costs of the website, and of issuing cards and such. It's designed to ideally work with catastrophic coverage, and gets used by people who have no health insurance. You can check out their website at www.simplecare.com

One of the problems I have with it is that they have very few providers in my area, and most of those are naturists or osteopaths. I wouldn't mind driving an hour or so to find a provider in Tacoma, with as infrequently as I use medical services.

I agree that the HSAs were the "sleeper" provisions of the Medicare bill, and it was one of the reasons I was happy that legislation passed. It's also the first thing John F'n Kerry would kill if he could. The challenge comes from finding super cheap catastrophic coverage. It's like auto insurance, I'm a careful driver, with a sterling record, I just want the cheapest stuff available to have a card to show to a cop who stops me for a burned out taillight.

Very well. I sincerly wish you the best on finding what you need and want. I liked hearing about your politics up there, too. I follow it as much as I can, but I must admit I follow CA's a whole lot closer.

Thanks for the BC/BS info. Freepmail me if you know of any national family plans that are simply "major medical" - catatrophic coverage. I couldn't do worse than we are with BC/BS

;-)