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Anyway, is this how it works?

You (or your employer) max out an HSA at $6,500 and you use that money to pay for doctors visits, etc. Then you buy a high-deductible, say $5,000, catastrophic coverage plan for about $100/mo. with an out-of-pocket limit of $4,000



Exactly.

My wife and I would put in the max contribution, and the IRS-required high-deductible plan cost us $210 monthly (through Humana). $10,000 deductible, and I forget about the out-of-pocket limit.

As a side point, we chose an HSA plan administrator that allowed the full range of investment options available to tax-advantaged accounts, so I trade stocks and options in the HSA account just as I do with retirement accounts. We have so few health care expenditures that we just pay them out of pocket, and the HSA is therefore growing nicely.
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