We did this for several years, and I was happy to move back to a more traditional plan when that became available. I always contributed the max to my HSA, but for my family of 6 it never seemed to be enough. I always felt like I was paying out of pocket for stuff. Medical expenses seemed to come at a time when I had not yet contributed enough that year to my HSA to cover them. Every situation is different, of course, and you need to consider yours, but for my family it turned out a lot different than I had expected. We needed medical care far more than I had planned. The total cost was still probably lower, but the expenses were not predictable or consistent which it made it more difficult to budget. When my wife started a job at our local school district we ditched the high deductible plan for her traditional one (which has been much better cost and service wise).