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Summary

To qualify for a Health Savings Account (HSA), you must meet each of the following requirements, each of which are described in other sections of this article:

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Medicare

You Must Be Under Age 65 And Not Have Medicare


High Deductible Health Plan (HDHP)

For purposes of Health Savings Accounts, a High Deductible Health Plan (HDHP) is a health insurance policy that fits the following rules with respect to both a front-end deductible (the amount you pay out-of-pocket before insurance pays) and an annual cap (maximum amount you pay for certain expenses).  As a general matter, any type of health insurance policy can be used with an HDHP. The most popular type of health insurance plan is a Point of Service (POS) plan.

  • Individual coverage: Your HDHP must have a deductible in 2013 of at least $1,250 and an annual cap of no more than $6,250 (including deductibles, co-pays and co-insurance)
  • Family coverage: Your HDHP must have a deductible in 2013 of at least $2,500 per person, and an annual cap of no more than $12,500 for the family (including deductibles, co-pays and co-insurance.)

Front-End Deductible

  • The deductible does not have to apply to preventive care which can be covered from dollar one. Preventive care includes:
    • Periodic health evaluations.
    • Stop smoking programs.
    • Obesity weight-loss programs.
    • Screening services.
    • Medication taken to prevent a disease or condition by a person who has risk factors but no symptoms of the disease or condition.
    • Medication taken to prevent a reoccurrence of a disease from which a person has recovered.
    • Medication used in connection with preventive services, such as obesity weight loss.
  • If you live in a state which limits the amount of permitted health insurance deductibles below the required amount, the HDHP only has to provide a deductible equal to the maximum allowed under your state law.

Annual Cap

  • The cap relates to covered expenses you must pay for in network health services, such as a deductible and copays. It does not include premiums or medical expenses incurred out of network. The amount of the deductible and cap varies depending on whether you have individual or family coverage.
  • If the plan pays different amounts for in-network or out-of-network services, the plan is analyzed for HDHP status by looking only at the in-network features. Out-of-network provisions which do not meet the requirements for a HDHP (such as maximum out of pocket amounts which exceed permissible HDHP limits) will be ignored. "In network" services or products are those that are performed by doctors or others who have arrangements with the plan to provide the services or products at rates which have been agreed in advance. Out of network providers have not reached such agreements.

If you're not sure whether a particular policy qualifiies as an HDHP for HSA purposes

Ask the health insurance company. If you have the coverage through your employer, ask your employer. Either way, get the answer in writing.

Permissible Other Health Coverage

You are permitted to have an HSA even if you have one of the following types of health related policies: