Health Savings Accounts

[MomtoCandJ]

Can some one please explain them to me?

We have a high deductible plan through ACA marketplace that is HSA elgible and we have no idea on how to open one, contribute to it or anything

[Guest]

Well, i don't know what ACA is, but the HSA is a savings account where you (if self-employed), your company (if that is a benefit they provide), or some combination of both put money to keep in order to reimburse yourself when you have to pay things before you've met that high deductible. We have an insurance broker, so we set the HSA up thru him. If you were doing it independently, I guess i would call a representative from the insurance agency.

[MomtoCandJ]

ACA= Affordable (not) Care Act.

[Tammyla]

We are not self employed, but have a HSA  FSA through dh's work.  Basically, we have an enrollment period and have to set an amount for the year to be deducted from his pay check.  I believe it's pre-tax and we have to send in our medical bills for reimbursement.  The particulars change from year to year and you have to use the funds by a certain time or you loose the money, but it's pretty straight forward.  (Eye and dental also quality and some years we have to use up the money if estimate what we will need.  That's when we get glasses etc.)

 

[SparklyUnicorn]

Yeah I did not like the HSA when we had one.  The only thing that made it tolerable is that my husband's employer at the time contributed quite a hefty chunk of change to it so it worked out.  They claim this gives you all this control and you can negotiate rates, and blah blah.  Total bull crap.  Nobody would tell me their rates up front. 

 

The one good thing is that the money rolls over.  So if you don't spend it, you get to keep it and if you are lucky and everyone is healthy you will have a nice amount.  It makes more sense if you are a young single adult.  I don't think it makes sense with kids. 

 

Did you choose this option or is that the only option you had/have? 

 

I'd contact the company and ask them what you need to do. 

[ddcrook]

You can set up a HSA through a bank or other financial institution.  If you google "set up a health saving account" you will find several institutions that you can use.  You would contribute to it by making deposits.

 

We have a HSA through my husband's employer.  Every month we make a pre-tax contribution and then whenever we go to the doctor we use our HSA debit card.  It has been an easy way to save for health expenses and we appreciate the tax break.

[babs]

Yeah I did not like the HSA when we had one.  The only thing that made it tolerable is that my husband's employer at the time contributed quite a hefty chunk of change to it so it worked out.  They claim this gives you all this control and you can negotiate rates, and blah blah.  Total bull crap.  Nobody would tell me their rates up front. 

 

The one good thing is that the money rolls over.  So if you don't spend it, you get to keep it and if you are lucky and everyone is healthy you will have a nice amount.  It makes more sense if you are a young single adult.  I don't think it makes sense with kids. 

 

Did you choose this option or is that the only option you had/have? 

 

I'd contact the company and ask them what you need to do. 

Ours does not roll over and we are limited in how much we can put in...smaller amounts every year, thank you Obama et. al. in D.C...

[MomtoCandJ]

We chose it off the ACA market place. We can't really afford anything else with a lower deductible. I seriously don't like this ACA stuff, I'd rather just pay out of pocket for our minor needs and call it good, there is no way we are going to rack up 12,000 in health care cost unless something catastrophic happens. We are paying more for crap coverage per month than what it costs us to go see our NP without insurance

[plansrme]

We are not self employed, but have a HSA through dh's work. Basically, we have an enrollment period and have to set an amount for the year to be deducted from his pay check. I believe it's pre-tax and we have to send in our medical bills for reimbursement. The particulars change from year to year and you have to use the funds by a certain time or you loose the money, but it's pretty straight forward. (Eye and dental also quality and some years we have to use up the money if estimate what we will need. That's when we get glasses etc.)

Part of what you are describing applies to an FSA, not an HSA. HSA money is not subject to a use-it-or-lose-it rule. It can always be used for medical, dental or vision expenses not covered by your high-deductible health plan. It goes with you if you change jobs and can be carried over forever. HSA money is available only as you pay into it, unlike an FSA, which is all available on Day 1 of the plan year.

 

To find an HSA provider, google. There are about a jillion out there. Your insurer probably has a deal worked out with one of them. It is up to you, though, to make sure you do not contribute more than the annual maximum.

[Leav97]

Ours does not roll over and we are limited in how much we can put in...smaller amounts every year, thank you Obama et. al. in D.C...

 

If it doesn't roll over, then you probably have a FSA not a HSA.

[zimom]

We have had an HSA (not FSA) health plan for several years. We have been happy enough with it. We use HSA Bank, and again, have been happy enough with it. It was recommended by a friend. An individual can deposit roughly $3500 a year into the account, a family $6500 (very broad estimates). We just have it set to auto draft from our checking a set amount every two weeks, but it is very flexible. You can purchase a set of checks from them for a nominal amount, their debit card is free if I remember correctly.

 

I use the debit card for all eligible medical expenses, basically anything other then OTC meds. The dentist counts, prescription eyeglasses, copays, deductibles, and on and on. Any money we don't use one year we can use the next.

 

An important note, this year we changed insurance companies but still have an HSA plan, we can keep using our same HSA account, no need to switch anything. Easy peasy.

 

At the end of the year they send us a statement that we use for our taxes. Just a couple of numbers to enter, not each individual expenditure.

[Tammyla]

You are so correct!  I wish it did roll over, and HSA didn't sound completely familiar to me.

If it doesn't roll over, then you probably have a FSA not a HSA.

 

[shawthorne44]

I have found that having the HSA helps in negotiations.  When I have negotiated, the price has been 1/2 or 1/3 of the fictional price.  Basically, the doctors know that the insurance is going to discount the charge, so they inflate it.  Then they also have to pay for someone to argue with the insurance company.  There are some doctors I haven't negotiated with.  Like the fertility doc I am seeing.  

[SparklyUnicorn]

Ours does not roll over and we are limited in how much we can put in...smaller amounts every year, thank you Obama et. al. in D.C...

 

Then this must be something else?!  Although we had this quite some time ago so maybe there are different things out there now.

[SparklyUnicorn]

I have found that having the HSA helps in negotiations.  When I have negotiated, the price has been 1/2 or 1/3 of the fictional price.  Basically, the doctors know that the insurance is going to discount the charge, so they inflate it.  Then they also have to pay for someone to argue with the insurance company.  There are some doctors I haven't negotiated with.  Like the fertility doc I am seeing.  

 

Yeah nobody would even tell me their rates.  They should be required to.  Apparently they aren't.  I mean can you imagine going to a store and buying something and they wouldn't tell you the price until you were up at the register?  That's how it was and it was scary.

[Arcadia]

Hubby's employer has a plan that includes HSA. The employer contribute to the HSA but he doesn't. We could use the HSA to pay for the out of pocket portion, the child psych we went to for adhd testing billed direct and so we didn't need to do any paperwork.

 

Yeah nobody would even tell me their rates. They should be required to

My dentist gives me a printed quote if asked. The doctors and obgyn give me the numbers on scraps of paper which does tally when the bill comes.

[Guest]

They claim this gives you all this control and you can negotiate rates, and blah blah. Total bull crap. Nobody would tell me their rates up front.

I did find this to be true (some) for prescription meds. I would say, "the medicine needs to be affordable, because I pay OOP." Then, drs. would choose a particular med that fit my needs. (Not that that would always be a possibility, as I am aware that some Rxs are very expensive no matter what.)

[Liz CA]

We are not self employed, but have a HSA  FSA through dh's work.  Basically, we have an enrollment period and have to set an amount for the year to be deducted from his pay check.  I believe it's pre-tax and we have to send in our medical bills for reimbursement.  The particulars change from year to year and you have to use the funds by a certain time or you loose the money, but it's pretty straight forward.  (Eye and dental also quality and some years we have to use up the money if estimate what we will need.  That's when we get glasses etc.)

 

This is how our FSA is administered as well. You can see chiros, do acupuncture or pay for extra lab tests with it. It also can cover deductibles on your other insurance. Some RX are covered but we have to select  pharmacy that runs it through FSA's system, i,e., Raleys pharma did not work but other independent pharmacies generally do. They also cover OTC meds.

I would check the websites first because OTC coverage varies widely.

 

It is deducted from gross income which lowers your taxable income. Our enrollment period is always at the end of a calendar year.

Ours is a FSA and it does not roll over. We spent December buying eligible items to use up the funds.

[Tammyla]

??? Is the HSA pre-tax as the FSA is???  

 

 

This is how our FSA is administered as well. You can see chiros, do acupuncture or pay for extra lab tests with it. It also can cover deductibles on your other insurance. Some RX are covered but we have to select  pharmacy that runs it through FSA's system, i,e., Raleys pharma did not work but other independent pharmacies generally do. They also cover OTC meds.

I would check the websites first because OTC coverage varies widely.
 

It is deducted from gross income which lowers your taxable income. Our enrollment period is always at the end of a calendar year.

Ours is a FSA and it does not roll over. We spent December buying eligible items to use up the funds.

 

[NancyNellen]

??? Is the HSA pre-tax as the FSA is???

Yes, our HSA is pre-tax.

[Southern Ivy]

??? Is the HSA pre-tax as the FSA is???  

Yes, it is pre-tax. 

 

We personally love our HSA. I haven't had a chance to read through all the previous posts, so sorry if I repeat.

We liked that if we hit our maximum out of pocket deductible ($6,000 for the family), then everything after is paid 100%. After hitting $3,000, everything is paid 70%. 

We've only done this 2xs when we had a birth and two emergency surgeries come up. This year, we actually get money to roll over! 

 

I've never had to negotiate rates. We get the typical insurance rates, then pay with our HSA card. Maybe ours is different due to the company policy? 

 

I will say this, though, HSAs are typically only good for people who are never sick or people who are always sick. If you have a lot of medical bills, you will meet your deductible faster and the rest will be covered 100% OR you have to use minimal amounts and it's rolled over. For the family that goes an average amount, it may not be the better option. 

 

And, just a random tidbit, if you happen to have money in your account after age 65, you can access it for non-medical expenses as well. Not that that probably matters to you right now, but a future consideration. 

[LostSurprise]

Yes, an HSA is also pre-tax. The difference is that your total at the end of the year rolls over and can even be used after you quit the HSA plan (all money in the account it still available to you for medical expenses). 

 

We've had an FSA and an HSA and I much prefer the HSA for this reason. Also, some FSA plans only apply to certain expenses (say, dental and vision) which can be a royal pain if your husband over-estimated the year before.

 

We've had an HSA for the last 3-4 years and a child with severe medical needs. It's helpful to have the money available at the beginning of the year when you haven't met your deductible. It also can be used for braces, glasses, medications, hospital visits, well visits...pretty much any credible medical expense (dental, vision, medical, mental health therapist).

 

I would add that you do have to fill out an additional form for your taxes which details what you put into the account (you'll receive a notification from the company), but it's fairly straightforward. 

[QueenCat]

Ours does not roll over and we are limited in how much we can put in...smaller amounts every year,

 

Are you sure it's an HSA?The allowed amounts have increased for those. FSA amounts have decreased.

[QueenCat]

??? Is the HSA pre-tax as the FSA is???  

 

If you do it with a payroll deduction.

[Tammyla]

Nancy, BushMommy, LostSurprise, and QueenCath...Thank you!

 

Our FSA has been cut back and no longer covers over the counters.   I can't wait to tell dh.

[Tammyla]

I have another question.  Are you all saying the HSA pays before your insurance does, and I'm confused on the negotiations?

[xixstar]

I have another question. Are you all saying the HSA pays before your insurance does, and I'm confused on the negotiations?

To qualify for an HSA account you must have a high deductible insurance plan. So you will be spending money from your HSA to meet your deductible. Does that help?

 

I am not sure about negioating rates -- ours is a basic savings account and I am sure The interest is minimal. We didn't shop around for an HSAccount because our employer had already selected a bank to work with.

[LostSurprise]

 An HSA is just a special checking account where you can only pay medical bills. You have a debit card or checks (or both) to access it. Money is taken out of your check pre-tax and placed in the account. Often the same bank is used that does your 401k. Because it functions like a checking account would, you can pay the bill whenever you have the money in the account and want to pay it. 

 

At our clinic they ask you how much of your bill you want to pay. If you have a limited amount in your HSA account you can pay some then, and more later, just as you would any clinic bill. 

[Tammyla]

Oh yes, that helps.   And that is why we have the FSA.

To qualify for an HSA account you must have a high deductible insurance plan. So you will be spending money from your HSA to meet your deductible. Does that help?

I am not sure about negioating rates -- ours is a basic savings account and I am sure The interest is minimal. We didn't shop around for an HSAccount because our employer had already selected a bank to work with.

 

[shawthorne44]

I have another question.  Are you all saying the HSA pays before your insurance does, and I'm confused on the negotiations?

 

The HSA pays before the insurance does.  Because the deductible is so high, it is pretty clear when you are under, near or over the deductible.  So, for example, except for the year DH had a surgery, all my medical expenses were paid with the HSA.  DD meets her deductible every year plus the $1000 extra misc deductible.  So, that is usually pretty cut too.  

 

So, for negotiation I tell them that I haven't met my deductible and that I'll be paying with an HSA debit card.  

[Veritaserum]

We have an HSA through dh's work that's through United HealthCare. The rates we pay for doctors and stuff are negotiated by UHC. The insurance person for dh's work set up the HSA account. We have debit cards that we swipe at the pharmacy or use to pay bills that arrive from providers. One really nice thing about HSAs is that you can use the funds for any medical expense even if it's not a provider on your plan. I used it to pay for home birth, for example.

 

Dh's employer puts in money every month and I think we set up an amount to deposit every month, too. The balance fluctuates as money goes in and out. When I log into UHC I see the balance.

 

If you have to negotiate rates yourself, that would be a pain.

[Veritaserum]

Our insurance pays first (well, adjusts the rate) and then we pay the remaining balance with HSA funds. It takes a few months.