  The rise in healthcare costs has led to the adoption of cost-sharing devices
in health plans. This article explores this discussion by simulating Health
Savings Accounts (HSAs) to cover medical and hospital expenses, supported by
catastrophic insurance. Simulating 10 million lives, we evaluate the
utilization of catastrophic insurance and the balances of HSAs at the end of
working life. To estimate annual expenditures, a Markov Chains approach -
distinct from the usual ones - was used based on recent past expenditures, age
range, and gender. The results suggest that HSAs do not create inequalities,
offering a viable method to sustain private healthcare financing for the
elderly.
