Yes—you can use an HSA with a PPO. But not with just any PPO. Since an HSA isn't actually a type of health insurance, HSAs provide the flexibility to be integrated with any HSA-eligible high-deductible health plan (HDHP). As long as your PPO is an HSA-eligible HDHP, you can use an HSA with the PPO without issue.
If you can receive benefits before that deductible is met, you aren't an eligible individual. Other employee health plans. An employee covered by an HDHP and a health FSA or an HRA that pays or reimburses qualified medical expenses can't generally make contributions to an HSA. FSAs and HRAs are discussed later.
There are three important criteria the health plan must meet to make it eligible. According to the IRS2 , HSA-qualified HDHPs must have: A higher annual deductible than typical individual health insurance plans. A maximum limit on the annual deductible and medical expense costs, including copays and other items.
There is no 20% penalty on excess contributions. If you no longer are enrolled in an HDHP you are not eligible to make contributions to your HSA, but you may request withdrawals for qualified medical expenses.
Once you turn 65, you can use the money in your HSA for anything you want. If you don't use it for qualified medical expenses, it counts as income when you file your taxes. Six months before you retire or get Medicare benefits, you must stop contributing to your HSA.
Drawbacks of HSAs include tax penalties for nonmedical expenses before age 65, and contributions made to the HSA within six months of applying for Social Security benefits may be subject to penalties. HSAs have fewer limitations and more tax advantages than flexible spending accounts (FSAs).
The HDHP may work best for a young, healthy, and lucky person who has no medical conditions that require regular care and extra money to save in an HSA. An individual or family that wants to avoid big bills at unexpected intervals might prefer a PPO.
If you're looking for a high-deductible health plan (HDHP) that allows you to contribute toward a health savings account* (HSA), the Blue Shield Silver 2600 HDHP PPO plan may be for you. You can prepare for future medical costs by contributing tax-advantaged money to your own HSA.
The Last Month Rule
There is a testing period of twelve months. This means you must stay eligible through the end of the next year, or else you will face taxes and penalties.
If you're enrolled in any type of Medicare or Medicaid, you lose your eligibility to contribute to an HSA. And because these public programs generally don't meet the criteria of an HSA-qualified plan, you lose eligibility even if you're still enrolled in an HDHP at the same time.
HSAs might not make sense if you have some type of chronic medical condition. In that case, you're probably better served by traditional health plans. HSAs might also not be a good idea if you know you will be needing expensive medical care in the near future.
Your HSA also covers expenses for standard dental cleanings and dental check-ups. One thing to keep in mind is that some of these procedures may have a co-payment, so it's important that you check with your dental insurance provider to find out exactly what you'll have to pay out of pocket.
If you enroll in a different high deductible health plan, your HSA will not be affected, and you can continue using it as you have. In addition, you always have the option to roll your HSA funds over into a different HSA.
While you can use the funds in an HSA at any time to pay for qualified medical expenses, you may contribute to an HSA only if you have an HSA-eligible plan (sometimes called a High Deductible Health Plan (HDHP)) — generally a health plan (including a Marketplace plan) that only covers preventive services before the ...
If you don't have an HDHP, have a family, and require frequent diagnostic medical care, a copay plan may be a better option. Neither an HSA or copay plan is better than the other; you just need to decide which plan meets all of your needs and will benefit you the most.
Cons of High Deductible Healthcare Plans
Individuals who are stretched thin for funds may delay or avoid seeking medical treatment due to the high cost of treatment. For example, someone injured may avoid the emergency room if they know it will result in an expensive bill that will be applied to the plan deductible.
What's considered an HSA-eligible plan? Under the tax law, HSA-eligible plans must set a minimum deductible and a limit, or maximum, on out-of-pocket costs for both individuals and families. The minimum deductible is the amount you pay for health care items and services per year before your plan starts to pay.
Preferred Provider Organizations (PPOs)
A PPO has a network (or group) of preferred providers. You pay less if you go to these providers. Preferred providers are also called in-network providers. With a PPO, you can go to a doctor or hospital that is not on the preferred provider list.
A PPO plan is a type of health insurance that gives the greatest access to a large network of medical providers or specialists. A PPO typically is not (but can be) an HDHP, which is the necessary condition for establishing an HSA. Most people insured by PPO plans are not eligible to open HSAs.
HSA Cons. The big drawback of an HSA is that you have to sign up with a high deductible health plan to be eligible for one. It is difficult to forecast medical expenses accurately.
HMO plans might involve more bureaucracy and can limit doctors' ability to practice medicine as they see fit due to stricter guidelines on treatment protocols. So just as with patients, providers who prefer a greater degree of flexibility tend to prefer PPO plans.
One of the biggest advantages of an HSA is that it offers a triple tax advantage, which means: Contributions to an HSA are federally tax-deductible, reducing your taxable income. Depending on where you live, you may also get a break on state income taxes. Assets in an HSA can potentially grow federal tax-free.
Myth #2: If I don't spend all my funds this year, I lose it. Reality: HSA funds never expire. When it comes to the HSA, there's no use-it-or-lose-it rule. Unlike Flexible Spending Account (FSA) funds, you keep your HSA dollars forever, even if you change employers, health plans, or retire.
Health Savings Accounts offer a triple-tax advantage* – deposits are tax-deductible, growth is tax-deferred, and spending is tax-free. All contributions to your HSA are tax-deducible, or if made through payroll deductions, are pre-tax which lowers your overall taxable income.