Take a worse health plan to be HSA eligible?

[significantshawn114]

It's benefit open enrollment season at work and I'm in the need of some advice. My company has about a few health insurance plans to choose from, and I've narrowed down to 2.

Option #1

$81 premium

$790 deductible

$3,700 Out of Pocket Max

$20 co-pay for physician office visits

Option 2 - HSA eligible

$95 premium

$1,500 deductible

$2,500 Out of Pocket Max

Deductible + 20% for physician office visits

Obviously this is a very personal decision. In my case I'm a healthy 36 year old that visits the doctor once every three months to get a refill of a prescription. Currently I pay $20 each visit and $18 for my prescription. I’m about to start a new prescription that insurance has denied coverage for and will run me $350/month - all out of pocket. Is having HSA access worth it for a higher deductible and doctor visits not being a small co-pay?

If I get an HSA, I planned to use the money from it to pay for my prescription so that I can get the tax savings. I've also heard people suggest not using the money put into an HSA and instead just letting it grow. I like the idea of that, but I also want to make that $350 monthly prescription cost go down as much as I can and paying for it with an HSA seemed like a good way to cushion that blow a little.

So my current job is fairly new as I started last December. I set up my insurance and quickly realized that my therapy sessions weren't covered. I was paying $20 a session, but now they would be $150 until I reached my deductible. I've also considered getting a vasectomy, but never pulled the trigger because of cost. So correct me if I'm wrong, but once I hit my out of pocket max, insurance should pick up everything 100%? Here's what Option #2 says about covering these:

Mental Health Services: Deductible + 20%
Voluntary Sterilization: Deductible + 20%

Any advice would be great!

Thanks!

[LivingAlmostLarge]

I'd like to know what others say because I totally don't understand how this whole OOP works either. I know we do not have a HSA and I'm not sure where we will end up this year.

[Bozzdivine]

Hey significantshawn114, While the deductible for Option #2 is higher, the out of pocket max is lower, which is beneficial in case of unexpected health expenses. It seems that the HSA could be a good fit for you, considering the high cost of your new prescription. The tax advantages might outweigh the higher deductible and co-pays. As for your therapy sessions and potential vasectomy, yes, once you hit your out of pocket maximum, insurance should cover the rest. Just keep in mind that the deductible and co-insurance will still apply to these services. Ultimately, it's about what makes you comfortable and meets your financial and health needs. If the potential savings from the HSA are significant enough, it might be worth considering. Hope this helps!