HSA question

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cppoly
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HSA question

Post by cppoly » Tue Jun 26, 2018 2:49 pm

An HSA account isn’t offered through my employer but I’m looking into setting one up on my own.

A high deductible plan is required to qualify ($1,350 deductible and $6,650 max out of pocket for individuals) but it makes no mention of whether this applies to in-network or out-of-network benefits in the IRS publication 969.

I wouldn’t qualify if I individually went off of in-network benefits or out-of-network benefits but incorporating both of these, I technically would meet those dollar value requirements. Would this make me eligible or are you required to only use in-network benefits?

jebmke
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Re: HSA question

Post by jebmke » Tue Jun 26, 2018 2:50 pm

In order to be eligible for an HSA, the HDHP plan offered by your employer has to be HSA qualified. Is it?
When you discover that you are riding a dead horse, the best strategy is to dismount.

cppoly
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Re: HSA question

Post by cppoly » Tue Jun 26, 2018 3:07 pm

I'm looking into setting this up myself through a bank or an HSA provider and not through my employer so I was looking at meeting the requirements on my own by reading the publication and figuring out if my plan meets the requirements. Or does my employer have to get involved and let me know this answer?

jebmke
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Re: HSA question

Post by jebmke » Tue Jun 26, 2018 3:09 pm

You still have to have an HSA-qualified HDHP health insurance plan under which you are covered. Do you? You should be able to get an answer from either your benefits people or someone at the insurance company.

edit: when I was on an HSA qualified plan under retiree benefits the confirmation at open enrollment time confirmed that HSA qualification. I needed that one year when the IRS audited my tax return and wanted to confirm that the deduction was legitimate.
When you discover that you are riding a dead horse, the best strategy is to dismount.

Spirit Rider
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Re: HSA question

Post by Spirit Rider » Tue Jun 26, 2018 3:46 pm

The HSA minimum deductible and maximum out-of-pocket limit only apply to the in-network limits. The base plan type deductible is not the only requirement for an HSA qualified HDHP.

There can be no general health insurance coverage before the minimum HSA plan type deductible is met:
  • There can be no co-pay or co-insurance plan payments even if just for prescriptions.
  • There can be no individual deductibles in a family plan < the minimum HSA family plan deductible.

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Artsdoctor
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Re: HSA question

Post by Artsdoctor » Tue Jun 26, 2018 3:56 pm

cppoly wrote:
Tue Jun 26, 2018 2:49 pm
An HSA account isn’t offered through my employer but I’m looking into setting one up on my own.

A high deductible plan is required to qualify ($1,350 deductible and $6,650 max out of pocket for individuals) but it makes no mention of whether this applies to in-network or out-of-network benefits in the IRS publication 969.

I wouldn’t qualify if I individually went off of in-network benefits or out-of-network benefits but incorporating both of these, I technically would meet those dollar value requirements. Would this make me eligible or are you required to only use in-network benefits?
Save yourself a tremendous amount of time on this. Do not try to crunch the numbers yourself. Call your insurance plan directly and ask if it's HSA-eligible. They will tell you yes or no. In fact, most HSA-eligible plans will have something to that effect in the title of the plan. If you do not have a yes/no answer to your question, I would go up the administrative ladder at your insurance company until you have a definitive answer. It would be very, very rare that an insurance plan has no idea what you're talking about AND have the plan be HSA-eligible.

danaht
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Re: HSA question

Post by danaht » Tue Jun 26, 2018 8:33 pm

Spirit Rider wrote:
Tue Jun 26, 2018 3:46 pm
There can be no general health insurance coverage before the minimum HSA plan type deductible is met:
  • There can be no co-pay or co-insurance plan payments even if just for prescriptions.
Actually you, can have a HSA qualified plan that bypasses the deductible on prescriptions that are "preventative" in nature. Also the yearly physical will also bypass the deductible (since it is usually free).

Spirit Rider
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Re: HSA question

Post by Spirit Rider » Tue Jun 26, 2018 8:55 pm

danaht wrote:
Tue Jun 26, 2018 8:33 pm
Spirit Rider wrote:
Tue Jun 26, 2018 3:46 pm
There can be no general health insurance coverage before the minimum HSA plan type deductible is met:
  • There can be no co-pay or co-insurance plan payments even if just for prescriptions.
Actually you, can have a HSA qualified plan that bypasses the deductible on prescriptions that are "preventative" in nature. Also the yearly physical will also bypass the deductible (since it is usually free).
That is true of all of the many preventive medical expenses (screening, vaccines, etc...), but totally misses the point.

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VA_Gent
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Re: HSA question

Post by VA_Gent » Wed Jun 27, 2018 7:58 am

Spirit Rider wrote:
Tue Jun 26, 2018 3:46 pm
The HSA minimum deductible and maximum out-of-pocket limit only apply to the in-network limits. The base plan type deductible is not the only requirement for an HSA qualified HDHP.

There can be no general health insurance coverage before the minimum HSA plan type deductible is met:
  • There can be no co-pay or co-insurance plan payments even if just for prescriptions.
  • There can be no individual deductibles in a family plan < the minimum HSA family plan deductible.
Are you sure about this? My family plan has a family and individual deductible and out of pocket.
It also has out of network deductibles and coinsurance limits as well as max out of pocket.

19. CALENDAR YEAR DEDUCTIBLE Deductible is applicable to services and Prescriptions that have Coinsurance; deductible is not applicable to services that have Copayments and Amounts above the Allowable Amount.
A. Employee Only Coverage $2,000 $6,000
B. Employee+Child(ren), Employee+Spouse, Family Coverage 4,000 $12,000
20. MAXIMUM OUT-OF-POCKET Includes Coinsurance, Deductible, Copayments, and Prescriptions; Excludes Amounts above the Allowable Amount
A. Per Individual $5,500 $11,000
B. Per Family $11,000 $22,000
Last edited by VA_Gent on Wed Jun 27, 2018 8:30 am, edited 1 time in total.
"In investing, what is comfortable is rarely profitable." - Robert Arnott

47Percent
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Re: HSA question

Post by 47Percent » Wed Jun 27, 2018 8:16 am

You cannot go just by deductible limits and out of pocket max alone.

Your best bet, and the only way to be sure, is to make sure that the plan is clearly marked/labeled as HSA compliant. It will be either in the name of the plan itself, or in the short description.

There are plans which seemingly satisfy the $ limits within compliance but are NOT HSA compliant (i.e. not considered HDHP plans). For example, they cannot allow any "free" telephone consults.

The DIY part can apply to managing the HSA savings account, but not to evaluating which is HSA eligible and which is not HSA eligible insurance. Those are clearly labeled and marketed as such.
Last edited by 47Percent on Wed Jun 27, 2018 11:35 am, edited 1 time in total.

Spirit Rider
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Re: HSA question

Post by Spirit Rider » Wed Jun 27, 2018 8:39 am

VA_Gent wrote:
Wed Jun 27, 2018 7:58 am
Spirit Rider wrote:
Tue Jun 26, 2018 3:46 pm
The HSA minimum deductible and maximum out-of-pocket limit only apply to the in-network limits. The base plan type deductible is not the only requirement for an HSA qualified HDHP.

There can be no general health insurance coverage before the minimum HSA plan type deductible is met:
  • There can be no co-pay or co-insurance plan payments even if just for prescriptions.
  • There can be no individual deductibles in a family plan < the minimum HSA family plan deductible.
Are you sure about this? My family plan has a family and individual deductible and out of pocket.
It also has out of network deductibles and coinsurance limits as well as max out of pocket.
An HSA qualified HDHP family plan can have individual deductibles, but those individual deductibles must be >= the minimum HSA family deductible (2018 = $2700). Plan/individual deductibles of $6K/$3K would be qualified, $4K/$2K would not.

The bottom line is that in order to be HSA qualified an HDHP can not reimburse expenses for anything but disregarded coverage before the minimum plan deductible. An individual deductible < the minimum family deductible would do that.

I didn't say an HDHP plan can't have out-of-network deductibles/limits. Just that only in-network deductibles//limits are used in determining HSA qualification.

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VA_Gent
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Re: HSA question

Post by VA_Gent » Wed Jun 27, 2018 8:43 am

Thanks for the clarification.
"In investing, what is comfortable is rarely profitable." - Robert Arnott

cppoly
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Re: HSA question

Post by cppoly » Wed Jun 27, 2018 9:39 am

Thanks for the responses. I will check with my HR department to see if the plan is HSA eligible.

Regarding in-network in-network deductible/limits, I now see the reference in the chart in publication 969. I don't think I am eligible now, but I'm still asking.

jebmke
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Joined: Thu Apr 05, 2007 2:44 pm

Re: HSA question

Post by jebmke » Wed Jun 27, 2018 9:44 am

cppoly wrote:
Wed Jun 27, 2018 9:39 am
Thanks for the responses. I will check with my HR department to see if the plan is HSA eligible.

Regarding in-network in-network deductible/limits, I now see the reference in the chart in publication 969. I don't think I am eligible now, but I'm still asking.
I'd also double check with the insurance company offering the plan if the HR department can't provide a definitive answer. Most good benefits people at large companies should know the rules but .....
When you discover that you are riding a dead horse, the best strategy is to dismount.

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