So-called “high deductible health plans” are a lot like conventional (PPO/HMO) insurance plans, but they typically have higher deductibles (over $1,000 per year). The idea is that even though the deductible is high, you save so much money from the lower monthly premium costs that the HDHP is a better deal in the long run, when used in conjunction with a tax-free Health Savings Account (HSA).

Last year, in order to setup an HSA, you needed to find a High-Deductible Health Plans that met the following qualifications:

1.A minimum deductible of $1,000 for self or $2000 for family coverage.

2. A maximum out-of-pocket limit of $5,100 for individual coverage, and $10,200 for family coverage.

3. Preventive care can have first dollar coverage (i.e. without a deductible). Preventive care examples include: periodic health evaluations like annual physicals, screening services like mammograms, routine prenatal and well-child care, child and adult immunizations, tobacco cessation programs, and obesity weight loss programs.

Prescription drugs taken to prevent the onset of a condition for which a person has developed risk factors for can be considered preventive care, like cholesterol-lowering medication. A general rule of thumb for what is or is not preventive care is the care does not include any service or benefit which treats an existing illness or condition.

4. The plan can use co-pays to cover preventive care. Higher out-of-pocket (co-pays and co-insurance) is allowed for out-of-network care.

5. The can’t cover prescription drugs before the deductible is met.

HDHP’s often offer a better value for money as compared to a lower deductible plan. HDHP premiums are significantly lower, and any out-of-pocket cost risk to can be minimized by funding an HSA to cover out-of-pocket costs up to your deductible. Also, HDHP premiums have not been subject to the kinds of rate increases that traditional health plans have seen over the last few years.

This is not true in all states and for all health plans.

Some have said that consumer-driven health plans, like the HSA+HDHP combo, works best for relatively healthy people. It is certainly true that if you’re healthy, and don’t use medical services during the year, you’ll save a lot of money with a high-deductible plan. But it’s also true that CDH plans, applied wisely, can result in savings and greater flexibility for consumers of all kinds. Individuals who are likely to make moderate or heavy use of medical services should be sure to understand the benefits covered under their plan, and should pay special attention to the co-insurance, maximum out-of-pocket, and any exclusions or carve-outs. Healthia’s health cost modeling tool can help you decide if a CDH plan will work for you.

Kurt Stammberger is VP, Marketing at Healthia Inc. Healthia was founded in 2005 to provide integrated comparison-shopping information on health insurance products and services for groups, individuals, families and small business employees.

HSAs have a “triple” tax advantage from a federal tax standpoint. Individuals receive full tax advantages for HSAs on their Federal Income Tax return (or through a salary reduction program in certain employer-sponsored settings) regardless of particular state’s tax treatment of HSAs.

An account beneficiary may take an above-the-line deduction (i.e. the amounts may be used to determine the individual’s adjusted gross income before any itemized or standard deductions are considered) for contributions made to an HSA during any month of the individual’s taxable year that the individual is eligible. The permitted deduction cannot exceed the sum of the “monthly limitations” for such months. In 2006, the monthly limitation for any month is 1/12th of the following amounts:

- For those with single coverage on the first day of the month, the lesser of the annual deductible under the HDHP or $2,700.

- For those with family coverage on the first day of the month, the lesser of the annual deductible under the HDHP or $5,450.

Funds in an HSA grow on a tax-deferred basis, and distributions from an HSA are tax-free so long as the funds are used for qualified (as defined by Section 213d of the IRC) health care expenses.

How does state tax treatment of HSAs differ from federal tax treatment?

HSAs (and the enabling legislation) are federal. As a federal program, each state decides whether to: a) comply with the federal guidelines, or; b) establish their own state guidelines regarding the tax treatment of HSAs. As a result, some income that may be tax-free at the federal level may not be tax-free at the state level.

Many states harmonize their tax treatment with the federal government. Those states include Arizona, Arkansas, Colorado, Connecticut, Delaware, Georgia, Hawaii, Idaho, Iowa, Indiana, Kansas, Kentucky, Louisiana, Maryland, Missouri, Mississippi, New York, Montana, Nebraska, New Mexico, Oklahoma, North Carolina, North Dakota, Pennsylvania, South Carolina, Oregon, Rhode Island, Virginia, Utah and Vermont.

Other states, however, treat HSAs differently from the federal government, at least for tax purposes. The following states have indicated that legislation must be passed at the state level before HSAs receive a tax benefit at the state level: California, Illinois, Maine, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, Ohio, Washington DC, Wisconsin, West Virginia and Tennessee. New Hampshire and Tennessee do not tax income, but do tax dividends and interest. Alabama has not indicated their position regarding state-level tax benefits for HSAs.
Finally, some states are not affected by federal income tax guidance vis-?-vis HSAs: those states include Alaska, Florida, Nevada, South Dakota, Texas, Washington and Wyoming.

Kurt Stammberger is VP, Marketing at Healthia Inc. Healthia provides integrated comparison-shopping information on health care products and services, doctors and health insurance plans to empower the drive towards Consumer-Driven Health Care.

If you’ve been following the news lately, you’ve probably heard about the contentious issue of Health Savings Accounts, introduced by the Bush administration in 2003 through the Medicare Modernization Act. At that time the concept generated little buzz - only recently has the debate heated up between critics and supporters of the initiative.

A Health Savings Account offers people a second choice when it comes to signing up for health insurance. It’s not a replacement for health insurance, but instead, combines aspects of personal savings with the complete coverage offered by a health insurance plan. Many defenders of HSAs believe it offers the best of both worlds so that patients can have more control over their own healthcare needs and save money in the process.

But what exactly does a Health Savings Account entail? Basically, a Health Savings Account is a savings account (set aside for the purpose of paying future medical costs) in conjunction with a high-deductible health insurance policy. If your employer or insurance company offers HSAs, you are given the option to deposit money into the savings account, up to a set amount. The deposit remains tax-free, even when you withdraw, and gains interest over time - just like a traditional savings account. The difference, of course, is that the money must be used to cover medical expenses you incur up to the deductible amount. So if you need to buy prescription eyeglasses, visit the doctor, or take an eye exam, you would withdraw funds from the HSA in order to pay those bills. HSAs can be used to pay for a wide range of healthcare expenses, not traditionally covered by health insurance.

The good news is that once you reach the deductible amount, your insurance coverage kicks in and you can use that to pay any additional medical bills you are responsible for during the rest of the year. Another positive aspect of a Health Savings Account is the fact that with a high-deductible insurance plan comes low monthly premiums. If you have little to no healthcare costs during the year, you will save a lot of money on premiums alone. At the same time, your savings account will gain interest and roll over to the next year. After several years, even if you need to make withdrawals to pay for certain medical expenses, you should have a significant amount of money set aside for a rainy day.

In addition, once you turn 65, you can withdraw any leftover funds to use for your retirement - and the balance remains tax-free. You can use the money for medical expenses, of course, or for any other expenses you have during your retirement years.

Opponents of HSAs argue that only the healthy and wealthy can afford to take advantage of the opportunities Health Savings Accounts offer to the public, while proponents of the plan believe this type of health insurance has the potential to give the average person more power to make informed healthcare choices. Only time will tell whether or not Health Savings Accounts have the potential to revolutionize healthcare in America.

Copyright 2006 Lisa Ip

Lisa Ip is president of Uniforce Insurance, which she founded in 1994, in Madison Heights, Michigan. For more information regarding health insurance in Michigan, visit http://www.uniforceinsurance.com or call 888-302-RATE