Why I Despise my HSA – Part Two
Posted by eemilla on January 23, 2011
Continued from last week’s Part One.
Ha! I did get pregnant right after signing up with my HSA, although it was another few weeks before I knew. I then brightened at the idea that the HSA covers preventive care fully, so I just knew all of my prenatal visits would be taken care of. Well, health insurance companies are wily so they devised a way to not pay for prenatal visits. They still consider them preventive care in their marketing materials and other publications aside from the policy itself (keep in mind the policy will always supersede all other communications), but all pregnancy care is billed at one time in what is called a global package. The global package isn’t billed until the baby is delivered, and because the preventive care prenatal visits are thrown in with the delivery they lose their full coverage. It’s like Spanish grammar, a group of females uses the female pronoun, but if there is one male in the group then the male pronoun takes over.
Once I got over the injustice of my prenatal visits not being fully covered as all preventive care is supposed to be, I was hit hard with almost five hundred dollars in lab work. Now I know lab work is expensive; in 2003 I did some basic blood work at my provider’s suggestion, and the lab billed over $275. The insurance company paid about $63 (thanks again to the uninsured for subsidizing my health insurance company). Although I’ve been in a sexually exclusive relationship for over a decade, and neither of us have ever tested positive for any sexually transmitted infections or diseases (we have both been tested a few years back), I had to pay over three hundred dollars to confirm that I didn’t have syphilis, HIV, or gonorrhea. The other tests were to confirm I had sufficient levels of iron and no urinary tract infections or proteins in my urine, so even though I was shocked at the cost, it didn’t upset me like the wasteful other tests. If I had been found to have an STI, I might be singing a different tune, but really it was my first wake up call to ask my providers why each and every test or procedure was recommended and to weigh the risks myself and provide either my informed consent or informed declination.
This is the point of the HSA; it was created in 2003 and signed into law by President George W. Bush in order to reign in ever increasing health care costs by making patients more aware of the actual cost of care and encouraging them to shop for price and quality. With traditional health plans, a doctor visit might appear to the insured/patient/consumer to cost a mere $15-20 rather than the $180-$250 the doctor actually bills; not to say the health insurance company is actually going to pay the $180-$250, they’ll likely have negotiated a price closer to $100, which brings us back to the uninsured subsidizing the insured and insurance companies. As I said earlier, my honey and I are blessed with good health, and we take care to eat well, relax, and exercise so we don’t generally get sick enough to go to the doctor, which makes us the prime market for an HSA/HDHP. The fully covered preventative care and the thought of turning my husband’s HSA into an IRA in the future (once his employer provides group insurance again) were the major selling points for me.
Continued next week in Part Three.