HSA— Account use and eligibility

HSA funds availability, rollover, and retirement use

Updated over a week ago

Health Savings Accounts empower you to save more, spend smarter and invest in your healthcare.

Read on to find out details for your HSA account use, or jump to a section with these links:

When are HSA funds available?

Your Health Savings Account (HSA) funds are available as you make contributions. You can set up monthly recurring payments, as well as make additional payments to your HSA until you have met the yearly contribution limit.

Can I change my HSA contributions?

You may be able to change your HSA election amount. You should plan on an election amount to your HSA that meets your needs for the entire plan year.

Check with your benefits administrator to see how often you can change your HSA election amount during the plan year.

How can I spend wisely from my HSA?*

With a health savings account (HSA), you have control over your medical spending. Even if you are a savvy consumer for non-medical expenses, you may not be aware of methods to save money on healthcare. Below are suggestions to stretch the dollars in your account.

Avoid retail price

Providers are often willing to negotiate amounts and time frames of payment.

  • Ask if there is a discounted 'cash price' for patients who pay upfront.

  • Suggest a payment plan that meets your personal needs.

  • Manage recurring payments easily by scheduling them in your online account.

Note: If you pay before receiving services, the expense may not be applied to your health plan deductible.

Research alternatives

If you have multiple options for doctors, hospitals and pharmacies, you may be able to find a lower price for high-quality care.

  • Ask for the price of services before you buy.

  • Compare costs online or through your health plan.

  • Check websites that rate doctors and hospitals.

  • Look into your prescription drug options. You may be able to save by switching pharmacies, using a mail order service or buying a larger supply.

The 'Resources' section of your online account has links to helpful comparison shopping tools. Our website also includes tools and resources to help you.

Spend wisely

While many medical expenses cannot be avoided, some services may not be essential to maintaining your health.

  • Ask questions about lab work, blood tests and examinations:

    • Are they necessary for your treatment?

    • Will the test be sent to a facility in your health plan's network?

    • Can you use a home diagnostic kit to find the results yourself?

  • Seek out coupons, rebates and free samples. Your provider may have access to these.

  • Call/chat with a provider using a telemedicine service instead of making an office visit.

  • Stay informed about your health. In many cases, more knowledge leads to smarter spending habits.

*HealthEquity, Inc. does not provide legal, tax, financial or medical advice. Always consult a professional when making life changing decisions.

How should I manage my receipts and records?

The balance in your health savings account is yours and rolls over every year. It is important to treat the record keeping of your HSA as you would your retirement plan, any other savings account or a credit card.

Here are some record keeping tips:

  • Make sure you review all of your account transactions.

    • If you see charges you don't understand or that don't belong to you, contact the provider or HealthEquity right away.

  • Keep records that allow you to reconstruct how you have spent your money.

    • Disputes or questions about billing and payments can arise even a year or two after a procedure or office visit.

  • Stay prepared for an IRS audit by saving HSA receipts for up to 7 years.

    • You'll also want to maintain records of any deductions claimed on your tax return.

How do I use my HSA at the doctor's office?

The following steps show how doctor visits work when you have a health savings account (HSA):

1. Receive services

  • Be sure to present your insurance ID card.

2. Bill your health plan

  • The provider may submit a claim to your health plan for services rendered.

3. Health plan sends an explanation of benefits (EOB)

  • An EOB is sent to you outlining the allowed charges.

4. Provider sends invoice

  • The provider sends you a statement reflecting the charges.

  • Make sure the amount matches the EOB sent to you by your health plan. If not, contact your health plan.

5. Pay provider with your HSA

  • You can pay the provider directly or reimburse yourself for the expense.

Note: Be sure to check with your health plan for in-network providers, which may cost you less than an out-of-network provider.

How do I use my HSA at the pharmacy?

Here's the process to use your health savings account (HSA) for prescription drugs:

1. Obtain prescription

  • Obtain a legal prescription from your doctor for needed medication.

  • Submit it to a pharmacy along with your insurance ID card.

2. Pharmacy confirms insurance coverage

  • The pharmacy verifies the amount you owe for the prescription.

3. Pay for your prescription

  • If you have a HealthEquity® Visa® Health Account Card*, it is a convenient method of payment. You can also pay out-of-pocket and reimburse yourself at a later time.

  • The expense is automatically applied to your deductible and/or coinsurance.

*The HealthEquity® Visa® Health Account Card is issued by The Bancorp Bank pursuant to a license from Visa U.S.A. Inc. The Bancorp Bank; Member FDIC.

How can I use my HSA funds in retirement?

Your HSA funds can be used to pay for your qualified medical expenses in retirement.

Your HSA withdrawals for qualified medical expenses are tax-free at any time.

HSA funds can also be used to pay for Medicare Part B, Part D, and Medicare Advantage premiums, if you are 65 or older.

An HSA does not require the account holder to begin withdrawing funds at a certain age.

  • If you spend HSA money on non-qualified medical expenses after 65, you will need to pay income tax on those funds.

  • If you spend the HSA money on anything other than qualified medical expenses before you are 65, you will need to pay income tax on those funds as well as a 20% penalty.

Can I distribute HSA funds for non-qualified medical expenses?

Health Savings Account (HSA) funds can be used for general non-medical purposes, without penalty once you reach age 65. Any withdrawn funds used for non-medical purposes are subject to income taxes.

The federal penalty for using HSA funds, if you are under age 65, is 20 percent tax penalty, plus the loss of tax-free treatment for the distribution of funds.

HealthEquity does not provide legal, tax or financial advice. Always consult a professional when making life-changing decisions.

What are my interest rate and cash options?

As a Health Savings Account (HSA) holder, you have two interest rate and cash options.

  • Basic Rates: The Basic Rates cash option is a federally insured option for your HSA Cash balance. Cash funds are held in an FDIC-insured or NCUA-insured institution and are eligible for deposit insurance, subject to applicable requirements and limitations. Interest rates are subject to change.

  • Enhanced Rates: The Enhanced Rates option offers higher interest compared to our Basic Rates option to potentially maximize health savings for eligible members. It is an interest-bearing group annuity contract issued by participating insurance companies for your HSA cash balance. Principal and interest are subject to risk of loss and not covered by deposit insurance. Interest rates are subject to change. Guarantees subject to claims-paying ability of insurer.*

To make changes:

  1. Login to your HealthEquity HSA online account.

  2. Select Interest Rates from the Manage Account section of the dashboard.

  3. Choose your desired rates.

You can change your cash placement option at any time.

*HealthEquity does not provide legal, tax or financial advice. Always consult a professional when making life-changing decisions.

How is an HSA split in the case of divorce? 

In the event a divorce decree or separate agreement requires a portion of a member’s Health Savings Account (HSA) funds be split, HealthEquity will transfer the funds as requested by the provided legal documentation. The member's ex-spouse can open an HSA with HealthEquity (or another custodian) to have the funds transferred. 

  • In this case, the split doesn't result in a taxable distribution from the existing member’s account. HealthEquity sends funds as a transfer to the new custodian, as the ex-spouse had ownership of these funds and we are just moving them to an account in the ex-spouse's name. 

  • To process this:

    • Fill out and submit the Instructions Upon Divorce of Account Holder form. From your online account, click the Support icon in the top right to find and fill out a form.

    • Copy of divorce decree or court order (could be called a separation agreement). 

    • The order/decree must state a specific amount or percentage as of a certain date. 

Are the children of divorced or separated parents eligible dependents? 

In most cases, a child of divorced or separated parents, or parents who live apart, will be a qualifying child of one of the parents. 

However, if the child does not meet the requirements to be a qualifying child of either parent, the child may be a qualifying relative of one of the non-custodial parents. In that case, the following rules must be used in applying the support test. 

A child will be treated as being the qualifying relative of their non-custodial parent if all four of the following statements are true: 

1. The parents: 

  • Are divorced or legally separated under a decree of divorce or separate maintenance 

  • Are separated under a written separation agreement, or 

  • Lived apart at all times during the last six months of the year, whether or not they are or were married 

2. The child received over half of their support for the year from the parents (and the rules on multiple support agreements, explained earlier, do not apply). 

3. The child is in the custody of one or both parents for more than half of the year. 

4. Either of the following statements is true. 

  • The custodial parent signs a written declaration, discussed later, that they will not claim the child as a dependent for the year, and the non-custodial parent attaches this written declaration to their return. (If the decree or agreement went into effect after 1984 and before 2009, see Post-1984 and pre-2009 divorce decree or separation agreement, later. If the decree or agreement went into effect after 2008, see Post-2008 divorce decree or separation agreement, later.) 

  • A pre-1985 decree of divorce or separate maintenance, or written separation agreement that applies to 2010, states that the non-custodial parent can claim the child as a dependent, the decree or agreement was not changed after 1984 to say the non-custodial parent cannot claim the child as a dependent, and the non-custodial parent provides at least $600 for the child's support during the year. 

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