What is the difference between a “qualifying” expense and a “deductible” expense?

A qualifying expense means you can use your HSA account to pay for that expense but it may or may not relate to your deductible, for example, you can buy prescription glasses with your HSA account, that would be qualified, however, that does not count towards your medical deductible.

From my understanding, you can use the HSA money for other health expenditures such as out of pocket dental but it does not count toward the $4000 family. My question is can I spend the school portion on dental or not?

Once the school portion is in your account, it is all your money and remember, you can use it however you want. As long as you use it for “qualifying” expenses, you will not get taxed or penalized. So yes, in this example, you can definitely use it all towards dental, including the school’s portion, just understand, it would not count towards your “deductible”.

How can I tell if a prescription is covered by insurance?

When you go to the pharmacy, you hand them your card and they will be able to tell you if it was covered last year, then it will be covered this year, also, you can use COMPASS to help and to shop for the price.

Advice about using Costco to fill prescriptions:

A member discovered that Costco has name brand drugs for much less. She wrote that at her regular pharmacy the cost of her prescription was $1,384, but at Costco the same prescription was $340.

I thought with an HSA my premiums would go down significantly. Why don’t a see a drop in my premium charge?

Look at your premium on your 11/25/16 paycheck. Now, look at your premium on your 12/09/16 paycheck. That is where you will see the premium drop. This is because the treasurer’s department pays one month in advance. Stating it another way… the drop we expected to see in January happened in December because the treasurer pays one month ahead.

What kind of plan to we have? What is the name of our healthcare plan? 

The name of our plan is United Healthcare Choice Plus HSA. If you forget the name of the plan, you can always find it on the bottom, right corner of your white UHC card.

How do I adjust how much money is taken out of my paycheck to go into my HSA?

You can adjust how much is taken out of your paycheck for your HSA by filling out this form and submitting it directly to the treasurer’s office.

Are there things that still cost us, could be a lot, because they are out of network- like Drs who read tests at the hospital – where we have no say? Do these things count to the deductible?

Yes, it is potential, but remember, you are in the same network you were in previously, chances are if you are using in network hospital, you will be in network for the services. If you know ahead of time, you can always make sure. Also, if you use a network facility and their staff is non-network and out of your control, i.e. anesthesia, radiology, emergency physicians…, they will be processed as in-network.  Occasionally United Health care does not match up these providers to the facility claim so they process as non-network, but this can be corrected.

After a visit, the doctor’s office request immediate payment. I make the payment. A few days after the appointment I check the My UHC page and see the bill was actually lower than I paid. How is that money reimbursed?

Please remember, you never pay right there at the doctor’s office, you present your UHC card, go in for your service and then wait until it is processed and you see your EOB (explanation of benefits) At www.myuhc.com That will show you the correct rate, then the doctor’s office will send you a bill. If you already paid and it was the wrong amount, you will need to contact the doctor and have them reimburse you directly.

My Pharmacy offers a discount program to get prescriptions cheaper, but it does not run through insurance. Is there any way to still count this towards my deductible?

If it is much more expensive using the insurance rate. A discount program would not count toward the deductible, however, you can use your HSA account to pay for them if you want. United Health Care will not allow you to use other discounts or plans and still have the claim apply to the deductible.  It is your choice to either use the plan benefits, or opt for a different savings program.

Why is there a $3 monthly fee? I have had HSA in the past and never had monthly fees.

There should be no monthly fees associated with your HSA account, please reach out to American Fidelity and let us know if you see anything.

UHC is showing a billed expense but I have not gotten a paper bill from my doctor. Does this still count towards my deductible even though I have not paid?

Yes, remember, UHC, once they receive the info, will immediately credit your deductible and then they are done  it is up to your doctor’s office to bill you and then up to you how you want to pay. UHC is not connected to that at all.  Remember, your HSA and UHC do not talk.

Explain this situation: A medicine through Optum RX costs $1200 for 3 months. The same medicine through the local pharmacy with insurance is $200/month, but if I pay cash is only $100/month. I tried paying cash and submitting for reimbursement, but it was denied.  

It sounds like the pharmacy was using some sort of discount or coupon program to give you the lower price, and then their own incentive.  Optum Rx does not accept any other discounts, coupons or programs under their plan.  You can either choose to use the drug coverage through UHC/Optum Rx, or you can use whatever discounts your pharmacy offers.  Optum Rx will not allow you to file a paper claim for these prescriptions.  Ask your pharmacy to run a test claim for the 30 day supply through your ID card, or access the pricing online at www.myUHC.com, to see the actual Optum pricing for a 30 day supply.  Or, you can opt to use your HAS account to pay for the discounted prescriptions, but they will not apply to the deductible.  Not all discount/coupon plans are less expensive; these promotions only apply to certain prescriptions, and some discounts only last a few months.

With other medical expenses I already have, why not go with $1200 and hit the deductible in 6 months? But that just feels wrong. How should this be handled?  

Again, it’s a personal choice.  However, if you will hit your deductible, it probably beneficial for you to use the Optum Rx pricing and have it apply to the deductible.  You can also tell the pharmacist you want it run through your plan (and not the discount plan) on a 30 day basis just to help with cash flow.  While it does feel “wrong”, the Optum cost is built in to the plan.  If you are not going to meet your deductible, then you may want to use the discount plan to save your money.

Can we still sign up for the accident insurance?

You can sign up this fall during open enrollment.


Do we need to save paper copies of receipts for allowed expenses such as prescriptions and office visits?

We do not require you do, however, if you ever got audited by the IRS, they will ask you to prove you used your money for “qualified”  expenses, so many people feel they need to save receipts or as long as you feel you have access online if you needed.

How can we assure we will have enough money set aside to meet our deductible each year? The maximum amount we can contribute is?

Remember, you can change the amount anytime you want that is going in your HSA account.  This year (2017), max for Family is $6750, single is $3400, and there is an annual $1000 catch up if you are over 55. These amounts include the board’s contribution, and they are more than the annual deductible.  If you only spend the HSA funds on the deductible (no dental or vision…) you can subtract the board contribution from the annual deductible, then divide the remaining amount per pay and have that amount payroll deducted.

Once our $4000 deductible has been met, will our doctor’s and places like CVS know that we don’t owe anything to them?

Yes.  If they ask for payment up front anyway, tell them you have met your deductible and should not owe anything.  They can call United Health Care at that point and verify the deductible.

Do we have regular eye exams covered under our plan? It looks that way when I read the manual.

You have the same eye care under this plan that you had with the PPO plan.