[JumpCrisscross]

> High Deductible Health Plans where insurance doesn't kick in until one has spent a deductible of several thousand dollars

HDHPs are a great deal for anyone who can set aside the deductible’s value in cash. They are a bad default. But a good thing to consider if you can set aside some cash.

(The problem with HSA-compatible plans is they have a maximum deductible. They’re thus almost as expensive as non-HDHP plans.)

[maxxxxx]

There is definitely a psychological problem. When I had a high deductible plan I always set the max aside but considering the potential cost of a doctors visit I often hesitated. 1000 dollars is still 1000 dollars even if you have set them aside beforehand.

[mgkimsal]

why is it a problem to have a maximum deductible?

Relatedly, it seems like there's roughly some 'max' insurance expects you to pay each year, and you can decide whether to take the risk using a high deductible plan, and potentially not have many expenses, but lower premium, or have higher premium up front.

8 years ago, our HDHP was ... $280/month. It's now north of $800, and the deductible went up. Yes, we're a bit older, too but it's still a bit crazy.

$280/month, with high deductible, meant that, in a bad year, we might have $15k in expenses before the insurance covered everything else. Now, it's more like $10k per year in premiums, and another $10k+ before insurance really would kick in. Catastrophic need? It's fine - I don't want to have to face a $400k bill. Day to day? This stinks.

[learc83]

8 years ago insurance was allowed to have yearly and lifetime policy limits. They could deny coverage for preexisting conditions and increase your premiums if you developed new conditions. You were also 8 years younger, which makes a big difference despite being only a few years.

Many people had policies with $100k yearly limits, any serious condition and they basically didn't have insurance.

[rootusrootus]

And these are the folks who complain now that they weren't allowed to keep their plan. So many people had (and have) no idea that they had basically no real coverage, just a policy that looked good on paper.

[JumpCrisscross]

> why is it a problem to have a maximum deductible?

Because it means I get to choose between $500 a month with a $6,500 deductible, and HSA-compatibility, and $150 a month with a $8,000 deductible. The latter is a better fit for my risk profile.

[mgkimsal]

those are just deductibles - i didn't understand what "maximum deductible" meant in that context.

Unfortunately, my experience, at least in my state, is such that none of the premium options are remotely affordable now. $2000/month with a $1000 deductible per year, or $1300/month with an $11000 deductible. Neither of these are anywhere near 'affordable' in my book.