Health Savings Accounts – Health Spending Accounts

Insurance companies have blended  high deductible health plans with savings accounts to create a category known as Consumer Driven Healthcare.  The idea is that, with the high deductible, you’ll be more careful as you are spending your own money and keep medical costs down.  Then, once you have reached your  deductible, your spending or saving account can be used to pay for copays or coinsurance.

Federal tax laws allow some plans to set up accounts that allow you to pay for health costs with pretax money, meaning the contributions to the Savings Accounts or Spending Accounts are deducted from your paycheck before federal and Social Security taxes are withheld (sometimes state taxes too). These plans have some limits and requirements, but are generally a good deal. Some common types are:

Flexible Spending Account (FSA): a pre tax account where unspent balances may not be rolled over, other than for a limited grace period after each plan year.

Health Reimbursement Arrangement (HRA): an employer funded pre-tax account where unspent balances may roll over from year to year. Typically offered in combination with high deductible plans.

Health Savings Account (HSA): a pre tax savings account funded by employer or employee that may roll over from year to year and must be offered in combination with high deductible plans.

So if I go to the doctor for a boo-boo, and the bill is $100, and I haven’t met my deductible yet, and I have to pay the whole $100 myself:

• It might take $140 or so before taxes for me to take home the $100 that I need to pay the doctor after the federal, state, and social security taxes are deducted.
• Or it can take only $100 if I use a health savings account that lets me pay health bills with money before it is taxed.