Business Owners Resource Network

June 4, 2009

Only 59% Aware of Health Savings Accounts

Filed under: Business Insurance,Employee Benefits,Financial Services — michellehodges @ 1:16 pm

Great article I wanted to share that came out yesterday by Money Management Executive…

Six years after health savings accounts were introduced, only 59% of the population has heard of them, only half of these people actually understand them, and only 14% of the overall population own them, Guardian Life Insurance found in its Spotlight on Consumer-Driven Health Plans Survey. “Because these plans offer compelling benefits for both employers and their employees, we wanted to uncover the obstacles to increasing participation, identify key motivators and develop Guardian resources to expand ownership of HSAs,” said Tim Bireley, vice president of group medical at Guardian. Fifty-two percent did not know that contributions to HSAs are tax deductible, and 55% did not know that withdrawals used for qualified medical expenses are also not subject to taxes. In addition, 60% did not know that they can take the HSA with them when they switch jobs. For their part, employers also mistakenly think that HSAs are complex. Many also do not contribute to employees’ HSAs, and Guardian found that would make the plans more attractive to 61% of employees. Fifty-seven percent said that if insurance for critical illness were included, that would make HSAs more attractive. “As the economy, coupled with rising healthcare premiums, forces business owners, employees and benefit decision makes to make difficult financial choices regarding their healthcare offerings, consumer-driven health plans can provide a solution,” Bireley said.

Do you know how an HSA paired with a high deductible health plan can benefit you or your company?  Please contact me at   913-262-0600  or email mhodges@benefitsdesigngroup.cc  for more information.

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May 4, 2009

Health Insurance: You Need To Understand The Basics

Filed under: Employee Benefits,Financial Services — michellehodges @ 2:17 pm
I ran across an excellent article by Mark Mitchell that helps to decipher health insurance jargon…

Health Insurance: Understanding the Basics

Americans today receive a barrage of health insurance information from every direction. Pundits speak of the national health care crisis; Medicare now offers additional options; and employee benefits officers often speak in a jumble of letters from HMO to PPO. For the consumer, choosing a health insurance plan can be quite confusing.

Health insurance is not “one size fits all.” Depending on your current state of health, budget, and individual needs, the best insurance for you may be far different than the best insurance for your friend or family member. A basic understanding of the various types of insurance that are available, and what each does and does not cover, can be helpful in determining which plan will work best for each person.

Traditional health insurance, also called “fee for service” or 80/20, is the type of insurance that most of us grew up with. You are entitled to visit any doctor, and the insurance company pays 80% of the bill. This type of insurance offers the greatest flexibility, but carries the highest out of pocket expenses. A deductible must be met before the insurance company will pay. The lower your monthly premium, the higher the deductible will be. The insurance company usually reserves the right to cap payments if, in their opinion, the doctor’s fees are higher than what is “reasonable and customary” in your area. This is an excellent type of coverage to have if you become extremely ill and require a network of specialists, or if your medical bills are astronomical. Once your expenses for the year reach a certain level, the insurance company will take over and pay 100%.

Many healthy people do not need fee for service medical insurance. They find that their out of pocket expenses are much lower with a “managed care” plan. There are two basic types of managed care – HMO and PPO.

In an HMO, or Health Maintenance Organization, you pay a monthly premium in exchange for comprehensive medical care. There is usually a small co-payment for doctor’s visits (usually ranging from $5 to $25), and a somewhat higher co-pay or deductible for hospitalization. Your out of pocket expenses are significantly easier to predict and manage with an HMO rather than a fee for service plan. However, an HMO introduces the concept of a “gatekeeper.” In an HMO, you must choose a primary care physician. That doctor, working in tandem with a risk management insurance officer, will determine your access to specialists. Finally, an HMO requires you to use doctors that are part of the HMO’s network. If you travel a lot, be sure to find out what the provisions are should you require an out of network doctor.

A PPO, or Preferred Provider Organization, can be considered a blend of HMO and fee for service plans. You will choose a primary care physician, and generally use doctors that are part of the organization. However, a PPO lets you see doctors who are not part of the network for a somewhat higher fee. This increased flexibility is excellent for those who travel frequently, or for those whose current doctor is not a member of the organization.

Many other options exist for covering your medical expenses. A Health Savings Account allows you to set aside pre-tax dollars each month. Catastrophic insurance carries a low premium with a high deductible, and is designed to cover you if you develop a serious illness or injury. However, for the average consumer, the choice is generally between fee for service and managed care. All types of plans carry their own advantages and disadvantages, and it is important to understand what these are in order to make the right decisions for your family.

For more information please contact Michelle Hodges at mhodges@benefitsdesigngroup.cc  913-262-0600 

April 14, 2009

HIGH DEDUCTIBLE HEALTH INSURANCE PLANS FOR INDIVIDUALS

Filed under: Employee Benefits,Financial Services — michellehodges @ 2:33 pm

High Deductible Health Insurance Plans For Individuals 

Do you pay more attention to your car than your body? You change your oil every 3000 to 4000 miles. You have your tires rotated every other oil change. Your air filter and brake pads are changed at the appropriate intervals.

Now, what about your body? You follow the recommended AMA guidelines for routine check ups and other health care services. You pay special attention to make sure you eat a balanced diet and always take the time to get enough exercise (hopefully!).  The reality is many Americans pay more attention to the maintenance of their car than they do their body.

From an insurance perspective, your automobile insurance company has a certain expectation that you will take reasonable care of your car. Things such as the routine maintenance of brakes and making sure your turning signals work properly are expected by your insurance company. Basic common sense says that proper automobile maintenance reduces traffic accidents and saves both you and your insurance company money.

Health insurance consumers can benefit by taking a similar approach to taking care of their body. For the average American, regular exercise, routine check ups and following your doctor’s advice will reduce your health care costs in the long run. It is really very simple. By doing the things necessary to stay healthy, you will need to seek medical care less frequently.

Even with a commitment to stay healthy, you will still need health insurance coverage to take care of the unexpected and sometimes unavoidable catastrophic situations. However, instead of paying the insurance company for a $1000 deductible, many individuals would benefit by purchasing a high deductible health insurance plan. Depending on the specific situation, it is not uncommon for individuals and families to save up to 25% on premiums with a high deductible plan. Health Savings Accounts (HSAs) can then be set up to coordinate with the high deductible plan. Approaching health care and health insurance wisely will benefit both your body and pocketbook.

For more information please contact me at  913-262-0600  or email mhodges@benefitsdesigngroup.cc

It only takes a few minutes to see how much money you can save when deciding if a high deductible health plan with a health savings account is a good fit.

April 1, 2009

CheckPoint HR today released its top five tips to help employees save on healthcare costs.

Filed under: Employee Benefits,Financial Services — michellehodges @ 3:01 pm

GREAT TIPS for anyone to use to help alleviate some healthcare costs…read on….

Edison, NJ (PRWEB) March 31, 2009 — CheckPoint HR Benefits Group (http://www.checkpointhrbenefits.com/), a licensed insurance agency dedicated to delivering a broad range of employee health benefits solutions and custom plan designs, today released its top five tips to help employees save on healthcare costs (http://www.checkpointhrbenefits.com/manage_health_care_costs.html).

 “Many businesses are experiencing substantial premium increases in providing healthcare coverage for their employees,” said Patrick Carragher, vice president, CheckPoint HR Benefits Group. “As we move towards consumer driven health coverage, there are a number of ways employees can take charge of their health and costs associated with out of pocket expenses.”

1. Work with your Doctor Most doctors understand the business and processes of insurance. Tap into their knowledge base for the best possible hospitals for specific procedures, Many doctors can provide patients with guidance in negotiating fees and/or working with the insurance companies on lowering out of pocket costs. In some instances, doctors will reach out to the hospital’s finance department (on behalf of the patient) and request that consideration be made when dealing with the finances of certain procedures. Bottom line, communicate and work with your doctor!

2. Know ALL of the Benefits available to you Insurance programs are aligned with a lot of ancillary benefits that consumers should be made aware of. Benefits such as gym reimbursements, employee assistance programs, massage therapy, chiropractic care, acupuncture, vision reimbursements, weight loss programs, free or low cost flu shots or immunizations, disease management programs, health coaching or nurse advice lines, are no cost preventive benefits. Make sure you read the fine print and take advantage of everything that is being paid for via premiums.

3. Be a Smart Consumer Individuals today have better access to information then ever before. With more control over their own health care (http://www.checkpointhrbenefits.com/consumer_driven_health_care.html), consumers are able to make educated and more informed decisions about options, procedures, costs, and treatment. Some Insurance companies now have released the costs for certain procedures covered under their plans on their Websites. This information allows individuals to better understand the true costs of care before they utilize their plan and allows them to make better financial decisions based upon quality as well.

4. Go Generic High deductible plans are taking traction in the workplace and with that so does the need for employees to manage their costs with more scrutiny. One consideration for maximizing your benefits without sacrificing quality is to ask your doctor about a generic drug. When working with your doctor, ask them if the prescribed medication has a generic equivalent that will work for you. If there is a viable equivalent, make sure the medication is listed on the formulary list that your insurance carrier make available on their Website.

5. Focus on Wellness One of the best ways to reduce health care costs is for people to get healthy! Companies today are rewarding employees who are proactive in their decision making and who lead healthier lives through physical fitness and increased presenteeism. Corporate Wellness programs (http://www.checkpointhrbenefits.com/wellness.html) offered today focus on tobacco cessation, know-your-numbers (BMI, Blood Pressure, Cholesterol), walking clubs and programs that increase physical activity and reduce negative behaviors towards health.

 

For more information, contact me at mhodges@benefitsdesigngroup.cc

March 17, 2009

Health Care Reform in 2009

Filed under: Employee Benefits,Financial Services — michellehodges @ 7:30 pm

Nice article on health care from insurance.com….

“Let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year.” President Obama made this bold promise to hopeful Americans in his recent address to Congress.

Few listeners debate the importance of health care, but providing quality affordable health care for every American will clearly challenge Democrats and Republicans to work together to meet this goal. As unemployment rises, even fewer Americans will have health insurance through an employer. And, rising medical costs are forcing small and large businesses to reduce coverage, increase co-pays and deductibles and raise the amount that employees must pay each month. Some small business owners have even converted traditional health insurance plans to high deductible plans. Insurance.com offers these tips for evaluating your health care options and saving money on your medical bills. My employer offers an HMO and a PPO. How do I decide? Both provide excellent care, but you may want to choose an HMO if its network of doctors and hospitals matches your needs. Health insurance with a Health Maintenance Organization (HMO) is generally less expensive. You’re required to select an HMO physician to be your primary health care provider. This doctor will coordinate all of your medical care, including referrals to specialists within your HMO network. If you seek treatment from a non-network physician, you will generally pay most of the cost yourself. A Preferred Provider Organization (PPO) is more flexible than an HMO plan, but it still operates with a list of physicians and hospitals that are “within the PPO network.” You may visit an out-of-network provider, but you will pay the difference between the PPO network and out-of-network prices. Both plans usually offer a prescription drug benefit, as well. Some companies are offering options that allow you to combine features of both HMO and PPO plans. I can’t afford full health insurance, but I want coverage for major emergencies. A high deductible health insurance plan or catastrophic health insurance offer coverage for major illnesses or accidents. For example, a plan with a $5,000 deductible requires you to pay all of your medical expenses up to $5,000 before your insurer begins to pay. If you choose a high deductible plan, try to save a small amount of money each month in a Health Savings Account (HSA) so that you’re not overwhelmed by routine medical expenses. I have health insurance, but it seems like I’m always paying for something. Sad but true. You may owe a co-payment for doctor’s visits or a trip to the ER. Usually, this is a flat fee, but it can get expensive if you don’t stay within your plan network. Secondly, payment for expenses is subject to your annual deductible, which is the amount you pay toward your medical expenses before the insurance company begins to pay claims. Some HMO plans do not have deductibles but do have co-payments. Lastly, there’s co-insurance, which is the percentage of your medical costs that you pay after you reach your annual deductible. 80/20 co-insurance is a common option, and that means that your insurer pays 80% of your bills and you pay 20%—after your deductible. So, anything you can do to reduce your medical bills will help you reduce your out-of-pocket expenses, too. I don’t have health insurance. What can I do? Almost every hospital has a financial aid office that will evaluate your personal situation and determine your ability to pay for required care. Generally, a hospital will provide sliding scale fees if your income is 400% or less of federal poverty limits and may eliminate bills entirely if your income is 200% or less of federal poverty limits. But hospitals have to make money, too, so they may not publicize these programs or provide much assistance in applying. Be prepared with recent copies of your tax returns and W-2’s to prove your need.

Michelle Scaro Hodges

mhodges@benefitsdesigngroup.cc

 913-262-0600

March 2, 2009

HSA’s and Personal Responsibility

Filed under: Employee Benefits — michellehodges @ 11:23 pm

By promoting competition, the free market does a better job at delivering goods and services than any government or monopoly program.  This is a simple truth, yet too few people understand it.

HSAs provide an incentive to promote this type of competitive market environment in health care.  HSA owners are more likely to shop with their health care dollars, and demand lower prices and better service.  They are more likely to ask for generics, to shop for better pricing for similar services, etc.  The mindset is that of any consumer shopping and wanting the best bang for their buck.   

We are already seeing the results, with doctor charges rising less in 2006 than any of the past 25 years.  There are also numerous companies springing up to serve the needs resulting from this new, consumer-driven health care.  With non traditional approachs to healthcare on the rise…i.e. holistic and natural remedies, HSA’s are increasingly popular because you can use your pre tax dollars to pay for such services. 

So what, exactly, do HSAs promote?  Personal responsibility, of course. 

Everyone knows that their medical expenses are likely to go up as they age.  Those who take personal responsibility put money aside to cover these future expenses.  And they have no worries about paying for medical expenses during retirement.

 Everyone also knows that the risk of sickness and disease increases with age.  Those who take personal responsibility eat right, exercise, and take care of themselves.  And they tend to be much more healthy and vibrant in their retirement years.

 If you have an HSA, and take care of your finances and health, you will pay lower taxes, lower insurance premiums, and fewer medical bills, and you’ll have a whole lot of money in a tax-free account one day.

HSAs seem to particularly appeal to those who resonate with this idea of personal responsibility.

Consumer Driven Health care…wave of the future…I think so!!!  What’s your thought on personal responsibility and health care? 

Michelle Hodges

mhodges@benefitsdesigngroup.cc

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February 26, 2009

A Basic Overview of Health Savings Accounts

Filed under: Employee Benefits — michellehodges @ 8:01 pm

I have found another wonderful article on HSA’s.   Consumer Driven Health Plans is a phrase you may have already heard and if not, will be hearing about in the near future.   HSA’s are for individuals as well as employee group plans.  Hope you find this information helpful and interesting!  Please contact me at mhodges@benefitsdesigngroup.cc or  913-262-0600 .  Thank you, Michelle Hodges

 

A Basic Overview of Health Savings Accounts Health Savings Accounts are becoming more of a need these days than a luxury. You must be enrolled in a high deductible health insurance plan in order to qualify for a Health Savings Account (HSA). Since Health Savings Accounts have been around, millions of people have qualified and gotten one. The trend should only continue to raise as more and more employers and companies offer this benefit as a bonus to their medical plans. Some companies aren’t quite there yet but many have jumped on the bandwagon. There are some basic rules that can help an individual or corporation decide to enter the HSA market:

To establish an HSA, there are some rules and regulations. It is like establishing an individual retirement account (IRA) in most cases. In fact the documents are very similar and the procedure as well. An HSA trustee (or HSA Administrator) can add terms to their agreement regarding the effecting policy and procedure of their HSA. These terms can include any of the following but that may not be all that is required. Included in your agreement could be definitions, fees and expenses, amendments, disqualifying provisions, investment options, distributions, transfers and rollovers, reports and records, termination and/or resignation, and liability protection. There might be more of less of these conditions depending on the insurer.

HSA eligibility requires you to have an Internal Revenue Code to even desire to be eligible. You must be enrolled in a high-deductible medical care plan. So, people who don’t pay a deductible or it is very low, do not qualify for this benefit. Some exemptions do apply of course but you would need to contact the right person to find out. You must not be able to be claimed as a dependent for anyone else or on Medicare. To qualify your deductible needs to be for an individual a minimum or $1150, and your out of pocket expenses can’t exceed $5,800 for that year. For a family, the deductible needs to be a minimum of $2300 and the out of pocket portion can’t exceed $11,600 per year. There is a cost of living deduction as well and your agent to better save you money will adjust things. Many organizations require that you prove you are eligible prior to a contract. It is the individual asking for the HSA that must figure out that they qualify or might qualify.

The yearly contribution can’t exceed the deductible amount or combination with out of pocket expenses. As long as the individual has the high-deductible health plan they are qualifying. If you lose this plan, you will not be eligible for that month or period of time. If you are married and have separate high-deductible health plan, it is the lowest deductible amount that the family as a whole can meet. There are no combining deductibles to get a higher benefit. If you qualify, you can establish a regular contribution, a rollover contribution, or a transfer contribution plan. For the money to be deductible for a specific tax year, one must file by the deadline to receive the benefits. If an eligible individual’s employer contributes to his or her HSA, the employer, not the HSA owner, is entitled to a deduction.

An HSA administrator or trustee reports the contributions on IRS Form 5498-SA, HSA, Archer MSA, or Medicare Choice MSA Information. Copies of the report are due to each participant and the IRS by May 31 of each year. The owner is responsible for reporting the contribution amount on the proper forms to be submitted and file them with the income taxes that year. The distributions are to be made by the owner, if different than the participant. These will tax-free if used to pay for, or reimburse qualifying medical expenses that occurred after putting the plan into effect. These expenses include and could exceed the diagnosis, cure, treatment, or prevention of disease, prescription and certain nonprescription drugs, and transportation and certain lodging costs primarily for and essential to qualified medical care and certain qualified long-term care services. It is an HSA owner’s responsibility to determine the taxability of an HSA distribution and whether it is legitimate. The guidance of a tax or legal professional may be necessary to determine whether an expense is a qualified medical expense to avoid penalties.

February 24, 2009

Supplemental Health Insurance

Filed under: Employee Benefits,Financial Services — michellehodges @ 11:09 pm

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In today’s world of rising health insurance premiums, I often have employers ask me how to help provide their employees with benefits but at the same time help them to contain costs.  Let’s face it, right now we all need to look at opportunities to get the best bang for our buck.  In the health insurance arena…one brillant way is to make available  supplemental insurance  policies to your employee benefit package such as Aflac and Colonial.  Here’s some more information to give you an overview of just what supplemental insurance is…

How Does a Supplemental Health Insurance Plan like Aflac and Colonial Work?

Supplemental insurance, such as what Aflac and Colonial offers, pays a cash benefit to the insured. The amount of cash and how it is paid out depends on the supplemental health insurance plan or policy. Some popular supplemental health insurance policies are specific disease insurance such as for cancer, accidental death and dismemberment insurance or accident health insurance, and hospital indemnity insurance.

Determine Your Need for Supplemental Health Insurance

Since you already have health insurance do you need any of these supplemental health insurance plans offered by Aflac and other insurance companies? Well, that depends on your risk factors and how much insurance you want to carry or can afford to carry and how much savings you have put back.

First, Obtain a Good Health Insurance Policy

Of course, the first thing you want to have is a good health insurance policy. A good health insurance policy will pay for your health insurance bills just fine. Supplemental health insurance comes in to help you pay for what your health insurance does not pay or other expenses you cannot pay if something should happen where you temporarily or permanently cannot make an income to pay your bills.

What to Consider when Choosing Supplemental Health Insurance

Only you can decide if a supplemental health insurance plan is right for you. Some things to consider when deciding if you need a supplemental health insurance plan are your health risk factors, your savings, and how much insurance you can afford. Of course no one can predict what their health will be in the future, but if you have always been in good health and take good care of yourself then you would be less likely to use a supplemental health insurance policy than someone who is often in bad health. Also, your savings should play an important role in your decision to purchase a supplemental health insurance policy. If you were in the hospital for a few weeks or more, would you have enough to cover your other expenses that your insurance would not? And, when deciding on purchasing a policy, you need to take into consideration if you can afford it or not. Supplemental health insurance policies are not often used so it is not worth it to you to purchase a policy that you probably will not use if it would be a financial burden.

Let’s now take a closer look at the three most common supplemental health insurance policies:

1. Disease Specific Insurance: This type of supplemental health insurance provides a cash benefit paid directly to you if you require treatment for a specific disease such as cancer. Usually the benefit is paid per day or per procedure. There is a usually a minimum daily benefit and a policy maximum. The cash can be spent in any way you would choose and getting your benefit would have nothing to do with how much your insurance paid for your medical costs.

2. Accident Health Insurance or Accidental Death and Dismemberment Supplemental Insurance: This type of supplemental insurance typically would reimburse you for medical costs resulting from accidents. Benefits are paid if you die (to your beneficiaries) or are disabled due to a specific accident outlined in the policy. Premiums are usually low and no medical exam is required. Accidents can include car accidents and accidents in the home or at your job. Also, if you loose limbs, fingers, toes, or your vision due to a covered accident, you may be able to collect a percentage of the death benefit.

3. Hospital Indemnity Insurance: This type of supplemental health insurance provides a daily, weekly, or monthly cash benefit if you are confined to a hospital stay. Usually there is a minimum hospital stay before benefits are paid. The cash benefit is paid in addition to any other insurance you may have. Benefits are usually reduced if you are confined to a mental hospital and often you can find plans through an employer that require no health exam.

Next week I’ll talk about how integrating supplemental insurance with a high deductible health plan makes perfect sense!

You can reach me at:

Michelle Hodges

Benefits Design Group

mhodges@benefitsdesigngroup.cc

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February 23, 2009

Health Savings Accounts…FAQ’s

Filed under: Employee Benefits — michellehodges @ 8:06 pm

With HSA’s being such a buzz word in the healthcare industry, I often have clients asking the same basic questions.   Here you will find some answers to some of the most common questions asked…

What is a Health Savings Account (“HSA”)?
A Health Savings Account is an alternative to traditional health insurance; it is a savings product that offers a different way for consumers to pay for their health care. HSAs enable you to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis.

You must be covered by a High Deductible Health Plan (HDHP) to be able to take advantage of HSAs. An HDHP generally costs less than what traditional health care coverage costs, so the money that you save on insurance can therefore be put into the Health Savings Account.

You own and you control the money in your HSA. Decisions on how to spend the money are made by you without relying on a third party or a health insurer. You will also decide what types of investments to make with the money in the account in order to make it grow.

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What Is a “High Deductible Health Plan” (HDHP)?
You must have an HDHP if you want to open an HSA. Sometimes referred to as a “catastrophic” health insurance plan, an HDHP is an inexpensive health insurance plan that generally doesn’t pay for the first several thousand dollars of health care expenses (i.e., your “deductible”) but will generally cover you after that. Of course, your HSA is available to help you pay for the expenses your plan does not cover.

For 2008, in order to qualify to open an HSA, your HDHP minimum deductible must be at least $1,100 (self-only coverage) or $2,200 (family coverage). The annual out-of-pocket (including deductibles and co-pays) for 2008 cannot exceed $5,600 (self-only coverage) or $11,200 (family coverage). HDHPs can have first dollar coverage (no deductible) for preventive care and apply higher out-of-pocket limits (and copays & coinsurance) for non-network services.

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How can I get a Health Savings Account?
Consumers can sign up for HSAs with banks, credit unions, insurance companies and other approved companies. Your employer may also set up a plan for employees as well.

How much does an HSA cost?
An HSA is not something you purchase; it’s a savings account into which you can deposit money on a tax-preferred basis. The only product you purchase with an HSA is a High Deductible Health Plan, an inexpensive plan that will cover you should your medical expenses exceed the funds you have in your HSA. However, HSA trustees often will charge fees for their services.

For more information,  I can be contacted at:

Michelle Hodges

Mhodges@benefitsdesigngroup.cc

913-262-0600

From www.ustreas.gov

 

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February 18, 2009

A Prescription for Wellness; HSA’s

Filed under: Employee Benefits — michellehodges @ 11:02 pm

Health Savings Accounts or HSA’s as you might have heard them called…Scary, maybe at first until you grasp the fundamental concepts.  HSA’s allow you to set up a tax-deductible account to pay for medical expenses that are not covered by your health insurance.   For example you can use your HSA funds to pay for your glasses, contacts, dental needs, some over the counter medication, etc.  And since few health insurance plans cover expenses like homeopathy, acupuncture, or chinese medicine many Americans are paying for these alternative therapies out of their own pocket.  With an HSA, these expenses are 100% tax deductible when paid for through a health savings account. 

Humana has put together a great little video on YouTube…check it out!

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