Health Savings Account: A Year in Review

Back in August of last year, I wrote an article here that asked if you should you switch to a Health Savings Account.This article was popular – and garnered some controversy. I think the controversy was due to the fact that there is still a large percentage of the population who are misinformed on what a High Deductible Health Plan with a Health Savings Account(HDHP/HSA) really entails.

To review, this type of plan consists of a high deductible amount – for my family plan it is $3200 for in-network healthcare. After you’ve met the deductible, the insurance company usually pays 80% and the plan holder pays 20%. But there is typically a maximum out-of-pocket amount that you will have to pay each year . For my plan, and I know this is the case because I reached it this past year, it is $6000. Your plan may vary so check with your plan administrator. What this basically means is that when you have paid out $6000 for that year, the insurance company pays the full amount of your in-network healthcare services. Once again, I am talking about using in-network providers because the deductible for out-of-network providers is significantly higher. By the way, this past year I only used in-network providers.

At the beginning of each year the employee decides on how much pre-tax money they are going to contribute to their HSA account. For an individual, in 2011, the maximum is $3050 and for a family the maximum is $6150. An equal amount is taken out of each paycheck and this amount goes into the Health Savings Account which is tied to a bank. The employee will receive a debit card which is tied to this bank account and, if desired, a checkbook. When you go to a doctor there is usually no co-pay to be paid and after negotiation with the insurance company you will receive a bill in the mail. At that time you can pay for your services out of this account with your debit card or with a check.

What is the advantage of the high deductible health plan? The greatest advantage is that if you have money left in your account at the end of the year you keep it! JP Morgan, who has been administering Health Savings Accounts since their inception, reported in their 2009 Program snapshot:

68% of accountholders contributed more than they spent during each month in 2009

This is the beauty of a Health Savings Account. If you don’t use it, it’s your money to keep. And that money can compile year after year. And, just as your 401K, you can choose to invest this money in various investment options. You can also use this money for any eligible healthcare expenses including contact lenses, dental work, psychiatric therapy sessions, and a myriad of other expenses.

My first-year overall impressions

First off, I’ll say that I am not one of the fortunate ones who had money left over in my Health Savings Account at the end of 2010. This past year just happened to be a very busy one as far as my family was concerned when it came to healthcare. We are all fine but there was no money left over in the account. But, I still love the plan.

Why? Well, I feel like I have some control over my health care now. I also have much more awareness of what I am paying for and what the charges are for certain procedures. I’m not just throwing my money into a “black hole” and waiting for the insurance company to tell me how much I owe for services.

Enhanced communication with your providers

With the HDHP/HSA plan, I am taking a much more active role in my health care. And I feel very good about that. As a result, I am communicating much more with my providers. Instead of just talking about my health with my doctor I’m now asking what procedures cost. Since I’m responsible for the first $3200 since that is my deductible, I’m certainly going to ask the pertinent questions. I know that some doctors don’t like this but that’s too bad — it is my health and my money. And one thing I learned from my primary care physician is that his compensation is directly related to how much money he generates for the hospital. So, if your doctor suggests that a procedure such as a prostate biopsy be done on you, you can give your opinion and ask for another PSA test before the procedure. This happened to me this year. My urologist was pushing for me to have a prostate biopsy but I asked for another PSA test. You know what happened? My PSA count went down which meant that there was no need to have a biopsy at that time. That procedure would’ve cost $1000 (plus lab fees) for reading the results.

You must get involved

With a High Deductible Health Plan you, as a consumer, must be involved. In other words, you should keep your receipts and keep track of your payments. I have a spreadsheet that tracks all of my spending when it comes to my health plan. Since you can pay for your healthcare with non pre-tax money, you definitely want to keep track of how you are paying for your medical services. If you keep your receipts and keep track of how much you are paying with your non pre-tax money, you can pay yourself back when there are funds in your HSA account. You can simply write yourself a check but you must be able to prove to the IRS that this money was for eligible healthcare expenses. This is another one of the added benefits of a HDHP/HSA plan.

Tax benefits, funds accumulate and no “use it or lose it”

Just the fact that you have another vehicle to put pre-tax money into is an added tax benefit to the consumer. And, if you are fortunate to have funds left at the end of the year that money will continue to accumulate in your account. There is no such thing as use it or lose it funds which is what you have with Flexible Spending Accounts.


Even though I didn’t have any money in my account at the end of 2010 I still think an HDHP/HSA plan is the best way to go for me and my family. I am hoping that this coming year our healthcare expenses won’t be nearly as high as last year. If that happens, I will have a surplus of funds at the end of 2011.

So if you are considering jumping into a high deductible health plan with a health savings account, do your research. Find out the details of your plan such as what your out-of-pocket maximum is and whether it makes sense for you and your family. You just might come to the conclusion that taking control of your healthcare and your finances with an HDHP/HSA plan may be just what the doctor ordered.


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  1. Jessica Journey on the 29th January

    2010 was my first year to use a Health Savings Account. I, too, was very pleased with the program! Of all the different benefit programs I have used, the HSA gave my family the most flexibility and the most control over our finances. Thanks for telling folks that it is a viable, relevant option!

  2. Bob Bessette on the 30th January

    Hi Jessica,
    Thanks so much for your comment. I’m surprised there weren’t more people chiming in on the article because my last one was pretty popular here. I think it’s probably because everyone has already chosen their health plan at this point so they are all set for the coming year.
    I love the HSA plan even though I had no money left over in my account at the end of the year. I know a lot of people who did. I just think it gets you more involved and there is not much risk due to the maximum out-of-pocket with my in-network services.
    Thanks so much for your contribution and I hope you and your family stay healthy!


  3. Suz on the 9th March


    Thanks for a great article 🙂 I have a couple of questions that I think you might be able to answer. Not sure if each Insurance Co- or each HSA bank is the same, but I received some very scary reports about Mellon Bank of New York as charging origination fees, departure & low balance fees and also that the health insurance co (not sure which co- but out of NY) which used to negotiate fees & offer $15.00 generic prescriptions no longer offered those options. I am in PA, considering openning an HSA (found a bank out of chicago which does not load fees, or have min balance requirements) and yet I am unsure about the Insurance co? I will be calling them soon, but was worried I might not get the complete answer & wanted to ask someone who has experienced this journey??? Thanks so much! great site!

  4. Calvin on the 5th April

    Thank you for the great article. I had a HSA last year 2011 and have money left over. Then I switched from the high deductible health plan to a HMO this year in 2012. My quick question is Can I still use the money left in my HSA in 2012 and on without an active high deductible health plan? Thank you!

  5. Pre TaxHealth on the 26th August

    HSA is a good solution for people paying high deductible. HSA relieves people from worrying about their savings. Funds are retained in the account safely or can be calimed immediately at any situtation unlike other insurance company. This one main advantage of HSA has pulled many people to start HSA.

  6. prostate on the 7th December

    Excellent topic, if I may also add… Salmon is such an excellent food when trying to lose weight.
    It has so many nutritional benefits, and can help keep you going for a long period of time.
    If you are a little afraid of cooking fish, canned salmon is an excellent, affordable alternative, that will taste wonderful.

  7. cowan jeffers on the 15th March

    This health plan is not for people who live paycheck to paycheck. How can people who could barely afford to pay the rent or mortgage supposed to have $3200 sitting around? Are you people for real? What about the folks who make less than $50,000 and who have children, a mortgage and health problems from the previous years and no savings due to paying health insurance and out of pocket expenses? What about them? How can this health plan help them??

  8. Ken on the 15th April

    Health Spending Accounts provide wonderful tax relief. Thanks for the article.

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