I’ve had an HDHP w/ HSA for years and love it. I have a hard time imagining that I’ll ever go back to a more traditional plan, though much of that depends on what happens with HDHPs over the next few years. On one hand, yes, my health plan makes more thoughtful about health care in general and I do find myself considering cost more than I ever did with a traditional plan. But on the other hand, over the past couple years, I’ve adopted an attitude wherein I’m perfectly comfortable going to the doctor because chances are…I’m GOING to hit my deductible at some point throughout the course of the year, and for me…the sooner the better. But, that’s because of the type of HDHP that I have, wherein there is no co-insurance, which means that once I reach my deductible for the year (which is only $2650, BTW), I’m DONE. I don’t have to pay another cent for health care at that point. If I had a high deductible PLUS 10-20% co-insurance on top of that…I’d likely feel very differently.

Between that, the fact that there are no copays, the fact that preventive care is included with no cost-sharing, and the fact that my employer pays 100% of my monthly premium (which was NOT the case when we had a much more expensive traditional plan), my HDHP has worked out tremendously well!

I’ll also add that I work in HR and am my company’s benefits administrator, so I’m intimately familiar with the REAL costs of group health plans, and even WITH paying 100% of of employee premiums under the current plan, my employer is paying over 30% less now than they were when we all had a traditional plan and they only covered 80% of our premiums.

So it’s a win/win, IMO. 🙂

I agree that it made me more reluctant to go to the doctor (perhaps part of the intention of some of these plans). Before, on the higher premium plan, I’d think “it’s just $20/30 copay, might as well drop in”. But you’re right between everything having individual costs (visit + tests+ other things you might not even expect) it’s hard to know ahead of time if the visit will be “worth it”. I got annoyed after some visits where they’d just say “yep, it’s a cold, get some rest and fluids” and think “I wasted my time and money for this visit!?!” but I think I’d be even more annoyed when I’m paying more (up front).

I know the insurance company has a “predict your costs” page where you can get an estimate before a visit, but it’s hard to know what exactly will happen.

It appears that health insurance of this type makes things more like just car insurance or other types: for emergencies only. Though there are some things that ACA has declared must be covered at 100%, so that at least helps a little.

I’ll definitely be tracking how my medical expenses change this year, and see if the lower premium/higher deductible plan was actually the right choice for me.