Oh, people on such plans incur massive bills all the time.

Suppose you're in a bicycling accident, you're knocked unconscious, and an ambulance takes you to a hospital that isn't in your insurance network.

Boom. Out-of-network charges.

If your bicycling accident was so bad that you need surgery, a five figure bill is a certainty. A six figure one is rarer -- but absolutely possible.

What's really messed up is that, even if you end up at an in-network HOSPITAL, you might get care from an out-of-network provider.

In this bicycle surgery hypothetical, for instance, your hospital and your surgeon might be in your network - but the anesthesiologist isn't.

Boom. Another out-of-network charge.

(Thats called Surprise Billing, btw)

At median income levels, there's no amount of HSA savings money that can insulate you from costs like that.

The current US insurance system asks consumers to walk an insane tightrope of cost controls.

It's no wonder a lot of us fall.

> (Thats called Surprise Billing, btw)

Yes, and in some states, it's starting to be illegal.

https://www.nytimes.com/2019/09/26/upshot/california-surpris...

You're conflating in-network, out of network with HSA -- as these also apply for POS and HMO plans - only traditional plans don't get the plan cost savings, tax deduction, (or if they're lucky the employers savings into an HSA account)

Your bicycling example isn't far off though (as someone who had an HSA and was in a bicycling accident). I had a ~$3600 deductible, and that was spent between an ambulance ride, ER visit, blood test, and MRI.

So, at that point, all costs would be on my insurer and I would theoretically no longer care to price discriminate for follow up visits (to get stitches removed)

I still have an HSA, though I make sure I get the lower deductible now.

To the best of my understanding, you are 100% correct. Why are you being downvoted? Do other people know something you and I don't know?

Yes. Look at the in/out network for your high deductible plan. None of the providers I use on a traditional plan are considered as in network for the same employers high deductible/hsa plan. Our high deductible plan does not cover out of network. Not at all. Fun!!!

That's not the case with my plan at all. We can use all the exact same providers as the traditional plan on our high deductible/hsa plan. We just switched to the high deductible plan a few years ago (after doing the math and realizing how much better of a deal it is), but we've kept all of our same doctors and specialists as we used before.

Wellll no one unless you somehow make it into an out of network situation. You know, like in an emergency. High deductible plans typically have much more constricted networks than the more traditional plans. Good luck figuring out what’s in and out of network while your appendix may be bursting!!!!

Exactly. If you have insurance, you should never receive surprise bills that are higher than your out of pocket maximum. Bad insurance might mean a higher out of pocket maximum, but that should mean what is says...maximum.