COLUMN: Getting to the moon through health insurance
October 13, 2004
We have seen health care costs become more expensive than an Apollo mission to the moon. Fortunately, there is relief in sight that will make health care costs roughly equivalent to the cost of a moon rock.
Heath savings accounts have been touted by some as the new wave in health insurance. The accounts allow individuals and families to build a nest egg, tax-free, to cover out-of-pocket medical expenses. The accounts would be used by those covered by high-deductible health insurance plans, which have become increasingly popular because of the vastly cheaper monthly premiums.
High-deductible health care plans require the patient to cover more out-of-pocket expenses, advantageous to the consumer because they have more control over small health care spending decisions.
Several independent studies have proven the effectiveness of this technique, finding those covered by the high-deductible plans spend less on health care while seeing no measurable negative long-term effects to their health.
Here is where the health savings accounts come in. There are several unique advantages of HSAs, the greatest of which is individual ownership of the account itself. Previous attempts to set up similar health accounts were restrictive and didn’t allow the money to roll over from year to year or employer to employer. HSAs allow both.
My theoretical HSA could receive contributions from my mom, other qualified family members, my employer or me, who would then get to deduct that amount from their gross income at tax time. I could take my HSA with me to my next job, even if I were fired from my first job after graduation because of my attempts to swallow flaming swords while at work.
When I have a “qualified health expense” as defined by IRS Section 13(d), I would be able to access my account through my HSA MasterCard debit card. There is no bureaucracy involved. Sweet!
There is an annual maximum of $2,600 for individuals or $5,150 for families that can be contributed to the HSA account. The caps are raised at age 55. The contributions I make to my HSA are all assessed pre-tax; then, when I use my HSA MasterCard, I don’t pay taxes on it when I use it for qualifying medical expenses.
Another unique aspect of HSAs is the benefit for people older than 65. The accounts can be used for anything I want at this point — I just have to pay taxes on the stuff that is not a “qualified health expense.” HSAs in this sense provide another way to save for retirement.
I can get an HSA from any number of insurance providers who are slowly catching onto this new opportunity. Golden Rule and Fortis Health are two key providers of HSAs. I can even invest my HSA — depending on the requirements set up by the provider.
Some HSAs simply act as interest-earning savings accounts with interest rates from 1 to 4 percent, where other plans are invested in mutual funds with expected returns at 10 percent. There is no dividend tax charged on the earnings of the HSA.
Where, might you ask, did this wonderful idea come from? HSAs were a part of the Medicare bill passed by Congress in December of last year by our own Sen. Chuck Grassley. He was the architect in his role as chairman of the Finance Committee.
Three cheers for HSAs. Three cheers for the promotion of an ownership society. I am thrilled to discover I am only giving up my moon rock, and I still have the money left over to save up for my flight to the moon.