Understanding high-deductible health plans
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Plans differ widely on their options.

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JoAnn Laing, author of "The Consumer's Guide to HSAs" and "The Small Business Guide to HSAs," recommends that anyone looking for a high-deductible health plan to get at least three quotes. You can get these through independent insurance agents.

"Make sure the quotes are for comparable policies," she says. "If one has a lifetime cap on benefits and the others don't, they aren't comparable. Look for specific options that are applicable to you. If you aren't planning on having a family, you don't need maternity coverage, for example. If you travel a lot, you'll want some provision for out-of-network-care coverage. Look for provisions about renewal and rate increases, and get some type of commitment in writing there."

There are some plans that exclude preventive care from your deductible, meaning that physicals, well-baby care and other preventive care is covered without charge to you or through a co-pay. However, under most plans, routine doctor's visits aren't covered, and many don't cover prescriptions. So, instead of paying a $25 co-pay when you visit your doctor, you might owe $75 or $100.

In addition, if you need expensive tests and/or hospitalization, you pay those costs out of pocket until your deductible is met, and then pay an ongoing percentage of that cost, up to 30 percent. The cheapest plans have the highest deductible and the largest co-pay percentage; the more expensive plans have lower deductibles and lower co-pay percentages. This is where the health savings account comes in: You and your employer contribute to that account, and those contributions cover your qualified out-of-pocket expenses.

Health savings accounts
Brokers, banks and financial institutions typically administer HSAs for companies and consumers.

The IRS has established rules for HSAs, which provide that:

• The HSA is a high-deductible health insurance plan with a minimum deductible of $1,050 for a single person and $2,100 for families. • Maximum out-of-pocket expenses are $5,250 for individuals and $10,500 for families. • Accounts are portable from one employer to another. • Funds can accrue from year to year; there is no use-it-or-lose-it rule. • Employers, individuals and family members may contribute. • Contribution limits allow up to 100 percent of the health insurance plan's deductible, but not more than $2,700 for an individual or $5,450 for families. • Withdrawals for qualified expenses and interest earned aren't subject to federal income taxes; employer contributions aren't included in gross income, and employee contributions are deductible from federal income taxes. • HSA contributions may be invested in a variety of savings and investing vehicles.

For Devon Herrick, a senior fellow at the National Center for Policy Analysis and author of several studies on consumer-directed health care, the fact that you can build up funds in your HSA and take them with you to another employer are major pluses.

"If you and your employer regularly contribute to an HSA and you don't use up these funds every year, by the time you are older and are likely to need more expensive tests and health care, you can have a healthy nest egg built up," he says. "If I invest the money in my HSA starting now -- in my mid-40s -- I could have $100,000 in it by the time I retire."