nun

The actual annual cost is going to be a balance between premiums, out of pocket costs, co-insurance networks and your actual health. For budgeting purposes you should still take the premiums and add that to the out of pocket max and if you spend less save it for the next time you are ill.

mrken30

Or spend the first couple of years on an HMO policy with higher premiums and lower out of pocket

zzrmark

This is news to me, I was led to believe that I would not qualify for any form of social benefit until I had paid taxes for 40 quarters (ie ten years, if no work breaks, etc). I'm a GC holder.
Have you a link to save me trawling the joke that is 'US.gov'?

scrubbedexpat099

As usual it is much more complicated than that and in some cases State specific.

Pulaski

It's not actually 10 years, it could be barely more than eight years of continuous employment, and could be a LOT less actual work than that, with large gaps.

The reason is that while the talk is about "quarters" it is calculated annually and based on income. I arrived in the US in November 2001, and by the end of February 2010 had accumulated the requisite 40 quarters despite there also being a six month gap during the second half of 2002. So I had only worked seven years (2003-2009), six months (first half of 2002), and about 15 weeks (end of 2001 and start of 2010), so significantly less than eight years of actual work. In other words, seven weeks work in 2001 accrued me four quarters worth of SS contributions, even average income would probably give you four quarters worth of SS contributions with about four months of work.

Pulaski

No. Did you read what I wrote above, and described in some detail. For most people, even those with above average useage of healthcare, the lowest cost option is probably going to be HD insurance and a linked HSA. The sooner you get your HSA funded with a rolling/growing balance, the sooner you will have that cushion that gives you the comfort and protection of "traditional" health insurance, but with the low cost and tax benefits of HD insurance and an HSA.

nun

To qualify for Medicare you need to be over 65. If you come to the US on a green card and are over age 65 you need to have 5 years residency before you can apply for Medicare.....you will have to pay the premiums in full if you don't have 10 years of FICA/Medicare payments

mrken30

I just found HMO more predictable and had far fewer unexpected costs. For instance tooth extraction under PPO was $500-$600 , OK I can save under an HSA. Under HMO it cost me $10 co-pay. Similar things happened with other medical procedures. Baby under PPO, $4k, HMO $250, big difference. I just found when it was covered HMO had less big bills to pay.

Rete

And what do you do in the dry period while you are building up equity in the HSA? You pay out of pocket for any healthcare services, meds and testing you need to have done. So you are paying for financial safety in the future and still having to pay out of pocket with taxable monies for your health needs. Do you have any clue what this means to a family whose sole income is $55,000 annually?

MidAtlantic

I pay the (substantial) difference in premium between my HD policy and what I would pay for the "traditional" policy into my HSA. My employer offers both so I know exactly what that figure is. The value of my HSA built up very quickly and I never had to use any taxed dollars for out of pocket expenses.

With the traditional policy you are always using taxed dollars to pay out of pocket expenses.

Giantaxe

I feel divided about this. On the one hand, I like the principle of high deductibility insurance. But on the other, from a societal point of view HSAs are effectively a transfer of wealth to those in better health who can thus build up reserves of tax-free growth in their accounts.

Not if you have an FSA, although they do come with a "use it or lose it" - bar $500 - provision. So far I've managed to juggle things so that all my out of pocket expenses are pre-tax.

MidAtlantic

No it isn't. The savings derive from substantially lower premiums, which are available to all.

You are correct. I always forget about FSAs because of their severe limitations.

Giantaxe

No. HSAs allow tax-free growth and later withdrawal to pay for medical expenses. If you are healthy, you have an ability to avoid tax on that growth; if you aren't, not so much in that your account is being used to pay much more for current expenses. In other words, over time the healthy are likely to get a bigger tax break than the sick.

Rete

That is wonderful for you. For my youngest child, there is no employer contribution so any funds are theirs alone both for the payment of the premiums to the stashing of funds in the HSA. Yes, they have built it up but it took nearly two years for a safe cushion to be accumulated for doctor visits, meds, etc.

Pulaski

Seriously? Do you judge everything through the filter of what is "fair"? You must be a blast at parties and family gatherings.

Life isn't fair, and in the grand scheme of things whether someone gets tax free growth on their HSA ain't gonna make a whole lotta difference either way - not to me, and not to a single mother living hand to mouth. Maybe you should go and complain to Walmart that it "isn't faaair" that it is much cheaper to buy toilet rolls in 48-roll packs and those living in poverty who can't afford to buy 2-3 months' supply, so pay much more per roll buying twin-packs.