All good points. To some extent you can work up to a $10k deductible using an HSA. First year, you elect a $4k deductible -- the premiums are more expensive but

All good points. To some extent you can work up to a $10k deductible using an HSA. First year, you elect a $4k deductible -- the premiums are more expensive but you have lower exposure. Drop the max into your HSA. If, at the end of the year, you've been healthy and haven't spent much out of the HSA, then change your insurance up to the next deductible level (e.g. $7500). Drop the max into your HSA. Assuming you stay healthy, your HSA accumulates a large balance and you can gradually lower your premiums. Keep in mind that you aren't required to spend from your HSA if you have expenses: if you can pay out of pocket for minor expenses, do it. This keeps your HSA balance up so you can afford the risk exposure of the higher deductible. As a bonus, the HSA contributions are tax deductible and if you hit retirement age with a balance in the account, you can (more or less) treat it like your other retirement accounts.