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HDHP and Catastrophe Health Insurance
Posted on 8/15/25 at 10:28 am
Posted on 8/15/25 at 10:28 am
Due to a job change and a few external factors, my family of 4 went about a year without health insurance.
Low and behold, my son broke his nose about a month after we did not have insurance. He had to be taken to the ER in an ambulance, given a CT scan, monitored for a while, and then stitched up. I told the hospital we didn't have insurance and asked them to give us the cash price. I was shocked to see that everything, including the ambulance ride, came to only $2400 total.
A month later, I took the kids to their normal pediatrician for a well checkup and physical, and the total cost was $100 for both children combined.
OBGYN yearly well visit was $160.
Adult well visit was $100 plus $65 lab work.
Finally, my daughter had staph on her elbow and the visit was $100 plus $40 for antibiotics.
In total, we spent around 3K, and it was a busier than usual year at the Dr. due to the broken nose/staph.
To add onto our company's health insurance during open enrollment next month, it is going to be $7200/year for the lower tier or $19,000/year for the upper tier. These numbers seem insane now that I know what the actual cash price is for medical care.
The biggest concern is being covered if anything really bad happened (car accident, heart attack, the big C). All of us are completely healthy, but those are the scary unpredictable that are not worth any risk. I have been researching HDHP, Catastrophic and Accident Health plans that have low premiums and high out of pocket deductibles. Has anyone ever had one of these plans and can speak to them?
My number one priority is my family's health, but it seems there are smarter, irregular options, that still provide lifesaving care when needed.
Low and behold, my son broke his nose about a month after we did not have insurance. He had to be taken to the ER in an ambulance, given a CT scan, monitored for a while, and then stitched up. I told the hospital we didn't have insurance and asked them to give us the cash price. I was shocked to see that everything, including the ambulance ride, came to only $2400 total.
A month later, I took the kids to their normal pediatrician for a well checkup and physical, and the total cost was $100 for both children combined.
OBGYN yearly well visit was $160.
Adult well visit was $100 plus $65 lab work.
Finally, my daughter had staph on her elbow and the visit was $100 plus $40 for antibiotics.
In total, we spent around 3K, and it was a busier than usual year at the Dr. due to the broken nose/staph.
To add onto our company's health insurance during open enrollment next month, it is going to be $7200/year for the lower tier or $19,000/year for the upper tier. These numbers seem insane now that I know what the actual cash price is for medical care.
The biggest concern is being covered if anything really bad happened (car accident, heart attack, the big C). All of us are completely healthy, but those are the scary unpredictable that are not worth any risk. I have been researching HDHP, Catastrophic and Accident Health plans that have low premiums and high out of pocket deductibles. Has anyone ever had one of these plans and can speak to them?
My number one priority is my family's health, but it seems there are smarter, irregular options, that still provide lifesaving care when needed.
4
Posted on 8/15/25 at 10:33 am to jsquardjj
I have been in a HDHP for years and between wife and kids ongoing random medical bills I’m not sure I wouldn’t have been better off to shell out the money for the more expensive lower deductible plan.
My kid tore his ACL playing football, we stayed in the channel with the team doc, team ortho, etc and even with the districts secondary insurance this will end up costing me a fortune.
My kid tore his ACL playing football, we stayed in the channel with the team doc, team ortho, etc and even with the districts secondary insurance this will end up costing me a fortune.
Posted on 8/15/25 at 10:45 am to jsquardjj
We were on a HDHP. Son broke his arm. Between that and other medical visits this year we shelled out about $12K with premiums first 6 months.
I can't say I recommend HDHP if you have small children. One semi serious issue that requires surgery and you're cooked.
I can't say I recommend HDHP if you have small children. One semi serious issue that requires surgery and you're cooked.
Posted on 8/15/25 at 11:00 am to DiamondDog
wouldn't a serious health event though qualify for the deductible in most cases?
The last one I was on was a $15k deductible for the whole family which was pretty decent
The last one I was on was a $15k deductible for the whole family which was pretty decent
Posted on 8/15/25 at 11:34 pm to jsquardjj
Highly recommend a high deductible plan with an HSA if your family is generally healthy and y’all aren’t the type to go to the doctor for every sniffle. I have one young child and we’ve only hit the deductible one year. That was kind of optional because we chose to have more expensive imaging done for peace of mind. Most years we only have preventative visits (fully covered) and maybe one or two doctor or urgent care visits for illness or injury. Those visits have always been around $200 with meds and everything, a bit more with X-ray.
Because we’ve been fortunate enough to have multiple healthy years, our HSA is funded well beyond what our max out of pocket would be if we were to have a bad year with major illness or accident. I also invest a portion of our HSA, so it has grown rather than just sitting in savings.
Because we’ve been fortunate enough to have multiple healthy years, our HSA is funded well beyond what our max out of pocket would be if we were to have a bad year with major illness or accident. I also invest a portion of our HSA, so it has grown rather than just sitting in savings.
Posted on 8/18/25 at 4:01 pm to Lightning
Do y’all go through the marketplace for your HDHP?
Posted on 8/18/25 at 8:43 pm to jsquardjj
Once your kids clear about two years in school, they need a ton less doctor visits. The MSA is also a sneaky retirement vehicle. I have about a $5k deductible, but with two kids under 15, I never come close. You also may get different pricing because you're essentially paying cash and not having to have the doctor file claims with BCBS, waiting six weeks for payment, etc. Just be aware that any problems you're going to have with medical billing in general are probably going to be 90% the person working the front desk that codes something wrong.
There are also services like Amazon One which you pay $100 a year for, but then have close to zero co-pays for anything. I paid $19 on top of the annual fee for my last checkup, scrips don't involve four foot long CVS receipts and are delivered to my door in 24 hours.
But always deny an ambulance ride unless you're in a tourniquet situation. It's normally thousands of dollars for a five mile ride.
There are also services like Amazon One which you pay $100 a year for, but then have close to zero co-pays for anything. I paid $19 on top of the annual fee for my last checkup, scrips don't involve four foot long CVS receipts and are delivered to my door in 24 hours.
But always deny an ambulance ride unless you're in a tourniquet situation. It's normally thousands of dollars for a five mile ride.
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