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Health Insurance Glossary

Definitions for common health insurance terms

health savings account (HSA)

DEFINITION: A health savings account (HSA) is a tax-deductible savings account that’s used in conjunction with an HSA-qualified high-deductible health insurance plan (HDHP).

HSA regulations allow you to legally reduce federal income tax by depositing up to $3,350 a year for individuals, or $6,750 for families, into a health savings account for tax year 2016, as long as you’re covered by an HSA-qualified HDHP. There’s no minimum deposit, but whatever you put into your account is an “above the line” tax deduction that reduces your adjusted gross income. Just like IRAs, HSA contributions can be made until April 15 of the following year.

For 2017, the family contribution will remain unchanged, but individuals will be able to contribute up to $3,400. In both years, account-holders who are 55 or older are allowed to deposit an additional $1,000 in catch-up contributions (this amount is not adjusted for inflation; it’s always $1,000).

Because the HSA is paired with a high-deductible health plan, your health insurance premiums will often be lower than they would be on a more traditional plan with a lower deductible. But HSA-qualified plans vary considerably in their out-of-pocket exposure; deductibles on HSA-qualified plans can be as low as $1,300 for an individual and $2,600 for a family. So you’ll find them among Bronze, Silver, and Gold plans, both on and off the exchange.

You can use the tax-free savings in your HSA to pay for doctor visits, hospital costs, deductibles, co-pays or prescription drugs. Once the out-of-pocket maximum on your health insurance policy is met, your health insurance plan will cover your remaining medical expenses, the same as any other health plan.

Prior to 2016, it was common to see HSA qualified plans that used aggregate family out-of-pocket limits. That meant the entire family out-of-pocket limit would need to be met before the plan’s benefits kicked in, even if all the claims were for a single family member.  But starting in 2016, all health plans – including HDHPs – must embed individual out-of-pocket maximums, which means that no single family member’s out-of-pocket expenses can exceed the individual out-of-pocket limit established by the ACA, even if the family is enrolled in an HDHP with a higher family out-of-pocket limit (note that there’s a widening gap between the upper out-of-pocket limits allowed for all plans under the ACA, versus the limit allowed for HSA-qualified plans).

It’s important to note that you can only contribute to an HSA if your current health insurance policy is an HSA-qualified high deductible health plan (HDHP). Not all high deductible plans are HSA-qualified, so check with your employer or your health insurance carrier if you’re unsure. Contributions to your HSA can be made by your or by your employer, and they’re yours forever – there’s no “use it or lose it” provision with HSAs, and the money rolls over from one year to the next. HSA funds can be stored in a variety of savings vehicles, including bank accounts and brokerage accounts (ie, the funds can be invested in the stock market if you prefer that option), and there are numerous HSA custodians from which to choose.

If you later switch to a health insurance policy that’s not HSA-qualified, you’ll no longer be able to contribute to your HSA, but you’ll still be able to take money out of your HSA at any time in your life to pay for qualified medical expenses, with no taxes or penalties assessed. If you don’t use the money for medical expenses and still have funds available after age 65, you can withdraw them for non-medical purposes with no penalties, although income tax would be assessed at that point (much like a traditional IRA).