Health Savings Account (HSA)

The Health Savings Account (HSA) has a colorful reputation. Depending on who you ask, it's either the best thing ever to come on to the healthcare market, representing a sweet investment opportunity for the healthy and wealthy, or it's an unaffordable luxury plan of no relevance to the ordinary, low- and middle-income American. Well, let's start with a simple definition. As the name suggests, an HSA is a savings account where you make provision for the need to pay all the obvious medical and long-term care expenses including some not included in the average health plan, e.g. dental care and drugs bought over-the-counter. Because this is for an approved medical purpose, the savings are "tax free", i.e. come out of your pre-tax income. You can deposit up to $2,900 per year as an individual. It doubles to $5,800 for a family. The income rolls over, i.e. it accumulates with the investment returns also being exempt from tax. To encourage you to make active use of the account, it's portable, i.e. you can move it from one job to another. It also remains valid whether you are unemployed or taking a voluntary rest between jobs. If you need to make a withdrawal, this is tax free so long as used for healthcare purposes. After you reach the age of 65, you can access these funds for any purpose, i.e. this can be a tax-free retirement savings fund.

If we stopped here, this would look a good opportunity for most people with a little surplus income. But an HSA must be paired with a high-deductible health plan. The minimum deductible must be $1,100 for an individual, doubling to $2,200 for a family. If a claim arises, you therefore pay this deductible and all the associated copayments and out-of-pocket expenses up to $5,600 (which doubles to $11,200 for a family) before the plan pays out. Thus, you may find treatment for an injury or illness eats into your savings or unused credit. Although the premium on a high-deductible plan will be lower than for the conventional plan, the savings will always be less than the potential out-of-pocket payments you have to make. Worse, if your health fails and you need more regular treatment, you will never realize the long-term benefits of an HSA. The money will never accumulate to give you real tax benefits. HSAs work best if you never make a claim. You will also be hit by higher administrative and transaction fees. If this gives you an incentive to refuse healthcare to maximize your tax benefits, this is a bad plan. Healthcare decisions should be driven by your medical needs, not financial advantage.

So, if you have good health and your financial resources will absorb the out-of-pocket payments should your health suffer, you should include an HSA in your request for health insurance quotes. The high-deductible premiums are among the cheapest you will find. But if you prefer the idea of a health plan where the insurance company picks up most of the bills, the HSA is not for you. You should focus your request for health insurance quotes on the conventional policies.

© 2010 Ranjan Kumar