I am American. Live here in the UK with my Brit wife.
After a certain number of years of UK healthcare, you are always a brit.
No. HSA contributions are made by payroll deduction so they come straight off the top (employer contributions are separate). As far as I know there are no exceptions to needing earned income that you control, at least any that provide a financial advantage.
The one downside is that they are not eligible for most everyone.
Anyone who has the choice should absolutely take HDHP plans with HSAs, though. I've done the math pretty carefully and they're categorically better, across any range of claims, than any PPO/HMO plan I've seen. Other plans are just outsourcing your cash flow management to your insurance company at a premium.
But you can make HSA contributions directly yourself and you have up to the tax due date to do so, I maxed my HSA contributions back in February or something, for 2021.
www.irahelp.com
HSA is nice if it is the default. For me it’s a terrible choice. I can get it, but the health care without it saves me so much money if I get anything at all done that it crushes on the savings the HSA offers on taxes. Literally one doctors visit and I’m in the green. Had to be hospitalized once each of the last two years. It cost me 150$ total. On the HSA plan I’d have been bent over a barrel.
I assume that includes the differential in premiums? In any combination of plans my wife and I have ever been offered, the HDHP is superior at any claims level from zero to $50k+, and at the level of $6k a year with no claims. That gap drops to $3500/yr if we had up to the deductible in claims, and then rises again linearly in a big spend year because the coinsurance rates are always better on HDHP plans.
My health insurance is 150$ a month. 5k deductible. Things like a cat scan are 100$ oop, surgery with a 3 day hospital stay ran me 650$ oop vs like 100k hospital quote. Most prescription meds are 2-10$. HDHP lost pretty fast over that, especially since I go to the doctor often cause it’s cheap. Not to mention that health insurance covers dental pretty well on top of it.
