Find affordable quality healthcare in Pennsylvania with a Health Savings Account (HSA). Premiums are low, your federal and state taxes are reduced, and a government subsidy is available that can substantially reduce the rate. These tax-advantaged plans are available in all parts of the Keystone State and put you in charge of your medical coverage. Many flexible high-deductible options are offered.
What Is An HSA?
A Pennsylvania Health Savings Account (HSA) is a popular alternative to mainstream Pa health insurance. It is a savings product that features a different way for policyholders to pay for their expenses. They allow you to cover existing costs and save for future qualified medical and retiree health expenses on a tax-free basis. Employers also often offer HSA options along with the popular PPO and HMO plans. A list of eligible deductible expenses is available upon request. Many larger employers may deposit funds (typically $500-$2,500) into your account.
Once you become eligible for Medicare, although contributions are no longer allowed, deposited funds can continue to be used for qualified Senior expenses. Examples include long term care premiums, copays, deductibles, Part D premiums, Part C (Medicare Advantage plans), and Part D (prescription drug plans). Custodial care (nursing home or in your own home) expenses can also be paid with accumulated funds. Annual limitations reduce the amount of tax-free withdraws to pay for long-term care policies.
Most major insurers, such as Aetna, UnitedHealthcare, Independence Blue Cross, Capital BC, Geisinger and Highmark Blue Cross Blue Shield offer private or Group HSAs. Your policy is an account that you always own, regardless of where you are employed or what company provides your coverage. Older grandfathered accounts without maternity benefits have been phased out. Whether you live in Pittsburgh, Scranton, Reading, Harrisburg, Allentown, or any other city, policies are available privately or through an employer.
As the state's premier trusted website for low cost plans, we specialize in taking the time to research and find the options that provide the coverage you need. The prices you view on this website are provided directly by the carriers at the lowest prices they offer. There are never any fees or monthly charges. We also help you compare different policies (on or off the Marketplace) with federal tax subsidies available. Not all carriers previously mentioned feature competitive options in all areas of the state.
You must be covered by a High Deductible Health Plan (HDHP) to be able to take advantage of HSAs. Sometimes called a "catastrophic" health plan, an HDHP is a low-cost policy that generally pays 100% of your medical expenses after the deductible has been satisfied. And an HDHP generally costs less than traditional medical coverage, so the money that you save on insurance can therefore be put into the account. This difference could be thousands of dollars each year.
Money not used in the current year, can "roll over" to the next year without any penalties or taxes. You may also choose to deposit significantly more funds than you withdraw each year, which results in a larger amount of money available in later years. It also helps prepare for large hospital bills from a chronic illness. $1,350 is the minimum single deductible, and $2,700 is the minimum family deductible.
The tax savings depends on your household income and current tax bracket. If you are in the 24% tax bracket and deposit $5,000 into your account, the projected tax savings will be $1,200. A $2,000 deposit will save $480. The money does not have to be spent to earn the deduction.
If you are Medicare-eligible, you can not purchase an HSA or contribute pre-tax dollars to the account. Also, any applicant that is covered through their wife or husband's FSA (Flexible Spending Account) or declared as a dependent on another federal tax return, is ineligible. You can delay Medicare enrollment if you prefer to continue to make deposits into the account. However, you must also wait to receive Social Security benefits.
You can also take your money out at any time. For example, if you change your medical coverage to non-HSA coverage, you may choose to liquidate your funds. However, since the deposits were made by yourself, they can be withdrawn at any time for whatever reason. If you have previously tax-deducted the funds, you may have to recognize that amount as taxable income. NOTE: The HDHP offers various coinsurance options, such as 0%, 10%, 20%, and occasionally 30%. Also, the deductible and maximum out-of-pocket limits are more than FEHB (Federal Employees Health Benefits) plans.
The "Side" Account
You own, and you take care of the money in your account. Decisions on how to spend the money are made by you without the usual restrictions of other savings vehicles. You also decide what types of investments to make with the money to make it grow. Deposits into the account are optional and you can make systematic monthly payments or periodic payments. The healthier you are, the quicker the fund grows since you are spending less. Also available is a systematic option that automatically pays your medical bills.
Typically, up to 3-5 debit cards are provided to each family to pay expenses as they occur. At the time of the office visit or medical facility visit, your insurance ID card is given to the provider. The claim is processed, and the network-negotiated discount is applied to the cost of services. Typically, within 30 days, a statement is sent which details your payment and the due date. The funds can be paid from your account.
The most common investment option is the "fixed" account, which pays a specified rate of interest on most of the money in the account. Of course, interest rates have declined in recent years, although the risk is low. Since it is the safest option, we highly recommend it for novice and conservative investors. Investing in more aggressive options (stocks, mutual funds etc...) can result in losses to your principal. Shifting from one account to another is allowed. For additional IRS Guidelines, simply click here.
Many areas have their own contracts. For example, the BlueCare plan, with its own Visa card, was available in the Northeastern portion of the state through Blue Cross. Capital Blue Cross will offer their version in the Harrisburg area and surrounding Central Pa area. Highmark in Western Pa utilizes Bank Of America. NOTE: Ultimately, you choose the bank or financial institution to set up the side savings account. UPMC and Geisinger also have high-deductible options.
Qualified Medical, Dental, And Vision Expenses
Funds can pay for any “qualified medical expense”, even if the expense is not covered by your HDHP. For example, most health insurance does not fully cover the cost of certain drugs, but HSAs can. However, you can not pay for over-the-counter drugs since the law was changed seven years ago. Once funds are deposited, the account can be used to pay for these expenses tax-free, even if you no longer have HDHP coverage. For Seniors, many expenses can be paid, including the cost of long-term health coverage.
For example, several of the most commonly prescribed drugs are Synthroid (hypothyroid), Crestor (cholesterol), Cymbalta (antidepressant), Diovan (high blood pressure, congestive heart failure, etc...), and Nexium (acid reflux). Generally, you pay out-of-pocket when these prescriptions are ordered. Although a network-discount is applied, these types of expenses are fully-deductible. Specialty drugs can also be used, although they are the most expensive type of prescription. A generic or preferred-brand drug should always be used, if available.
The funds in your account roll over automatically each year and remain under your control. There is no time limit on using the funds. Dental and vision expenses can also be paid from the account, although the money you spend generally does not count towards meeting your deductible. Thus, if you incur a large dental bill for a root canal, or need to purchase multiple pairs of glasses, you can safely pay for it any time of the year.
Private dental and vision insurance plans are offered, although they are not extremely cost-effective. Limitations and waiting periods can result in high out-of-pocket expenses, especially during the first 12 months after enrollment.
IRS Form 8889
IRS Form 8889 is filed with your federal tax form when you have an HSA. You must indicate if you have a self-only or family policy. Contribution information will be asked. Distributions and deductions are entered on the form, along with employer contributions made upon your behalf. An additional 20% tax may be assessed on some distributions. Many revisions have been made to the form, and all changes can be viewed online. There are three parts to the form (contributions and deduction, distributions, and income and additional tax).
HSA Plans Available In Pennsylvania
First Priority my Priority Blue Flex HMO Silver 4550 HSA
Highmark my Direct Blue Erie HMO Silver 4450 HSA
Highmark my Direct Blue HMO Silver 4450 HSA
Highmark my Direct Blue EPO Silver 4450 HSA
Highmark my Direct Blue Lehigh Valley EPO Silver 4450 HSA
Highmark my Direct Blue Conemaugh EPO Silver 4450 HSA
No Medical Question Underwriting
Modified underwriting of applications is utilized, so no health-related questions are asked. Therefore, you will not be charged a higher rate because of an illness or sickness. For example, if you had been treated for cancer the day before you applied for coverage, you would still be accepted, assuming it is during the Open Enrollment period or you qualify for an SEP exemption. If you missed Open Enrollment, an SEP will be required to obtain guaranteed benefits.
You may purchase a non-Obamacare plan if you miss the deadline, but no contributions may be made. For example, if a short-term plan is purchased to cover yourself and family members throughout the year, effective January 1, you can obtain another HSA and begin contributing again. If you are without coverage, or a policy lapsed, contributions can not be made.
If you have accumulated monies from an existing HSA, you can continue to utilize those funds. If you attempt to apply outside of designated Open Enrollment periods, an SEP (Special Enrollment Period) exception will be needed. However, you can also choose to "freeze" or leave the account in-force without making any withdraws or contributions. During this time, all interest will be credited, although no tax-deduction will be offered for contributions into the account unless an active HDHP plan is maintained.
Obtaining Pa healthcare coverage for persons working for themselves can often be very challenging and frustrating. The HSA provides budget-friendly premiums along with unlimited benefits. That's quite a combination! There is no obligation to contribute funds into the savings portion of the account. Also, excess funds can be deposited to be used for specific Medicare expenses.
We highly recommend Pennsylvania Health Savings Accounts. Actually, I have a policy for myself and my family. It has worked well for us and we have substantially reduced our premiums. Preventive coverage is not subject to the deductible and out-of-pocket expenses receive a "negotiated Network discount," which reduces the medical bill. In some instances, the reduction is more than 70%. If it's good enough for me, I guarantee it's good enough for you!
To view your options, please enter your zip code at the top of the page. Only highly-rated companies are considered, and we will always keep you updated on any carrier changes. Or, call us and we'll be happy to review and discuss which HSA plans are best for your specific situation.