[USER]

I have a high deductible health insurance plan with HSA. $4k fam deductible, $10k out of pocket max. Currently $65k HSA balance ($2k cash, rest invested).

My 2 kids are on the plan, wife is on her own separate plan.

One kid is special needs with high medical expenses but is on a Medicaid waiver (due to his disability) as secondary insurance, so his bills are covered- sometimes this works out that it gets our family deductible and oop max taken care of but not always.

Otherwise we typically pay out of other savings for medical expenses to keep HSA intact for retirement.

I recently had a concussion and found myself hesitant to get appropriate treatment to avoid spending money, even though we have the money and could always tap the HSA to cover the OOP max if I had a big expense.

We’re a very active family participating in fairly high risk activities, particularly myself (ski mountaineering, backcountry skiing, downhill skiing, mountain biking, whitewater boating, etc.) and do them while traveling internationally.

While I’ve slowed down and adjusted my risk tolerance since having kids, I have a bit of a history of being accident prone with many close calls.

I’m finding myself being drawn to an additional insurance product by Spot (through Blister+) which provides $25k coverage per accident for medical and rescue for these and other activities anywhere in the world for $400/yr.

Given that I can buy rescue insurance for travel as needed and cover my oopmax with the HSA, I probably don’t need this product on a mathematical level.

But on an emotional level where I’m being honest with myself about actually getting the best care I can right away after an accident, I find myself thinking it could be worthwhile.

For my kids, I would of course not bat an eye at getting them prompt, appropriate care.

Thoughts on how to think through this? Thanks.

[Erica]

Legally, there are limits on double coverage while taking advantage of an HSA, so please confirm you’re not violating any.

I’m curious that you’d be fine committing to an extra premium, but hesitant to spend in the event of an emergency?

I love our HDHP because the premium commitment is low, so I only pay out if we need it and that’s what the savings is for.

We have a separate line item in our budget for basic medical and only use the HSA for bigger things.

[Bill]

If the choices are pay $400 vs skip important medical care, then pay $400.

If you are open to other options, spend the money on some therapy sessions to help get your relationship with money in a healthier spot.

If you are struggling with spending in this sort of extreme situation, it’s undoubtedly impacting other parts of your life as well.

[Trevis]

Make sure that your US insurance covers you internationally, especially if participating in a high risk activity. I suspect that it doesn’t.

Some travel insurance will cover you, but be careful because what they cover and what they don’t takes some detailed investigation.

Also, seriously consider the risk vs benefit of things like emergency rescue vs actual medical treatment.

Setting your broken leg may be a drop in the bucket vs if they have to come and get you with a helicopter. And that part may not be covered.

[Author]

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