Download You must have an IRS Qualified High

HSA Process Review
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HDHP + HSA
Health Savings Account
You must have an IRS Qualified High Deductible Health Plan (HDHP) to open an
HSA. The two pieces work together to help you cover your medical expenses.
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 Medical and prescription drug
Deductible
HDHP Plan
Prescription Drugs
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expenses accumulate to the same
combined deductible
 The HDHP (processed by SAS)
covers medical expenses after the
deductible has been met
 Prescription drugs have copayments
that apply after the deductible has
been met, and are then covered
after copayments.
 Funds in the HSA can be used to pay
for any eligible expenses as defined
by Section 213(d) including
deductible and copayment charges
HSA Process Flow Chart – Deductible not yet met
Member goes to the
doctor’s office for
service and gives NEW
insurance card
information only
Provider submits claim
to insurance
Insurance determines if
deductible is met
Claim is processed and
applied to deductible
Insurance mails
Explanation of Benefits
(EOB) to member,
statement of remittance
to provider
Provider bills member for
outstanding liability
amount
Option 1: Member pays
provider with available
HSA funds
Option 2: Member pays
provider with own out of
pocket(OOP) funds, then
reimburses themselves
with HSA funds
Option 3: Member
chooses to pay OOP and
saves HSA funds for future
use
NO
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HSA Process Flow Chart – Deductible previously met
Member goes to the
doctor’s office for
service and gives
insurance card
information only
Provider submits claim
to insurance
YES
Insurance processes
claim
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Insurance mails check to
provider and
Explanation of Benefits
(EOB) to member
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Insurance determines if
deductible is met
No HSA funds
needed. Any HSA
funds left in
account at the end
of the year will roll
over to the
following year.
How the plan works
Single Plan with $1,300 HDHP
HSA – YEAR ONE
WSD contribution
Your contribution (Optional)
You see your doctor for an annual physical
(Preventive)
$1,000
$300
HSA account balance
$1,300
-$0
$1,300
A minor hiking accident sends you to the
emergency room
-$638
$662
Monthly prescription filled at $25/month
-$300
$362
HSA balance at the end of year one
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$362
will roll over to
following year
Plan, Save and Pay for Health Care
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