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What Breaking My Shoulder Taught Me About HSA Plans

by Matt Jones, CPA
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If an HSA sounds familiar, it’s likely your company offers it as a benefit – otherwise it can be a relatively foreign concept, but could be worth asking your HR team about. HSA stands for Health Savings Account and as the name implies, it allows you to put aside money for your health care expenses. These accounts typically cost less each month than a regular health plan. 1

Here’s the catch: if you get sick or injured, you may have to spend more of your own money on health care bills. There are plenty of articles out there about HSA accounts and how they can work well, especially for young people who are relatively healthy and don’t go to the doctor often.

But, what does happen if you do get seriously injured and need surgery? Well, it just so happens that I’ve had an HSA account since 2013 and recently had my first experience with a serious injury – not a bad run though.  Last month it finally caught up with me – I had shoulder surgery.

Did this HSA plan backfire on me? Not quite. Here’s the true story, without the gory details.

The Injury

Nothing makes me feel older than slipping and falling; particularly when that happens in a very public place surrounded by strangers.

For instance, Public Square

My wife and I met up with her cousins to ice skate with their children. At first, the plan was to watch from the sidelines, but it actually looked like a lot of fun. So, we decided to rent skates and each take one of the kids to give their parents a break. I offered to grab the older of the two, Hank.

The thing about skating with a four-year-old is that, unfortunately, they are going to fall A LOT. Fortunately, they only have about three feet to travel and seem to be made of rubber. After 20 minutes of skating, and nearly a dozen falls for four-year-old Hank, I was getting hungry and cold, so I made the executive decision that we would take one final lap. 

Before we could even pass the gateway, Hank fell again, this time taking me down with him. Unfortunately, I had more than twice as far as Hank to fall before hitting the ice, popping out my shoulder, and causing multiple fractures and a torn labrum. Soon we were on our way to the emergency room for our first of several misdiagnoses. 

Staying positive

The Cost

In the coming weeks I had an x-ray, 2 CT scan, and MRI. Ultimately, the injury was worse than the doctors thought and surgery was necessary to remove a chipped bone and repair my labrum. Sparing the gory details, it was a successful surgery (although twice as long as expected at 3.5 hours) and I’m expected to make a full recovery within a few months.

While stuck on the couch with my dominant arm immobilized, my brain trailed to the long-term effects of this injury, not just physically, but financially. “Will my bank account recover? How much is all of this going to cost? I’ve never gone through anything like this before…” Because in the moment, when you’re in pain and told surgery is necessary, you don’t typically stop to ask about prices. 3

HSA accounts typically cost less each paycheck than a traditional health insurance account. For simplicity, let’s assume the HSA plan costs $25 less than my traditional health plan each paycheck and I get paid twice per month. That means I save $4,200 by choosing the HSA plan ($25 per paycheck x 24 paychecks per year x 7 years). 4

During my 7 years using an HSA, I haven’t had any other major injuries. I have annual check ups, prescriptions, and did some physical therapy on, wait for it… my other shoulder. So, I’ve been able to bank the savings. In addition, my employer contributes money to my HSA, resulting in an additional $300 in my case. I’ll use the savings to cover my portion of the surgery costs, which are substantial, but less than what I’ve saved. When all is said and done, the total amount I’ll have to pay will end up very near $4,000.

Below are two of the billing statements I’ve received. These can be scary, but it goes to show why you want to have insurance- for the worst case scenarios and Friday nights ice skating with four-year-olds. I was shocked that the surgery itself was way less expensive than the operating rooms and all the supplies. Never would have guessed.

I’ll have to think hard next year whether I want to stay with an HSA account or switch to a traditional health insurance account. I’ve been happy with an HSA in the past and financially it has worked in my favor. The additional money in my paycheck was saved and invested, and some of it went toward recovery ice cream.

Let me know your thoughts in the comments. Keep it classy, no politics please.

2 comments

Susan Kautz February 15, 2020 - 9:36 pm

Healthcare costs in US are crazy. I am avoiding surgery because of the cost. Ridiculous as my (shoulder LOL) pain is debilitating. Will be reading your blog!

MattJones February 16, 2020 - 7:49 am

Agreed, Susan! Shoulders are challenging… Have you ever considered healthcare tourism?? I don’t have any experience personally, but Spo might be familiar and a quick google search can provide some more info.

Comments are closed.

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