HSA for America Blog

Health Sharing, Health Savings Accounts, and
Other Strategies for Those Who Don't Receive Health Insurance Subsidies

How to Choose the Best Option for 2018 – Health Insurance or Healthshare Program?

October 31st, 2017

Cost-sharing-reduction payments are made to insurance companies to offset some of their costs for providing discount health insurance plans to Americans who earn up to 200% of the federal poverty level (FPL). This insurance marketplace was set up by the Affordable Care Act (ACA) to provide about $7 billion to insurers to encourage them to continue offering the plans to lower-income people.

Now that cost-sharing subsidy payments have stopped, insurers still have to offer lower deductible plans to low-income consumers, but the tax-payers won’t be directly funding the $7 billion a year it costs to do that.

What Happens Now That Cost-Sharing-Reduction Payments Have Stopped?

Halting the payments is expected to lead to increases in premiums, as insurers will have to continue providing the subsidy to consumers. Insurers would still need to offer those plans with lower co-pays and deductibles to people who earn up to 250% of the FPL.

Some insurance companies may decide it is no longer worth selling health plans on the marketplaces as they will no longer be able to get financial help for the costs they are bearing.

Will All Consumers Feel the Higher Costs?

This only applies to consumers who get insurance on the individual market; this plan does not affect people who get coverage on the job or through a government program. If your income is low enough to qualify for a subsidy, you may not feel much of the impact because your subsidy will also go up as your premium does.

People who make too much income to qualify for the premium tax credits are the ones who really feel the brunt when premiums increase. However, this impact may be limited since some states specifically permit insurers to increase premiums due to cost-sharing reduction uncertainty.

What to Do: Shop Around or Consider a Healthshare Program

If you have a Silver plan and you’re not eligible for premium subsidies, compare the available plans during open enrollment to ensure you’re getting the best plan. In many states, the new rate increases will be concentrated on Silver plans, so Bronze or even Gold plans may be a much better value.

Regardless of which plan you have now, if the rates are jumping, definitely shop around. Note that you may have to change physician networks if you change plans, so make sure your doctor is in your new network if that is important to you.

Healthshare program is also an alternative to health insurance that works in much the same way. Although it’s not health insurance, healthshares cost half or less than the cost of an unsubsidized health insurance policy. Healthshare members are also exempted from paying the ACA tax penalty.

Medical providers are accepting healthshares as an alternative to health insurance, so it is easier for patients to find exceptional medical care. You get a membership card once you enroll and you give your doctor the card when they ask for your insurance. To learn more about how healthshare programs work, we’ve created a video to make it easier to understand.

Concierge Medicine and your HSA

September 26th, 2017

Concierge medicine is becoming more popular nowadays with more people than ever choosing this type of provider over more traditional physicians. If you have a health savings account (HSA) plan, having Concierge medicine knowledge can help you cut down your healthcare costs.

What is Concierge Medicine?

Concierge medicine refers to the relationship between a primary care physician and a patient in which the patient has to pay an annual retainer fee. While the consumer-driven healthcare accounts do not cover the initial expense of concierge fees, they cover any medical services fee paid for at the offices.

Patients of concierge practices enjoy greater access to their physicians, preventive services, personalized healthcare, and educational wellness.  The concierge business method offers patients perks like 24-hour access to a doctor, quick responses, appointments without wait time, answers to questions and treatment via e-mail, and even house calls as defined under their concierge agreement.

Using HSAs to Cover Concierge Medicine Cost

When it comes to covering the annual fee for this service, people who have HSA plans often use the funds from their HSA to pay for it.  How?

Funds from your HSA can be used to reimburse your cost of concierge medical services. You can use your HSA funds tax-free to pay for individual health care services that you receive from your concierge physician, but you cannot pay your full annual concierge medicine service fee with your HSA funds without penalty. Here’s an outline to help make things a little more clear:

  • Let’s assume you paid $2,500 for your concierge membership.
  • You used your membership for $1,000 during that year in medical services that were not reimbursed by insurance, but were HSA-qualified.
  • If your physician provides an invoice that shows the actual cost of qualified medical expenses received under your concierge agreement, then you can reimburse yourself for that $1,000 from your HSA.
  • However, you cannot reimburse yourself from your HSA for concierge services that are more than your annual concierge fee.

Qualification for Reimbursement

There are exceptions and qualifications, of course. You can reimburse your HSA or send payment to the medical concierge directly from your HSA regardless of the criterion of the medical expense. If you reimburse yourself for concierge services received, ensure you keep detailed records in case of an IRS audit of your HSA.

Final Thoughts on Concierge Medicine

Whether to choose concierge medicine or not is an entirely personal decision. Much of it depends on whether you are happy with your current level of care through your primary care provider. You may also be limited by your geographic location; while this model of medicine is becoming more popular and therefore more available, you may not be able to find a concierge practitioner where you live.

Since my personal goal is to help you save money on your health care needs, including on both premiums and out-of-pocket expenses, I will say that there is no reason why you should not choose concierge medicine if it is available to you. The overall expenses, including the annual fee, are not likely to be more than you are currently paying, and in many cases may even be less. This is especially true if your doctor offers discounted services for cash payments.

How Freedom of Choice Affects The Cost of Healthcare

August 29th, 2017

Many in government seem to think they know what’s best for us by controlling health insurance – who must purchase it, who the plans must cover, what benefits the plans must cover, and how the insurance companies can administer them. Though there are some good intentions behind some of this, the results have been catastrophic for people who aren’t receiving government subsidies. But when government gets out of the way, the market can come up with amazingly affordable solutions.

Skyrocketing Premiums and Dwindling Options

Since insurance companies are forced to cover people regardless of pre-existing conditions, they are once again dramatically increasing the premiums on all their planholders.

That is, if they are staying in the market at all. Blue Cross Blue Shield just announced their departure from many states, as have other companies.

So we now have a situation where in many cases there is only one single company that offers coverage in many areas, or even in an entire state. And the federal government wants to force you to buy insurance from them. If you don’t, you pay a tax penalty. And if you don’t pay that, you go to jail.

At this point, it is not uncommon for a family to be paying $1500 a month or more for their health insurance! For comparison purposes, you can lease a 2017 Porsche 911 Carrera Coupe for only $1200 a month.

A Simple Solution: Healthshare Programs

What if the federal government takes a step back on all these rules, restrictions, and regulations regarding the kind of health protection people need? Will this give people the freedom to choose and decide where to spend their money and how they can make arrangements among themselves to share medical expenses when something unexpected happens?

In fact, there may already be a solution… Healthshare programs.

These programs don’t carry the same regulations & restrictions that health insurance plans do, and they generally manage to avoid regulation by state insurance commissioners as well. This allows for groups of citizens to agree to a system of sharing medical expenses without undue regulation and the forced commitments the government would prefer to dictate.

Healthshares aren’t required to cover the 10 essential benefits, and don’t typically cover pre-existing conditions. Because they attract more health-conscious people, these plans typically cost less than half than the premiums you have to pay when getting an ACA-approved health plan. Plus, you can sign up all-year round.

Fortunately for members of Healthshare programs, they are exempt from the requirement to carry government-approved health insurance, or any associated penalties.

Most importantly? It’s a choice that you, me, or any other American can make: not a decision foisted on us by government meddling. In building or joining a Healthshare program, individuals like us can take on the role health insurance plans once could, only more effectively.

Six Favorable Changes To Health Savings Accounts Under GOP Health Bill

July 20th, 2017

Congress has been unable to pass a new healthcare bill as of yet. We believe that HSAs should play a big part in giving consumers more control over how their healthcare dollars are spent, and judging by the GOP proposals so far, there are some potential changes that will have a good impact on Health Savings Accounts and consumer-directed health care.

Here are six specific impacts that the House proposal has on Health Savings Accounts and consumer-directed health care and how it could affect you.

  1. Increase in 2018 Health Savings Accounts (HSA) Contribution limits to the high-deductible health plan (HDHP) out-of-pocket maximum. Starting January 1, 2018, the annual maximum contribution level for HSAs will increase for both individual and family coverage. The individual HSA limit would increase from $3,400 to $6,550, and the family contribution limit would rise from $6,750 to $13,100. This is a very positive change that will allow people to put aside more pre-tax money to cover future potential medical expenses.
  2. Repeals the ACA contribution limit on FSAs (currently $2,600 for 2017). According to reports, approximately 20% of Americans insured by private insurance can contribute to an HSA since they are enrolled in a qualified high-deductible plan. For those not covered by an HDHP, this change effectively allows for significantly higher contributions to help cover large out-of-pocket expenses.
  3. Allows both spouses make catch-up contributions to one HSA. If you and your spouse are both over age 55 and you both plan on making “catch-up” contributions to your HSAs, you must open a second HSA account for the second catch-up contribution. This change will lower your administration costs and simplify the contribution process.
  4. Repeals the prohibition on over-the-counter medication as certified medical cost distributions from FSAs, HSAs, and health reimbursement arrangements (HRAs). The ACA increases the cost of over-the-counter medications in comparison to prescription drugs for anyone who wants to pay from their HSA. With this repeal, the cost of healthcare would reduce for people that use HRAs, HSAs, and FSAs to purchase the products, according to report.
  5. Lower the penalty for non-qualified HSA distributions made before age 65 from 20% to 10%. The reason for the punishment is to ensure that an individual uses HSAs for its purpose which is as health care saving tools, and not as tax shelters. The report says that with a lower penalty, HSAs would be more attractive because the fear of the 20% penalty may have scared people from using HSAs as a saving account
  6. Allows qualified distributions to reimburse medical cost incurred within 60 days of HDHP coverage. Individual may not be permitted to claim their medical expenses as qualified distributions until they met the legal requirements used in creating their HSA even though an HSA-qualified health plan may cover them. This condition would give individuals 60 days to cover these instances according to the report.

To this, I’d like to had a couple more suggestions. First, why not let anyone contribute to an HSA. Incentivizing people to put aside money to cover future medical expenses would be a great benefit to society.

I’d also like to see contribution limits even higher, so that if people accumulate, say $30,000 in their HSA, they could have the option of choosing a very low-cost, very high deductible catastrophic plan, with their HSA funds as a back-up to cover their deductible.

HSAs allow consumers to control their healthcare expenses, including paying for expenses like acupuncture or chiropractic care, that might not be covered under most health insurance plans. Whatever changes Congress makes to our healthcare system, it is important that they continue to expand the availability and functionality of HSAs.

June is National Safety Month

June 28th, 2017

Did you know that preventable injuries are the fourth leading cause of death in the United States? During this National Safety Month, the  National Safety Council aims to educate and influence behaviors which can result in preventable injuries and deaths at work, homes, on the road, and communities.

Here at HSA for America, I want to encourage you to become advocates for safety in your homes by making simple lifestyle changes to recognize hazards better, prevent injuries, and be prepared.  Here are some tips to make a safe decision for you.

What Are The Common Causes Of Injuries At Home?

The home should be our safe haven. However, millions of people suffer injuries each year at home. There are several causes of home injury and they include falls, improper lifting, and fatigue.

How To Reduce The Risk Of Falling?

Falls are common home accidents, especially for young the elderly and children. These falls can lead to serious injuries like broken bones, concussions, and even death. According to the Centers for Disease Control and Prevention (CDC), falls are the most common cause of traumatic brain injuries.

The best way to prevent falls is to take these extra precautionary measures around the house:

  • Secure carpets to the floor.
  • Wipe up spills immediately.
  • Install railings on the both sides of your stairs.
  • Keep floors clear of tripping hazards like shoes or toys.
  • Provide adequate lighting in every stairway and room.

How To Reduce The Risk Of Back Injuries?

Back injuries are common problems at home and work. About 31 million Americans will experience lower back pain at some point in their lives according to the American Chiropractic Association. Daily stretches and exercise can strengthen your back.

Below are things you can do to lessen the threat of career-ending back injuries:

  • Reduce stressful body movements.
  • Pace of work and rest breaks.
  • Never twist or bend your back.
  • Lift heavy objects correctly.
  • Limit the amount of weight you carry.

How To Lessen The Risk Of Fatigue?

Studies say we need at least 7 to 8 hours of sleep every day. According to the CDC, one in three adults doesn’t get adequate sleep, and 37% of the U.S. workforce is sleep deprived.

Fatigue makes us more susceptible to injuries. Here are tips to reducing the likelihood of fatigue:

  • Eliminate unnecessary light.
  • Eat healthily and get some exercise.
  • Avoid eating right before bed.
  • Remember that bedtime is for sleeping.
  • Keep your bedroom temperate, neither cold nor hot.

Be Prepared With An Accident Insurance

You can’t stop accidents from occurring, but you can have a financial safety net in place in case they do. Having an accident insurance can help in reducing your medical bills and out-of-pocket costs that you may incur after an accidental injury. As medical costs continue to increase, accident insurance provides a vital layer of financial protection.

I hope that with these tips, you can protect your family both physically and financially as well.

What’s in the New Healthcare Bill?

May 11th, 2017


Last week Congress passed a bill to repeal Obamacare, called the American Health Care Act, and now it is the Senate’s turn to craft a bill, so that it can be reconciled with Congress’ bill.

One of the core provisions of Obamacare is the “community rating” price controls, which charge all people in a zip code area that are the same age, the same amount, regardless of risk. This is what has caused premiums to skyrocket. There is no fundamental change to this rule, but the bill does provide the options for states to allow underwriting, a change that should dramatically reduce premiums.

Other changes:

  • The mandate is repealed, and people would no longer be required to purchase a plan, unless they want to.
  • Individuals who forgo health insurance for more than 63 days must pay a 30% surcharge on their insurance premiums for a year. (The purpose is to encourage people to obtain and keep coverage while they are healthy.)
  • Companies are not required to offer coverage to their employees.
  • Repeals most Obamacare taxes (This includes higher Medicare taxes on the wealthy, taxes on medical devices, health insurers, drug companies, investment income, tanning salons, and higher quality health insurance plans.)
  • Allows states to decide if they want to mandate certain benefits, and what those mandates would be (including requirements that all policies cover maternity care or contraceptives)
  • Allows underwriting if the states that decide they want it in order to lower premiums. Allocates $8 billion to help states subsidize high-risk patients.
  • Gives states greater flexibility in administering Medicaid, and cuts federal funding
  • Insurance companies must still charge males and females the same rates, despite the risks.
  • Insurers could charge young people as little as 1/5 what they charge an older person (as opposed to 1/3). This could help lower costs for young people, and get more healthy people into the risk pool.
  • Expands tax credits to more middle-class Americans. Costs are likely to go up for some lower income people.

Greater HSA Impact

HSAs, or health savings accounts, allow people to set aside pre-tax money to pay for future medical expenses. The more that the individual consumer is involved in the purchase decision, the more price-sensitive they will be, and thus the more responsive the healthcare providers should be.

Anything that can increase price transparency and competition in the medical industry will help lower costs for everyone. Here are some of the main changes having to do with HSAs.

  • Doubles the HSA contribution limits to match the current out-of-pocket max. This would raise the contribution limit for an individual from $3,400 to $6,500, and from $6,750 to $13,100 for a family.
  • Cuts the penalty for non-medical-related HSA withdrawals before age 65 from 20% (under Obamacare) back to 10%.
  • Reestablishes the right to pay for over-the counter-medications without a prescription with your health savings account dollars. We support this, as there is no reason to force people to purchase prescription medication (and pay for an accompanying doctor visit), when and over-the-counter medication would suffice.
  • Allows a couple to both make catchup contributions to the same account.

Much of the other hysteria you may have seen in social media about the bill is from people who may not clearly understand how this bill works. People with pre-existing conditions are not all about to lose their coverage, and minor health problems like acne will not prevent you from obtaining health insurance.

While there are some positive changes that will help lower costs in the states that take advantage of the opportunity, I’d personally prefer to see even more emphasis on HSAs, allowing anyone to contribute to one, raising the contribution limits even more.

And, of course, none of this means anything until the Senate comes out with their version of the bill.

Life Insurance Made Easy

April 28th, 2017

We insure our cars and most individuals will even pay a monthly premium on cellular devices, but we often fail to include life insurance as one of our priorities.  When we’re young, we just don’t think that it’s necessary or in some instances, believe we can’t afford it.

The reality is – we can’t predict our life spans. Have you thought about what would happen to your family financially if something happens to you? Getting a life insurance plan in place gives you that peace of mind that your loved ones will not feel the financial burdens.

Anyone who has family members dependent on their income can’t afford not to have life insurance. I’ve explained the common life insurance programs below to help you understand how each type works and help you make the best option that fits your needs.

Term Life

When we think about “term” life insurance, as the word suggests, the policy covers the insured for a fixed amount of time. This is the least expensive type of life insurance. It provides security for our dependents that we leave behind. The plans are flexible and you can choose a premium according to the family’s budget. There’s even an option that provides protection if you should become disabled to work.

Whole Life

Whole life, unlike term life insurance, provides lifelong coverage. In addition, the plan will ensure payment at the time of demise regardless of when the policy was purchased.  One of the benefits of having whole life is its cash value. The insured can accumulate enough savings to help in times of need instead of placing a second mortgage on the house.

Universal Life

The universal life policy is like whole life except the plan provides flexible premiums and bereavement benefits. Additionally, it provides financial assistance in the event of adverse changes to the insured’s financial condition. Some universal life policies even provide long-term care coverage since long-term care costs can drain the savings rather quickly.

What Life Insurance Truly Means

Life throws us all curveballs. Having a life insurance policy on you and/or your spouse means that the family is protected, should someone die unexpectedly – in a car crash, through an unexpected illness, or some sort of freak accident. Getting life insurance only seems complicated; however, it’s a simple task, and most people are surprised at how low the rates usually are. And remember, it’s best to get one in place sooner rather than later because premiums increase as you age.


How to Retire Better: What You Can Do Right Now

March 29th, 2017

With medical costs skyrocketing, it is essential to save money for the rainy days as early as now. When things are going well for us, we shouldn’t just give ourselves high fives and sit back and relax.  We should be planning for the times when things will go wrong and we are feeling stressed. Not planning for retirement can be devastating to people later on in life.

Here’s what you can do now to help you retire better.

Health Savings Accounts

One great step towards retirement is setting up a health savings account which you can use to help pay for increasing medical expenses once you retire. A Health Savings Accounts (HSA) is a tax-favored savings account combined with a qualifying HSA insurance plan.

It allows you to deposit tax-deductible funds into a savings account that you can use to cover medical costs that would not normally be covered by a health insurance policy such as your deductible, or treatments like hydrotherapy or chiropractic services. For a list of the qualified medical expenses which you can use your HSA funds, check out our qualified expenses page.

If you don’t use all the money in your HSA by the end of the year, those savings roll over and keep earning interest, tax free This is a great way to build up an additional tax-favored retirement account.

Any withdrawals you make to pay for qualified medical expenses are tax-free. When you withdraw money for expenses that aren’t HSA-qualified, it is taxed like the rest of your income and you aren’t penalized in any way, provided that you are 65 years old or older. Building a tax-free savings account through your HSA is an incredibly smart and effective way to save for retirement – you could save up thousands or even hundreds of thousands of dollars by the time you retire.

You can even use HSA funds to pay for long-term care insurance premiums. If you are 40 or younger, you can only use up to $370 each year from your HSA to pay for a long-term insurance plan. If you are 71 or older, you can use up to $4,660 per year.

Insure Yourself

If you have dependents, another great strategy to save towards retirement is to make sure you have adequate life insurance coverage. With a life insurance plan, you pay a nominal fee for each month and it guarantees your family so much money upon your death. When you have a life insurance plan in place, it gives you the peace of mind in knowing that your family is taken care of if something were to happen to you

Start Saving Up Now

It’s never too early to start saving for retirement. Opening a health savings account today is a great way to build your nest-egg when it’s time for you to retire. Plus, having a life insurance plan in place is a smart way to provide that added security to your loved ones’ future.


New Thinking on the Road to Price Transparency

February 27th, 2017

price transparency

I’ve been an advocate for price transparency in healthcare for as long as I can remember. Even then and until now, health insurance companies and healthcare policy experts have been proclaiming that it’s coming to a healthcare market near you.

Implementing price transparency would seem to be the way to foster more of a free-market approach to healthcare, where consumers have the ability to make choices as to which doctor or facility will provide their healthcare, based on price and quality. When price transparency becomes a reality, the market will more effectively set the price for care and procedures, and theoretically that should result in lower prices and more satisfaction for all.

Some healthcare companies are taking a different approach to pricing their services in an effort to attract consumers by providing an easy, understandable pricing model. They’re thinking more like retailers and pricing their services in a “bundle,” instead of the traditional medical model that involves including the cost of every procedure and supply used as a single line item.

For example, instead of charging a patient who presents at the doctor for a suspected urinary tract infection for an exam, a urinalysis, and a urine culture, some providers have taken the top 30 or so most-common presenting complaints and have started charging one price for everything involved in the visit. This saves on administrative and billing costs for the provider, and makes it simpler for the insurance company to process the claim. And it allows consumers to more easily comparison shop between service providers, since the costs are established up front, and consumers can make a decision as to which provider to choose based on that information.

Hopefully this new thinking will catch hold and spread quickly around the healthcare world, and other healthcare providers will begin to innovate more with respect to new pricing methods.

The Numbers Are Stunning: Healthshare Plans Are Booming

January 26th, 2017

According to a recent article published by U.S. News and World Report, faith-based healthshare plans are exploding in popularity. With around 200,000 people enrolled at the time the Affordable Care Act (the ACA, or Obamacare) was enacted in 2014, the number of people choosing this strategy as a way to cover healthcare costs was pretty small. But if you had bet that the advent of supposedly “AFFORDable” healthcare coverage would have sent those people running in droves for ACA coverage, you’d be wrong.

The numbers of people covered by these plans since 2014 has nearly tripled, and the trend shows no signs of slowing down. The most recent Open Enrollment Period (OEP) for health insurance, which winds down on January 31, has actually sent more people looking for alternative ways to cover their families without being on the wrong side of the individual mandate – that’s the law that says you have to pay a penalty if you don’t have an ACA-compliant health insurance plan. The ACA has resulted in premiums that are out of reach for many families, topping $2,000 in many cases.

Faith-based healthcare sharing plans started as a way for churches and other groups of a religious nature to band together to help each other pay their medical bills. When the ACA was passed, several of these groups voiced concerns that some of its mandates went against their beliefs, so these plans were allowed to stay in place. And this coverage strategy has become more and more attractive as ACA plan rates have gone up and up.

Make no mistake – these plans aren’t insurance. And you have to be in relatively good health to qualify for inclusion in the group. But you can sign up at any time – not just during the OEP, and you might find that your monthly costs are substantially lower that what you’d pay for an Obamacare plan.
Interested in learning more? Click here to learn about rates, and the application process. And comment below if you’ve found coverage for your family’s medical expenses with one of these plans.