Each January for the last decade or so, we have seen a wave of new enrollees in high deductible health plans with a Health Savings Account (HSA). And each January, we see these new enrollees confused by the plans.
For those of you new to an HSA (or just looking for some more insight), here are some things you didn’t know about an HSA and how to use it more effectively.
Prescription drugs count towards the deductible, but may have higher upfront costs
With an HSA, the cost of prescription drugs will count towards your deductible and maximum out-of-pocket. However, rather than paying a set co-pay for a prescription, you are now responsible for the negotiated price of the specific drug. This means if you were paying a $15 co-pay, but the actual drug costs $35, you will be asked to pay $35. On the reverse side, if you have already met your deductible and maximum-out-of-pocket for the year, you would pay $0.
Your experience at office visits may change
If you were accustomed to an office visit co-pay, this will likely change. At many facilities, you will pay nothing at the time of service and will wait for the visit to be processed through your insurance. You will then receive a bill and pay accordingly. Some facilities (particularly specialists) may ask you to pay a deposit or portion of the visit up front. The visit will still be processed through your insurance and any net payment due will be billed to you. While there are dramatic cost differences throughout the country, you might expect a visit to cost $100 to $250 for a general practitioner and $250 to $500 or more for a specialist.
Preventive care services are covered
Certain preventive care services are covered by the insurance plan and there is no cost sharing. You will want to check with your insurance provider to see what services are covered and the frequency that is covered. The most common services covered include: annual exams, child wellness visits and immunizations.
You can ask for a payment plan
Most facilities and hospitals offer financing options. If you incur a large expense before funds are available in the HSA and do not have other funds available to cover the expense, you can ask for a payment plan. As long as you are able to make recurring payments as HSA funds are deposited, most facilities will work with you.
You have a right to ask for negotiated or discounted prices
While it can be difficult to think about, you have the right to see if the provider will offer a further discount. If you can pay the entire bill upfront, the provider is more likely to accept a discount. Services like Medical Cost Advocate are available and will negotiate on your behalf. If they are able to save you money, they receive a small portion of the savings as their fee. If they are not able to receive any savings, you pay nothing.
You are in control
For many people, high deductible health plans with an HSA are scary. But, you are in control. You own the funds in the HSA and you decide how you want to fund, use and even invest the funds. You now have a greater interest in getting involved in your health care decisions.