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Comment by jdlshore | Hacker News Reader

A better option than going cash is a HSA through the government marketplace. It will give you tax deductions on your savings, you’ll end up paying almost everything out of pocket (same as cash), but you’ll be protected against total ruin if you need emergency care.

Don’t buy insurance outside of the marketplace. The ACA places limits on what insurers can deny, and those limits protect you from the rampant problems that existed before the ACA. I’m not sure if those protections apply to insurance purchased outside the marketplace.

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I was going to say. This is probably one of those few things that Bush got somewhat right.

HSA limit is $4,300 annual, how does that protect against total ruin? That's a hospital trip in a Uber and a few tylenol.

They are probably using “HSA from the government marketplace” as shorthand for “a combination of an HSA with a HSA-eligible health plan from the state ACA marketplace”; the HSA doesn’t protect you from total ruin, thr linked high-deductible health plan should.

One emergency visit is like 10k here now. Best of luck.

As @dragonwriter said, the HSA doesn't protect you against ruin, the linked high-deductible insurance does. You use the HSA for your ordinary medical expenses and get a nice tax discount from it. The HSA is also acts as a retirement investment account.

So, if you're young with minimal healthcare needs, you can get multiple benefits:

1) High-deductible insurance that's (relatively) cheap but still protects you against financial ruin

2) After 10 years of maximum contributions, you'll have ~$10K in cash for emergencies and about $33K in retirement investment contributions.

Thanks for clarification, but I believe my private-market health insurance plan even though high deductible is not eligible for a HSA. I believe you have to use a healthcare.gov plan to be eligible for HSA which are significantly more expensive. So, not sure the benefits are there if your monthly premiums are 25-40% more expensive (HC.gov + HSA) than a private-market plan.

All health insurance plans in the US are private-market.* You may be confusing ACA-compliant plans (private insurance that's allowed to be listed on healthcare.gov and is eligible for subsidies) with non-ACA-compliant plans (not allowed to be listed on healthcare.gov, not eligible for subsidies).

Be careful about non-ACA-compliant plans. They're cheaper because they engage in sketchy behaviors that leave you without coverage when you need it.

*Well, except Medicaid, Medicare, etc.

You’re correct. I should be saying ACA compliant plans vs non-ACA instead of “private”. I have a non-ACA plan thus why I can’t have a HSA.

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