As often happens to investment vehicles created by legislation, Health Savings Accounts (HSAs) have suffered under the complex regulations meant to discourage misuse. However, the accounts have potential to do more than simply allow investors to save and pay for health-care expenses with tax-free dollars. They offer a potential way for individuals to bridge gaps in health insurance coverage that may occur during times of unemployment or in retirement.
The Medicare Modernization Act of 2003 created HSAs. Anyone younger than 65 can open an HSA after purchasing a qualified high-deductible health insurance plan. An individual can maintain an HSA and be covered under other insurance policies, as long as that person doesn't "double dip" and have medical expenses paid by both insurance and the HSA.
To be considered "qualified" the insurance plan must have a deductible of at least $1,050 for individuals or $2,100 for family, and have a limit of $5,250 individual and $10,500 family for out-of-pocket expenses. Choosing a policy that qualifies can involve insurance and tax issues that should be discussed with professionals in those fields.
Contribution caps are the lesser of the insurance plan deductible or the IRS maximum. For 2006, the IRS max is $2,700 for individuals and $5,450 for families. Individuals 55 or older can make a $700 catch-up contribution in 2006.
Many employers offer flexibility spending accounts for medical expenses (and sometimes child care) that allow employees to set aside pre-tax dollars for medical expenses not covered by the company's health insurance, including premiums and deductibles. Unlike flexible spending accounts, however, HSA contributions and gains can be rolled from year to year--there's no "use it or lose it" requirement--and you retain ownership of the funds even if you terminate employment. If your employer offers a flexible spending account, you should take a description of the account requirements and restrictions when you discuss an HSA with your financial professional.
Because you establish an HSA independent of your employer, these accounts can provide a health care expense "safety net" should you terminate employment (voluntarily or involuntarily). They also provide retirees with another investment vehicle that offers tax deductions for contributions, tax-free growth and tax-free withdrawals for medical expenses. Withdrawals for nonmedical expenses after age 65 are still taxable, and a 10% penalty applies for nonmedical withdrawals before age 65.
If you plan to use HSA funds in the near term, a liquid, interest-bearing account like a savings account may be appropriate. However, if you don't anticipate an immediate need for all or part of your HSA funds, the accounts are self-directed, allowing you to use other investment options. Your financial professional can help you determine which investment vehicle best meets your needs.
According to a 2006 survey by Watson Wyatt and the National Business Group on Health, health care insurance premiums have been rising at two to three times the rate of inflation for the past five years. Understanding the complexities of health savings accounts may be one way to lessen the blow and prepare for the future.
Health Savings Account 2009
More and more people now have the opportunity to choose Health Savings Accounts (HSAs) over other, more traditional, health insurance coverage – more companies and financial institutions offer this option than ever before. For the healthcare consumer, this is good news. When the community as a whole is given more choice when it comes to healthcare options, everyone benefits. HSAs let you decide how to manage your own medical needs and work out a financial plan that works best for your specific circumstances.
An added advantage of Health Savings Accounts is the prospect of lowering the nation's rising healthcare costs, and making the price of medical care more affordable for everyone. But how can revamping the current health insurance system affect healthcare from a financial standpoint? More to the point, how can a different kind of health insurance make it easier for most people to pay for required medical expenses?
In 2003 the Medicare Modernization Act introduced the concept of HSAs to the American public for the first time. A Health Savings Account is meant to encourage people to invest in their own healthcare through personal savings, and reduce health care costs at the same time; a revolutionary idea that has the potential to be the starting point for positive changes in healthcare. Health Savings Accounts have sparked a lot of debate amongst those who believe in the idea and those who are wary of its ability to change the face of healthcare as we know it.
When you get down to the fundamentals, HSAs are truly designed to improve healthcare and make it accessible to the vast majority of people. For the individual, HSAs make it easier to pay for medical expenses when they arise. Coupled with a high-deductible health insurance policy, a Health Savings Account allows you to save pre-tax money and earn interest tax-free. This allows you to have money set aside to cover a whole host of medical bills, including items that aren't necessarily covered by traditional insurance plans, such as dental expenses or alternative treatments. Individuals and employers can deposit up to $2700 per person and up to $5450 for a family, and any time you need to withdraw any amount to pay for qualified healthcare costs, you can do so tax-free. In addition, premiums for high-deductible insurance policies can be as little as half the amount of traditional PPO policies.
And because a Health Savings Account is tied to an insurance policy, more expensive treatments are covered, usually 100%, after you've met your deductible. When you turn 65, any savings remaining in the account can be withdrawn tax-free to be used for medical expenses you incur in your senior years. In addition, the savings you accumulate in a HSA work like a retirement fund. The money grows tax-deferred like an IRA, and you can withdraw the money after age 65 to pay for non-medical expenses without penalty, although you will be required to pay taxes. It is important to note, however, that amounts withdrawn prior to age 65 are subject to penalties and taxes.
Giving the individual more consumer power when making healthcare decisions not only helps you and your family save money, but also creates an environment in which healthcare costs in general become more reasonably priced. Essentially, the price of healthcare is so high because free market forces have little sway in the realm of healthcare products and services. Insurance coverage causes a disconnection between the consumer and the item purchased. When you visit the doctor or purchase a prescription from the pharmacist, you don't know the real price tag. All you see is your insurance payment and the price you pay at the cash register, after your insurance company pays the balance.
This lack of price transparency has led to less competition within the marketplace. People have traditionally chosen their doctors, health products, and other medical items based on location, convenience, or other factors not related to price. When people have the choice to compare different health care providers based on quality of service and price, soon overpriced healthcare will become a thing of the past. People will shop around and force providers to price healthcare more competitively.
As more and more people turn to Health Savings Accounts, medical providers will feel the pressure to post their prices and compete for the consumer's business. Armed with the knowledge of what healthcare actually costs, individuals and families will be less willing to overuse the system, which also drives up prices. (When healthcare appears to cost little or nothing, most people are prone to make use of services even though it may be unnecessary).
At the same time, HSAs naturally promote the use of preventive care. When people understand the true costs associated with healthcare, they will be willing to pay a little more up front to keep their engine running smoothly rather than pay a lot more at a later date to fix a problem they could have avoided.
Health Savings Accounts have also put affordable healthcare within reach for more people, who were previously paying medical expenses out-of-pocket due to inadequate or non-existent insurance coverage. The low premiums of a high-deductible HSA plan together with the option of putting your money in a savings account that earns interest has already encouraged large numbers of people who previously went without coverage to purchase a health insurance plan.
Only time will tell whether or not Health Savings Accounts can drive down skyrocketing healthcare costs, but the system created by such accounts, which affords the individual more freedom to control his or her own financial and medical destiny, bodes well for the future of healthcare in America.
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