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HDHP and HSAs

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  • HDHP and HSAs

    Our family has a high deductible health plan and HSA with an in-network deductible and out of pocket max of $2700/5400 individual/family and separate out-of-network deductible and out of pocket max of $5400/10800.  We have an in-network doctor who offered us a 20% cash pay discount.  If we do not plan to hit our deductible/out of pocket max this year, would it be advantageous to just pay cash?  Can we still use the HSA if we pay cash?  Does this change at all if we end up hitting our deductible?

  • #2
    Is the 20% cash pay discount 20% of the insurance negotiated in-network rate? I probably wouldn't mess with the cash discount. Many insurances will cover preventative health visits so it sounds like you're not really planning on using it on much else.

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    • #3
      Unfortunately starting down the path of reproductive endocrinology so not quite sure.  Not even sure if it is "covered" by our health plan and/or to what extent.  Could we conceivably run up to our maximums within 3 months?  (end of calendar year).

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      • #4


        Unfortunately starting down the path of reproductive endocrinology so not quite sure. Not even sure if it is “covered” by our health plan and/or to what extent. Could we conceivably run up to our maximums within 3 months? (end of calendar year).
        Click to expand...


        You could absolutely meet your maximums that quick. I feel like most insurance plans don't cover reproductive endocrinology but you really need to read your insurance coverages and understand it. I'd bet you'll be paying everything out of pocket regarding that with no coverage by insurance.

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        • #5
          Unless you would spend down the basis in your Roth IRA to pay qualified medical expenses, why would you use your HSA? I’d recommend saving the receipts for future medical expenses (in retirement or in a God-forbid catastrophic situation) if you can possibly afford to pay OOP at this stage.

          Understandably, what you’re undergoing is expensive and emotionally draining - sending the very best wishes your way that it is successful and in a very short time.
          Financial planning, investment management and CPA services for medical professionals | 270-247-6087

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          • #6
            So they told my wife it's illegal to have her as cash pay if she has insurance. Is that true?

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            • #7




              So they told my wife it’s illegal to have her as cash pay if she has insurance. Is that true?
              Click to expand...


              Not at our local hospital, although I no longer get a 50% discount - I think they trimmed it to 20-25% (but still let me pay with a credit card!)
              Financial planning, investment management and CPA services for medical professionals | 270-247-6087

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              • #8
                Just went to have labs done. People with no insurance get a 50% discount but if you have insurance you have to pay full price. No cash pay discount. Not hard to understand why so many people believe insurance as currently structured is a scam. I've never had my pharmacy refuse to allow a good rx coupon cash pay though. Are the rules for drugs different?

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