Health Savings Account
A
Health Savings Account (HSA) is an account that
you can put money into to save for future medical
expenses. There are certain advantages to putting
money into these accounts, including favorable tax
treatment. HSAs were signed into law by President
Bush on December 8, 2003.
Who Can Have an HSA
What Happens to My HSA When I Die?
Opening Your Health Savings
Account
Need More Information about HSAs?
Advantages of HSAs
Using Your HSA
Determining Your Contribution
High Deductible Health Plans (HDHPs)
Finding HDHP Coverage
HSA Contributions
Who Can Have an HSA
Any adult can
contribute to an HSA if they:
• Have coverage under an HSA-qualified “high
deductible health plan” (HDHP)
• Have no other first-dollar medical coverage (other
types of insurance like specific injury insurance or
accident, disability, dental care, vision care, or
long- term care insurance are permitted).
• Are not enrolled in Medicare.
• Cannot be claimed as a dependent on someone else’s
tax return. Contributions to your HSA can be made by
you, your employer, or both. However, the total
contributions are imited annually. If you make a
contribution, you can deduct the contributions (even
if you do not itemize deductions) when completing
your federal income tax return. Contributions to the
account must stop once you are enrolled in Medicare.
However, you can keep the money in your account and
use it pay for medical expenses tax-free.
What Happens to My
HSA When I Die?
If your spouse becomes
the owner of the account, your spouse can use it as
if it were their own HSA. If you are not married,
the account will no longer be treated as
an HSA upon your death. The account will pass to
your beneficiary or become part of your estate (and
be subject to any applicable taxes).
Opening Your Health
Savings Account
Banks, credit unions,
insurance companies and other financial institutions
are permitted to be trustees or custodians of these
accounts. Other financial
institutions that handle IRAs or Archer MSAs are
also automatically qualified to establish HSAs. If
you cannot locate a local institution willing to
establish your
account, check links under “Resources” on the
Treasury website.
Need More Information
about HSAs
Treasury’s web site has
additional information about Health Savings
Accounts, including answers to frequently asked
questions, related IRS forms and
publications, technical guidance, and links to other
helpful web sites. Treasury’s HSA website can be
found through
www.treas.gov (click on “Health Savings
Accounts”) or directly at the following address:
http://www.treas.gov/offices/public-affairs/hsa/
.
Advantages of HSAs
Security – Your
high deductible insurance and HSA protect you
against high or unexpected medical bills.
Affordability – You should be able to lower
your health insurance premiums by switching to
health insurance coverage with a higher deductible.
Flexibility – You can use the funds in your
account to pay for current medical expenses,
including expenses that your insurance may not
cover, or save the money in your account for future
needs, such as:
• Health insurance or medical expenses if unemployed
• Medical expenses after retirement (before
Medicare)
• Out-of-pocket expenses when covered by Medicare
• Long-term care expenses and insurance
Savings – You can save the money in your
account for future medical expenses and grow your
account through investment earnings.
Control – You make all the decisions about:
• How much money to put into the account
• Whether to save the account for future expenses or
pay current medical expenses
• Which medical expenses to pay from the account
• Which company will hold the account
• Whether to invest any of the money in the account
• Which investments to make
Portability – Accounts are completely
portable, meaning you can keep your HSA even if you:
• Change jobs
• Change your medical coverage
• Become unemployed
• Move to another state
• Change your marital status
Ownership – Funds remain in the account from
year to year, just like an IRA.
There are no “use it or lose it” rules for HSAs.
Tax Savings – An HSA provides you triple tax
savings:
(1) tax deductions when you contribute to your
account;
(2) tax-free earnings through investment; and,
(3) tax-free withdrawals for qualified medical
expenses.
Using Your HSA
You can use the money in
the account to pay for any “qualified medical
expense” permitted under federal tax law. This
includes most medical care and services, and
dental and vision care, and also includes
over-the-counter drugs such as aspirin.
You can generally not use the money to pay for
medical insurance premiums, except under specific
circumstances, including:
• Any health plan coverage while receiving federal
or state unemployment benefits.
• COBRA continuation coverage after leaving
employment with a company that offers health
insurance coverage.
• Qualified long-term care insurance.
• Medicare premiums and out-of-pocket expenses,
including deductibles, co-pays, and coinsurance for:
- Part A (hospital and inpatient services)
- Part B (physician and outpatient services)
- Part C (Medicare HMO and PPO plans)
- Part D (prescription drugs)
You can use the money in the account to pay for
medical expenses of yourself, your spouse, or your
dependent children. You can pay for expenses of your
spouse and dependent children even if they are not
covered by your HDHP.
Any amounts used for purposes other than to pay for
“qualified medical expenses” are taxable as income
and
subject to an additional 10% tax penalty. Examples
include:
• Medical expenses that are not considered
“qualified
medical expenses” under federal tax law (e.g.,
cosmetic
surgery).
• Other types of health insurance unless
specifically
described above.
• Medicare supplement insurance premiums.
• Expenses that are not medical or health-related.
After you turn age 65, the 10% additional tax
penalty
no longer applies. If you become disabled and/or
enroll
in Medicare, the account can be used for other
purposes without paying the additional penalty.
Determining Your
Contribution
Your eligibility to
contribute to an HSA is determined by the effective
date of your HDHP coverage. If you do not have HDHP
coverage for the entire year, you will
not be able to make the maximum contribution. All
contributions (including catch-up contributions)
must be pro-rated. Your annual contribution depends
on the
number of months of HDHP coverage you have during
the year (count only the months where you have HDHP
coverage on the first day of the month).
Contributions can be made as late as April 15 of the
following year.
High Deductible Health
Plans (HDHPs)
You must have coverage
under an HSA-qualified “high deductible health plan”
(HDHP) to open and contribute to an HSA. Generally,
this is health insurance that does not cover first
dollar medical expenses. Federal law requires that
the health insurance deductible be at least:
$1,100* -- Self-only coverage
$2,200* -- Family coverage
In addition, annual out-of-pocket expenses under the
plan (including deductibles, co-pays, and
co-insurance) cannot exceed:
$5,500* --Self-only coverage
$11,000* --Family coverage
In general, the deductible must apply to all medical
expenses (including prescriptions) covered by the
plan.
However, plans can pay for “preventive care”
services
on a first-dollar basis (with or without a co-pay).
"Preventive care" can include routine pre-natal and
well-child care, child and adult immunizations,
annual
physicals, mammograms, pap smears, etc.
Finding HDHP Coverage
Any company that sells
health insurance coverage in your state may offer
HDHP policies. Although Treasury cannot recommend
any specific names of companies selling these
policies, you should be able to find a qualified
policy by contacting your current insurance company,
an agent or broker licensed to sell health insurance
in your state, your state insurance department, or
check Internet links under “Resources” on the
Treasury website.
HSA Contributions
You can make a
contribution to your HSA each year that you are
eligible. You can contribute up to the amount of
your HDHP deductible but no more than:
$2,850* -- Self-only coverage
$5,650* -- Family coverage
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*2007 amounts; adjusted annually for inflation.
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