Raw Onions Give Me Heartburn
A Story About Health Savings Accounts
A while back a family member of mine (we’ll call him Jim to protect the innocent) made an appointment to see his doctor due to a new, unfamiliar yet mild, pain in his chest. Being young (mid-20s at the time) and otherwise very healthy, Jim had chosen a Health Savings Account (HSA) health plan from his employer earlier in the year that had the highest deductible ($3,500 for individual) and lowest contribution per paycheck. Makes sense, right? As chance would have it, Jim’s mild chest pain began soon thereafter.
The doctor tested Jim’s blood work and ran through a series of questions. All looked good. The doctor, in an effort to find the root cause, recommended a Trans-Esophageal Echocardiogram or TEE. This is where it gets interesting…
Light bulb #1: Jim asked the doctor, “How much does that test cost?” To which the doctor replied, “Don’t worry; it’s covered by your insurance.” Jim then explained to the doctor that he was in a “new” HSA plan and was responsible for the first $3,500 of any/all claims. The doctor replied that the test runs “about $2,500.”
Light bulb #2: Jim, knowing the doctor was trying to find the root cause, but not wanting to pay $2,500 for the test, asked another important question to his doctor: “Is there a reasonable alternative to that test?” Jim’s doctor responded that, since the blood work looked good and didn’t feel he was in any apparent danger, he requested Jim keep a journal of what he eats. Three weeks later, Jim realized through his journaling that raw onions give him heartburn.
Ahhh, consumerism at its finest! The beauty is that, in the event Jim’s condition was serious, and big dollar inpatient claims were to follow, Jim’s HSA plan offered him the catastrophic protection he needed. Due to 100% coinsurance, Jim’s maximum out-of-pocket was capped at his deductible level of $3,500. With that, Jim could have aligned care with the best doctor and facility in town if inpatient services were needed. He wouldn’t want to “price shop” open heart surgery and wouldn’t need to.
So what areas can Jim price shop?
- How much does your doctor charge for an office visit? Rest assured it’s not $20, and those that simply pay copayments likely have no idea what their doctor actually charges. HSA participants tend to know exactly what their doctor charges for office visits.
- Do I take my non-emergency situation to the emergency room. Or find an urgent care facility? Or try to see my family doctor? Urgent care, in many cases, will cost less than half of the ER, and your doctor could charge half of urgent care.
- Is there a generic or therapeutic equivalent to the brand drug my doctor prescribed? In a prescription copay environment there may be a $20-$50 spread between generic and brand drugs. When paying the actual (discounted) retail cost of the prescription through your HSA plan, that difference (and potential savings) could be hundreds of dollars.
- The cost of tests like MRIs can vary greatly from one location to the next. If your doctor recommends you get testing done at a certain location, this is merely an option for you. By using price transparency tools you can find the most cost-effective MRI facility in your area.
As Jim’s story proved, HSA plans tend to create better healthcare consumers. It starts with behavioral change, engaging with your healthcare practitioner, using price transparency tools and taking ownership of your own health and circumstances. All this is good stuff, and we didn’t even speak to the tremendous tax advantage that HSAs also provide. For more information on HSAs and their benefits, contact a member of the ‘A’ Team.
- But I Really Like My $20 Co-Pay!
- Health Savings Accounts: Your Healthcare 401(k)
- HSAs: Consumerism at its Finest
- The Perfect Match
- Total Cost of Employee Benefits Calculator
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