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Comment by prokes | Hacker News Reader

You may want to consider a High Deductible Health Plan (HDHP), which generally offer lower monthly premiums for a higher deductible. This reduces your monthly cost but should something happen, would require more paid out of pocket before insurance contributes. The main benefit is a safety net in case something serious happens.

Additionally, with an HDHP you may be eligible for a Health Savings Account (HSA), which are tax advantaged savings for medical coverage, reducing your cost of care.

If you're interested in HSA's I have blogged on their benefits[1] and wrote a web app to track your HSA spending[2].

[1] http://www.hsaedge.com/ [2] http://www.trackhsa.com

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Absolutely consider an HDHP. I did a ton of analysis on how much I paid in premiums versus how much was actually paid out on my insurance plan, and I discovered that in a typical year on my old "gold" plan, I paid out twice as much in premiums as the insurance company paid on my behalf. To put this in real terms, I paid $12k in premiums and I needed $6k in care. My HDHP premium is more like $1.5k, and although the idea is that I pay for everything out of pocket, I've been surprised at the amount of stuff that's been covered as "preventative". And the out-of-pocket maximum is capped on the HDHP to barely more than the amount I paid in premiums on the "gold" plan. I encourage you to run the numbers. It's really eye-opening.

It's interesting to see different people have such different experiences. For me, my wife and I both have chronic health issues, in her case more serious ones, and so HDHP makes no sense for us. I can see how for people without those issues it can make a lot of sense if you use your insurance less for chronic treatment and more for preventative care and, as you said, a safety net. On the plus side, you can generally switch from HDHP to a low deductible plan at the next plan year start date should your situation change (as ours did).

Yeah, that makes sense. The way it works out for me, even a year with astronomical healthcare costs is only going to cost me a couple thousand more because of the HDHP, and I saved nearly $8k last year due to the extremely low premiums, even after considering the out-of-pocket healthcare costs for my whole family. The way I look at it, that $8k has already paid for 2-3 hypothetical worst-case years sometime in the future.

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