Compound It! Why I'm not planning on an HDHP next year…

One of the goals of the HSA Store Learning Center is to highlight how great HSAs can be for people looking to save tax-free money for future healthcare needs. But we also aim for transparency, and will point out situations when an HDHP doesn't always make sense for people. Since it's open enrollment season, we've asked our team of writers to share their own stories about insurance and financial needs. Here's one that shows the "other side" of the HDHP discussion.


Since 2015, my husband and I have been self-employed. It's been great for our lifestyle - we get to work from home, play with our dogs, go grocery shopping when everyone is at work and take as many vacation days as we want.

It also means we're responsible for our own healthcare choices. We've been buying healthcare coverage through the federal marketplace ever since we both quit our previous jobs.

Since becoming self-employed, we've had high-deductible health plans (HDHPs) that are eligible for HSAs. These plans have saved us money through low premiums and tax savings.

My husband and I both turn 30 this year, and so far we've been really lucky when it comes to our health. Except for the occasional cold, we've managed to avoid any serious illnesses and injuries. That's why an HSA-eligible HDHP has been such a good choice for us. In general, experts say you should stick to a high-deductible plan when you're healthy and don't need to visit a doctor frequently.

That's how we treat most expenses - if a cheaper alternative will do the trick, we choose that option. We've never seen the point in paying a big premium every month for gold-level health insurance, because we've always been in such good health.

Or at least, we used to be.

Earlier this year, I found out I have a genetic condition that requires extensive surgery. I decided to schedule the surgeries starting in January 2019, which gives me plenty of time to plan ahead.

Since I know I'll be having several operations next year, I need to sign up for a high premium plan in 2019 so I pay less out-of-pocket. My future plan will have a lower out-of-pocket maximum, so I should pay less overall than if I kept my high-deductible plan.

Unfortunately, that means I won't be eligible for an HSA next year, which only works with high-deductible plans. I still want the tax savings and benefits of an HSA, so this year I'm planning on contributing enough to max out my contribution limit. I'm hoping that amount will be enough to cover the surgery as well as any follow-up appointments and procedures.

Even though I consider myself well-versed in HSA and health insurance rules, it was a few months before I realized I should max out the HSA this year to use for next year's operations.

If I chose not to save money in my HSA, I'd have to pay for the surgery out of my bank account, forfeiting any tax savings I'd get with the HSA. Even though it's hard to stash away thousands of dollars on top of our other financial obligations, I'd rather plan ahead.

I'm still nervous about next year, but I feel confident in how I'm approaching things from an insurance perspective. I may have months of surgery recovery to look forward to, but I won't have to spend any of that time worrying about my finances. When 2020 rolls around, hopefully I'll be back to contributing to my HSA, in case these needs come around again.

Compound It! is your weekly update of achievable, effective, no-nonsense HSA saving and investment advice, delivered by people who make it work in their own lives. For the latest info about your health and financial wellness, be sure to check out the HSA Learning Center, and follow us on Facebook and Twitter.

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