If your current is $500, you pay 500*12+500 deductible or $6500. Plus co-pays

$75 increase, 575*12+500deductible = $7400 plus co-pays

HSA (75-20?) or $55 increase $555*12+2000 HSA =
$8660 no co-pays.

Thankfully I have not needed it and, when I have had to go get treatment, I make clear to the doctor that (a) (s)he's getting paid from my pocket by my check, so do it quickly and (b) I'm a lawyer who does plaintiff's cases, so do it right the first time.

First, if you are self employed and can itemize, you might also be able to deduct the premiums you pay.  

Second, the HSA accounts can be invested in interest bearing and I believe some are allowing stock investments too.  This income should also be considered when trying to evaluate choices.  

I can't help you but just note that this is one reason we should all have universal health care.

In contrast to your $600 per month, I have a 100% employer paid for plan.  I have no idea what that does to my salary.  I know that I, a non union engineer, can thank 50,000 fellow union employees (mostly mechanics and aerospace workers) for a health care plan that in a few weeks will pay for about $150,000 of services for me, for no deductible.

About ten years ago, my health care plan paid for about $50,000 for a week of ICU treatment for me.

Wikipedia has some nice references for further information

Link

I had a decent insurance plan based upon co-payments and no deductibles (except on prescriptions...an annual deductible that I easily met), and the our employer eliminated the plan.  My choices were high deductible plans or Kaiser (closed HMO).  I have a pre-existing condition so I knew that I could easily spend the deductible, and would make a run at the out of pocket max each and every year.  So, I went with the closed HMO.  I hate to give up my specialist and primary care doctor, but I just can't afford the high deductible plan.

There is an organization called freelancers union.  They are interested solely in self-employed people and have medical and dental insurance at group rates.  They do not have it available in Mass., unfortunately.  I will see if I can find the contact info for you.  

Gotcha coming and going.

Clerk took one look at records, saw I have cancer which requires continual monitoring, and told me I was better off paying an arm and a leg.

I don't know what happens if someone with an HSA does get a chronic condition--would that prevent getting coverage for more traditional insurance in the future for that condition?

Gee, maybe we need someone in the WH who will actually fight for national health insurance!

A few years ago, end of the Clinton years in the WH, I was terrified to learn a woman acquaintance in her early 50's was paying $1,500/month for health insurance. She'd had a heart attack and couldn't go without insurance, she felt. I cannot imagine what she's being charged now! And, now, I'm almost there.

I don't know how old you are, but if you're 40+, I would strongly recommend avoiding catastrophic insurance. As someone noted above, the plans vary widely in what they will / will not pay for. Once you hit 40, the chance of needing a simply diagnostic procedure like a colonoscopy or endoscopy is a lot higher than when you're 25.

My husband is an attorney here in Indiana.  He is partners with an elderly attorney.  I had great insurance when I was a teacher, before I had my daughter 5 years ago.  I didn't realize my teacher insurance was great at the time, but I sure know now!  For a few years we got "insurance"  through a Small Business Association network.  That was just a disaster.  I don't want to go into the details, as it would take hours to list all the ways in which we were screwed by our "coverage."

Almost a year ago I changed insurance and went with an HSA.  We have a family plan so the deductible is 5800.  We do use a PPO network. Under our plan we each have a small amount for preventative care.   Our old plan had nothing.  

In the few times we have seen a doc, I have been happy with the PPO discount we have received.  Our old plan would sometimes give us just a $1.00 discount on in-network services.  I'd write letters and spend hours on the phone in order to get the correct amount discounted.

Now regarding the money you put into your HSA account - $2,000 in your case.  In our plan if we fund our $5800 a year we can deduct that amount on our tax return. We don't have to touch that money and we don't lose it if we don't use it.  It builds up year after year.  And at age 65  whatever money we have in that account can be withdrawn without penalty, if we so chose.  It would be taxed at that time.  

We also DON'T HAVE to put the money into our HSA account. There is no penalty for not doing so.  

In short, the HSA works out well for our lives.  IT certainly isn't ideal and I won't recommend it for everyone.  It is much better than the non-insurance we were paying so much for which also had a high deductible but covered nothing.  

I was in the same boat as you a couple of years ago, and I went the HSA route.  I crunched the math every which way I could, and found it to be a better deal in every single scenario.  

The ideal scenario is where you have no expenses, i.e. the ideally healthy person.  Everything you put into the HSA account just stays there, tax free, year to year, until you spend it or withdraw it.  

Think of it this way - each month, take the $95 savings and put it into your HSA.  That way, you feel the same "pinch" as if you'd stayed on your current plan (which I'll guess is some form of PPO).  Now that's $1,140 a year in pre-tax dollars you have towards your health care expenditures.  Take that number and play with some scenarios.  I can't work through them with you without knowing more about your current plan, in particular what you pay for co-pay on your doctor's visits, if you're paying some 80/20 ratio after hitting your deductible, etc.

You can almost always find good insurance plans through a large Chamber of Commerce if the bar association doesn't offer it.

So let's say you build up a $5,000 balance in your HSA. It's yours until you spend it.

Not only do I spend a week contemplating, what option I should choose for my family by weighing costs and premiums out with a choice I want (doctor) when it comes to switching plans but I look ahead.  I do put money into a MFSA account which is separate from a HSA account where most companies pay into at least 1000 or more.

When we lived in Florida, my husbands' premiums for the family, including myself were 1000 a month.  That wasn't including copays and deductibles.  We dropped all insurance on me because it saved us almost 400 bucks a month. Mind you he was a programmer working for a "benefits" company.  It was a joke!  At one time, we needed the extra money on his check and canceled all insurance (did not reenroll) for the family (it was required for him to carry it, regardless).  The month we stop carrying insurance, my daughter broke her wrist.

Later, I decided because we have kids and you never know how many bones they will break, we forced ourselves to only spend 225 a month on groceries (family of 6).  MMMM< mac and cheese makes you FAT!

My other daughter was a competitive gymnast and it was required for her to carry insurance.  Thank god, we did at that time because she broke a vertebrae and MRIs would accept us unless we could fork out some big bucks .

So, you really have to consider this.  Could you cut back even further to carry insurance, since they have increased your premiums.  (That's a big jump).  Are you willing to take a chance on massive bills, just in case you catch some virus or e coli.  :)  

But if I don't get sick, since I don't spend $2k a year on covered expenses (most of my money goes to things like vision, preventive care and dental which again are not covered under the policy) wouldn't I be paying $2k on top of my premiums? Since my current deductible is $500, wouldn't I be paying $1500 a year or $125 a month more to save $95 a month in premiums ($75 increase vs. $20 less)?

NO..you have the option of putting $2000 into an account that you will earn interest on.  That interest is not taxable.  The $2000 sits in your account until you spend it.  You can only spend it on medical expenses (if you spend it on other stuff there are tax implications).

This is a pretty good deal for you under your current health needs.  You are paying about $1200 less per year in premium.  The downside is that you have to pay the first $2000 of expenses per year.  Your current plan has a $500 deductible and presumably some other co-pays and what not.  This is how it plays out:

If you incur exactly $2000 in medical expenses (the worst scenario if you buy the HSA), you will pay:

Current Plan - $600 X 12 (premiums) + $500 (deductible) = $7700.

HSA - $505 X 12 (premiums) + $2000 (deductible) = $8060.

This assumes that your current plan has no co-pays.

As for HSA or no, I went without it. Not because I thought through it, but because even with math degress, it made my head hurt. :-) Well, I looked at it a bit, but I ended up with an individual policy with a medium deductible. It has a limit of 5M, so I added catastrophic on top of that for more.

You should distinguish between routine and catastrophic medical care.  The theory of insurance says that you should pay out of pocket for routine care and insure only against expenses that are unlikely to happen or that you could not afford should they happen.  For medical insurance, that means opting for high deductibles and copays in return for lower premiums.  

Then you try to pay routine expenses from pre-tax rather than post tax dollars.  If you're in the 25% bracket, paying pre-tax amounts to a 25% discount.  Employer provided health care is pre-tax, which is one of the reasons it's cheaper for your employer to provide health care directly than to pay you more to buy your own (another reason is that large employers get a group rate).    The HSA is a way to do this -- but be careful if the fees (as someone said).  About tax bracket: you should use your marginal tax bracket, which  is higher than your total bracket, because the first part of your income is taxed at a lower rate.  If you have a 25% marginal rate and 10% overall rate, that means that you send 10% of your income to Uncle Sam, but if you had one more dollar, 25 cents of that would go to him.  

My philosophy is that insurance companies will try to get our of paying whatever they can so I would rather not have them pretend that they are going to pay, not have to deal with the bull, and just contribute the savings to the HSA.

Also, remember that you wouldn't actually be paying  the 2000 if you hit your deductible because the income is tax exempt. So figure out what your bracket is and how much of that 2000 of your income would be left after taxes and that is your actual cost if you hit your deductible. To pick a round number, lets say you are taxed at a rate of 20% which is 400 out of your 2000 deductible. If you reach your deductible, it only actually only costs you 1600 because the income is tax free.

Then figure out the savings on your premiums that you would be throwing into your HSA. I don't know the specifics, but over the course of a year, there is a good chance you can count on breaking even (or better than even) after factoring in your premium savings and tax savings even in a year where you hit the deductible.

The max contribution for 2008 is 2900 and I always put in the max. With health care being the way it is I know that I will spend that money at some point and I would rather spend tax free income. If I die, the money (which is also being invested) goes to a beneficiary. Also, the current law (though it could change at any time) is that you get a one-time rollover from your HSA to an IRA. There is a max on the rollover though.

Another thing to keep in mind is that a lot of HDHPs will cover some preventative things. It depends on the plan, but a lot of them will cover a yearly physical for instance so that is something to ask about when you shop. Another thing to look at when shopping is administrative fees on the HSA. It is common for it to be around $3 a month, so you should figure this into your HSA cost, but some plans will waive the fee once you have funded your account to a certain amount (mine is 2000).

I think dollarwise, I do save money. The last time I checked, it was about $100 a month more to get more extensive coverage. By using the HSA, it is about even dollarwise, but I get the added benefits of: can use the tax deductible HSA money for my dentist, eye exams, eyeglasses, prescription sunglasses. The other benefit (that I have not used yet), is after deductible is met, hospital admissions are covered 100%. ALL the other plans have a co-pay of $500-$1,000 per hospital admission.

Under the US treasury guidelines, for my age, I can deposit any amount up to $3,650 a year.  Deposits into the HSA account come right off the top of your gross income as do the schedule C business expenses. My HSA deductible is $1500.  So, for me, I will probably end up depositing around $2,000 (enough to meet deductible, plus money for dentist and eyeglasses-want it tax deductible).

I have a Harvard Pilgrim plan. There are a number of basic health things that are covered EVEN BEFORE a deductible. These include an annual physical, a few basic lab tests, and a mammogram. Other than those few basic things, anything else is paid by me until I reach $1500. For example, the colonoscopy, the anesthetist for the colonoscopy were both paid by me from the HSA savings account.

However, an additional benefit to having health insurance is just because I use Harvard Pilgrim, all doctors and other medical providers REDUCE the amount from the initial amount billed. I don't remember the exact numbers, but the colonoscopy may have been initially billed at $1,000, but was reduced to $600.  

Once I pay the $1,500 deductible, EVERYTHING is covered by Harvard Pilgrim, FULL COVERAGE.

The HSA mechanism is very good.  The doctor submits a bill to Harvard pilgrim.  It is rejected and I get a letter showing the amount I owe based on the reduced amount doctor will accept. Harvard pilgrim keeps track of bills submitted and sent to me for payment. When they send me bills totaling $1500, HP will then pay for everything.  Thus, the $1500 means I have ACCUMULATED $1500 in bills. It is not necessary that I have paid out what I owe.

When I was deciding what plan to get, I added the annual cost of the monthly premiums plus the $1500 deductible and it was less expensive than the all inclusive plan. All the more inclusive plans had a co-pay per hospitalization of $500-$1,000 which is not tax deductible right off the top of your gross, but instead goes into that line item where you add it up and it must be some percentage.  So for both a combination of cost and tax benefits I chose it.

This is based on adverse selection.  Here's an example of how it works:  Blue Cross & Blue Shield come up with a new group called "Healthy Virginians."  They may market it or they may not but...any new enrollee gets dumped into this group. The premiums are great, everyone who is eligible to join is ecstatic and remarks how they can't understand why people say there's a health insurance crisis.

Until...four or five years later when the group gets older, more enrollees have pre-existing conditions and voila, Blue Cross markets a new program (same coverage, just different name) called Choice Virginia.  New enrollees are placed in this newer group, the healthy enrollees at Healthy Virginia start to shop and move to the newer group and the old Heathy Virginia keeps more and more of the insureds who can't move because of preexisting conditions.  The group's rate, of course, keep rising and rising and any healthy person who remains helps to underwrite the higher cost of the poor saps who can't move.

And just so you don't think it will get better when you hit age 65 and start Medicare.....

The following is joint figures for myself and my wife...

Medicare Doctor + Hospital - $2400.

Medicare Drugs             - $1120.

Supplemental               - $3800.

Base Total                 - $7320.

In addition, the Medicare Drug plan only pays $2500, and then you pay until your out of pocket hits about $4000. You then pay about 5%...

So it is easy for most of us ROF's to hit $12000.
a year..

BTW - The supplemental pays what Medicare doesn't, which is substantial, so get it. But it is NOT secondary insurance. If Medicare doesn't cover it, the supplemental doesn't either.

Medicare pays only the first 21 days of a skilled nursing facility for long term care. After that it takes additional insurance coverage. I don't have the details, but it is sky high. Typically the patient is forced in to Medicaid and the state takes whatever savings the person has left, and then their home and whatever retirement income they have coming in.

To those who think they are getting "free" insurance through their employer I can only say it is truly, "Pay me now or pay me later."