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How They Work
HSAs consist of two parts; the first part is a high deductible health insurance plan. These plans usually have a deductible for single employees and a deductible for families of two or more. The second part is a savings account established after the insurance plan is put into place. The savings account is where your employer and you put savings up to your deductible on a January 1st through December 31st basis. On an annual basis, what you do not spend out of your HSA savings will roll-over to the following year. You will receive a Visa card that is attached to this account to pay for health expenses.
How Claims are Paid:
Pharmacy -
Show your health insurance card.
Receive the health plan’s discount at the time of purchase.
Pay the discounted fee with your HSA savings account Visa.
Doctor’s Office Visits/Lab/Hospital:
Show your health insurance card.
Do not pay the Doctor anything at the time of your visit. Remember, your plan pays 100%, up to the amount you have in your savings account.
Wait for the EOB (Explanation of Benefits) to arrive from the insurance company.
Call the Doctor, lab or hospital; give them your Visa card number and authorize the discounted payment shown on the EOB.
HSA Basic Rules -
Must have an HSA eligible health plan.
Cannot have secondary health insurance.
Must be under the age of 65.
Must be a full-time, permanent employee.
Reasons to Choose an HSA -
Save dollars in your own savings account, owned by you, usually funded by the premium savings from your old health plan.
You choose where dollars are spent, not the insurance company.
100% coverage for all services with no co-pays or co-insurance until you have exhausted your savings.
Ability to roll savings year to year until age 65 when savings can roll into your retirement plan.
Excellent choices of medical professionals without referral requirements.
Superb PPO benefits with low out-of-pocket cost if HSA is funded.
Reasons not to Choose an HSA -
You will have high medical costs, i.e. impending surgery or a serious on-going illness,
You have high Rx costs, i.e. Lipitor or insulin.
You like HMO benefits with just co-pays.
You do not want to administer a cash account.
You do not want to take the risk of a high deductible HSA plan.
You are a poor money manager.
HSA Overview -
Covers medical and Rx expenses after deductible.
PPO plan has large choice of medical providers.
Lower premium costs.
Lower overall maximum out-of-pocket costs compared to standard PPO’s.