by Ashley
This is my second year with a Health Savings Account. Last year we only had routine doctor’s appointments, and I had banked a decent amount of money into the HSA. Our family out-of-pocket-max is $7,000 so that’s the amount I invest.
This year, and another $7,000 being invested, I knew I wanted to take the plunge on a couple of elective medical procedures I’d been thinking about for quite some time.
Why now? HSA vs FSA
For the first several years at my job (where I started work in 2015), I had a Flex Spending Account. The reason I’d opted for an FSA initially is that it allowed for more coverage with our insurance (lower deductible). That was important to me at the time, given that some of our medical expenses were variable and unexpected (helloooooo, kidney stones!)
The big down-side to an FSA is that the funds are use-it-or-lose it. As a result, I would contribute less money annually since it didn’t roll over from year to year. The “pro” for both FSAs and HSAs is that the money is deducted from my paycheck pre-tax, which is a nice tax advantage.
I switched to an HSA after tracking medical expenses for several years (so now they’re more predictable!). Also, being in a relationship with my now-husband helped because I had more stability in terms of income and living expenses, etc.
The down-side of an HSA is that you must use a high deductible plan and you pay for most medical care 100% out-of-pocket until your deductible is met. That’s why I have chosen to invest our out-of-pocket max ($7,000/annually) so we have a nice buffer just-in-case of catastrophic event. That said, we’re now into year 2 and haven’t hit our deductible, even with my routine specialist visits (due to chronic kidney stones I see a urologist and nephrologist every 6 months). We have a nice little stockpile of money growing in our HSA.
Long-term, the plan is to invest that money and watch it grow. It will be there for any medical expenses and, ideally, will grow to a substantial amount to help us in retirement with medical expenses. But on the short-term, I’ve had a couple elective medical procedures I’ve been really itching to get taken care of. Since we had the money sitting in our HSA either way – why wait?! I dubbed 2022 the “Year of Elective Procedures.”
Elective Medical Procedures
Big caveat – you can NOT use HSA funds for elective cosmetic surgery. My elective procedures do not fall into that category.
LASIK
The first procedure I had completed early this summer – I got LASIK eye surgery! I was very nervous about this procedure, but had been wanting to get it done for years. As I watched our HSA funds growing, I knew I wanted some of the money to go toward my vision. I do not have vision insurance and was paying out-of-pocket for annual eye exams, contact lenses, and glasses. I was spending approximately $1200-1500/year for eye expenses. My LASIK surgery cost $3700 and I was able to pay for it entirely out of my HSA. It cost me nothing from my regular paycheck/checking/savings and I figure it will pay for itself in 3 years’ time! Money well spent and it’s been priceless to be able to wake up and instantly SEE!
Salpingectomy
The second procedure is actually occurring later today. I’m having a bilateral tubal with salpingectomy. In layman’s terms, I’m having my fallopian tubes removed. This procedure is one-part elective and one-part medical necessity. The conversation started with my doctor because I want to have a hormone-free permanent birth control. I do not want any devices implanted in me and I cannot risk a pregnancy. Due to my health background, a pregnancy could be fatal (I had HELLP syndrome with my twins and am at increased risk of recurring HELLP syndrome if I were to get pregnant again). I don’t want to take any chances.
In speaking to my doctor, it was recommended that I have my tubes removed due to a family history of ovarian cancer, which originated in the fallopian tubes. By removing my tubes, I get the permanent hormone-free birth control I desired, and also lower my risks of ovarian cancer down the road.
This was a tough and personal decision for me and I don’t really want to talk politics or debate different birth control options. If you vehemently disagree with my choice, that’s your right. But this was the best choice for me and my family. That said, I didn’t make the decision lightly. I’m afraid of going under general anesthesia. I actually had this appointment scheduled for November 2021 and cancelled when I got cold feet. It’s happening this time though. If you are a praying type, I appreciate any prayers (or good vibes, well wishes, etc.). I’ll be going under the knife at approximately 3pm Arizona time today! I’ve been assured it’s a quick and easy surgery (as easy as major abdominal surgery can be), but I’m a big scaredy cat so I still have anxiety about the procedure.
Costs
Jury is still out about how much the salpingectomy is going to set me back. Google tells me that they cost approximately $11,000 and my insurance has me paying 10% copay, approx. $1,100. But the U.S. health care system is pretty messy, in my opinion. It’s been really tough to get exact costs. My doctor’s office says this procedure is 100% covered (just like my birth control pills are 100% covered by insurance). But I would be shocked and amazed if I didn’t receive some type of bill afterward. I received a bill from the surgery center for $350 and have already paid it. Basically – I don’t really know what to expect in terms of cost, but I have no doubt that I’ve got enough in our HSA to cover it, whatever it may be.
Controversial?
Is it controversial to be paying for elective medical procedures while still in the depths of debt-payoff? IDK. To me, I’d still be investing the same amount in my HSA regardless of whether I had these medical procedures or not. I feel like I might as well be taking care of my medical needs – after all, that’s what the money is for!
As I said, I do have a long-term plan to let this money grow, invest it within the HSA, and have it help as a buffer throughout retirement. But for now….why not use it if I’ve got it? Especially since it doesn’t impact any of my take-home pay.
What are your thoughts? Would you be open to completing elective medical procedures while still deep in debt?
Hi, I’m Ashley! Arizonan on paper, Texan at heart. Lover of running, blogging, and all things cheeeeese. Freshly 40, married mother of two, working in academia. Trying to finally (finally!) pay off that ridiculous 6-digit student loan debt!
You need to push for today’s procedure to be 100% covered because it absolutely falls under the birth control coverage! Do not let them make you pay for it! 100% covered! And good luck!
Thanks! It went well. I’m very sore today but overall better than I’d expected!
Hi!
I don’t think that there should be a debate about your health since this is what it ultimately is about. People first then money then things per Size Orman who coined the phrase, but really per anyone with blood running through them.
You have an HSA specifically for this. It shouldn’t matter how much debt you have.
Thank you! I was really worried folks would think it was a bad idea too invest $7k/year into an HSA while still in debt, so it’s nice to see so many supportive comments! I appreciate the perspective from Suze Orman too about people first, then money. <3
“If you vehemently disagree with my choice, that’s your right ”
Actually it’s not anyone’s business and if they disagree with your health choices because they somehow think your health is less important than your breeding potential, I invite them to go jump into the sea.
I lol-ed at this comment (even though the laughter hurt my abs!) 🙂 Thanks for your support!
I want Lasik so bad but I’m really scared. How was the pain? Did you have to keep your eyes still and open the whole time? That price isn’t quite as bad as I’ve been imagining.
I’m gonna be honest because everyone told me it was super “no big deal” and that was NOT my experience. The first day the pain was tough. Like, writhing around in bed in agony type pain. And you’re essentially blind the first day which was shocking and jarring for me. BUT after about day 2-3, things were a lot better. Now I’m a couple months out and I definitely do not regret it and, if anything, wish I would’ve done it sooner. But I’m all about realistic expectation-setting so I just like to be real that the procedure, itself, and the initial aftermath that first day were pretty tough.
You contribute to it for it to be used!! So, it makes sense to me. Your body, your choice! Your money, you’re using it as you see fit <3
Thank you, JJ!
You know, I work in healthcare. “Elective” just means “not emergency.” It doesn’t mean “not necessary.” Honestly, this idea that you should forgo necessary healthcare because of debt is just shortsighted nonsense that’s duplicated in the capitalist marketplace that does not invest in people or equipment in order to make the balance sheet look good in the short term but cripples the business in the medium to long term.
I really appreciate this perspective, Kerry! Honestly, I was not expecting folks to be so supportive. And I fully agree with your explanation of elective just meaning “not emergency” (not that it isn’t necessary). I think I’ve typically heard it with “elective cosmetic surgery” which is a whole different ballgame than the procedures I had done, which had nothing to do with cosmetics. Thanks for your comment!
These may fall under the elective surgery category but, they are health related. If they were plastic surgeries just for looks, some might argue with you about getting them while in debt. Still, it is nobody’s business but yours. Wishing you a speedy recovery and a healthy and long life.