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HSA Process Review
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Health Savings Account
HDHP + HSA You must have an IRS Qualified High Deductible Health Plan (HDHP) to open an HSA. The two pieces work together to help you cover your medical expenses. Health Savings Account Deductible HDHP Plan Prescription Drugs Medical and prescription drug expenses accumulate to the same combined deductible The HDHP (processed by SAS) covers medical expenses after the deductible has been met Prescription drugs have copayments that apply after the deductible has been met, and are then covered after copayments. Funds in the HSA can be used to pay for any eligible expenses as defined by Section 213(d) including deductible and copayment charges
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HSA Process Flow Chart – Deductible not yet met
Member goes to the doctor’s office for service and gives NEW insurance card information only Provider submits claim to insurance Insurance determines if deductible is met NO Claim is processed and applied to deductible Insurance mails Explanation of Benefits (EOB) to member, statement of remittance to provider Provider bills member for outstanding liability amount Option 1: Member pays provider with available HSA funds Option 2: Member pays provider with own out of pocket(OOP) funds, then reimburses themselves with HSA funds Option 3: Member chooses to pay OOP and saves HSA funds for future use
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HSA Process Flow Chart – Deductible previously met
Member goes to the doctor’s office for service and gives insurance card information only Provider submits claim to insurance Insurance determines if deductible is met Insurance processes claim Insurance mails check to provider and Explanation of Benefits (EOB) to member YES No HSA funds needed. Any HSA funds left in account at the end of the year will roll over to the following year.
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will roll over to following year
How the plan works Single Plan with $1,350 HDHP HSA – YEAR ONE WSD contribution $1,000 HSA account balance $1,350 Your contribution (Optional) $350 You see your doctor for an annual physical (Preventive) -$0 $1,350 A minor hiking accident sends you to the emergency room -$638 $712 Monthly prescription filled at $25/month -$300 $412 HSA balance at the end of year one will roll over to following year
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Plan, Save and Pay for Health Care
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