HSA Open Enrollments Sample
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A quick and simple overview of a Health Savings Account ENrollment Slide show. We use this for employee meetings to help explain the plan.
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HSA Open Enrollments Sample
- 1. Health Savings Account (HSA) An Exciting New Benefit for You and Your Family An Introduction
- 9. How Medical Claims are Processed Note: Timing of HSA fund withdrawal need not be associated with timing of claim Claim processed. If you are responsible for any payment, an explanation of Payment (EOP) is mailed to the physician 3 5 Payment is made by you to the physician $ $ $ $ $ $ You may withdraw money from Health Savings Account, using your HSA debit card or a check, to pay for claim 5 $ $ Present the Member ID Card Physician 1 Member EOB sent to you Physician receives EOP (Explanation of Payment) 4 4 2 Physician sends claim to health insurance carrier H.S.A Plan
- 10. How Pharmacy Claims are Processed Note: Timing of HSA fund withdrawal need not be associated with timing of claim Member $ $ $ $ $ $ 3 If you paid out-of-pocket for your prescriptions, you can reimburse yourself from your HSA $ You can use debit card to access HSA funds directly for payment $ Pharmacist 1 Present ID Card and pay for prescriptions 2 Pharmacist sends claim to Cost of prescription(s) applied to deductible /out-of-pocket maximum
Notas do Editor
- First, we will take a look at preventive care. Preventive care includes your annual physical, well child visits, diagnostic screenings (cholesterol screenings, colorectal screenings, influenza and pneumococcal vaccinations, annual mammograms, pap smears and pelvic exams, bone density tests for women age 65+). When accessing a Core Network Provider for preventive care, these services are covered at 100% and are not subject to the deductible. You have first dollar coverage with no deductible. When accessing a Standard Network Provider or a non-participating provider, your preventive care is subject to your deductible and coinsurance.
- The annual deductible is the amount you are responsible for paying before the insurance begins paying. All medical and pharmacy claims, excluding your preventive care, are subject to the deductible. Meaning the deductible is combined for your medical and pharmacy benefits. If you have family coverage, no one in the family is eligible for the Health Coverage until the family deductible is satisfied. Once you have met your annual deductible (you can use the funds in your HSA to pay the deductible), your Definity Plan health coverage will begin paying.
- The Health Savings Account (HSA) is a financial account that you can use to accumulate tax-free funds to pay for qualified health care expenses. This account is used to offset your liability. It could cover a portion of your deductible and any non-preventive services. It may also cover the expenses associated with pharmacy costs. The account is set up in your name and is funded by you and/or your Employer. The account acts like a regular checking account with a debit card and accrues interest. All money in the account is owned by you and is fully vested as soon as it is deposited. Plus it ’ s portable, so if you leave the company, the account is still yours. If you use the funds for qualified health care expenses, you will pay no taxes. If you use the money for other expenses, you will pay a tax and penalty fee. After the funds in your HSA have been exhausted, you will be responsible for the cost as defined by your benefit plan. We will go into more details on the Basics of HSA ’ s in a few minutes.
- Giving you piece of mind is important. That ’ s why your plan will have an out-of-pocket maximum to protect you. So everything that you pay towards the annual deductible and coinsurance will be applied toward the out-of-pocket maximum. After this maximum has been met, the plan will pay 100% of covered services. Members rarely reach the maximum, but it ’ s nice to know that your family ’ s finances are secure.
- Your spouse and dependents don ’ t need to be covered by the HDHP in order for you to use account funds to pay for their out-of-pocket health care expenses. Plus it ’ s portable, so if you leave the company, the account is still yours. Funds in your HAS bank account will grow and perhaps be larger than your deductible in future years depending on one ’ s spending.
- Now let ’ s take a look at how you would access care in the UnitedHeatlhcare ’ s Definity consumer driven plan. You would present your member ID Card at the physicians office. the Physicians office would “ swipe ” your ID Card and verify benefits with UnitedHealthcare The Physicians will submit the bill to the UnitedHealthcare claim center for processing The claim will be processed and any member responsibility will be determined. UnitedHealthcare ’ s Definity claim center will issue an Explanation of Benefits (EOB) and Health Statement to the consumer and an Explanation of Payment (EOP) to the physician. The subscriber decides if available funds from the HSA will be used to pay for the qualified medical expense. If there were not enough funds in the HSA, then you – the consumer- will be responsible for making payment to the Physician. We encourage you to wait until you have received the Health Statement, so you will know the correct amount due the physician after the UnitedHealthcare network discounts have been applied for services rendered at a network physician.
- All pharmacy claims are subject to the medical deductible. Once the deductible is satisfied, then $10/$30/$50 prescription coverage applies until the maximum out-of-pocket is reached. Once the MOOP is reached the prescriptions would be covered at 100%. When you need to get a prescription filled you simply: Go to the pharmacy and present you Health ID Card The Pharmacist will send the claim to the UnitedHealthcare Definity pharmacy vendor and the cost of the prescription will be applied to either your deductible or out of pocket costs. If you paid for your prescription out of pocket, you can reimburse yourself for those prescription expenses from your Health Savings Account