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Kathy,

I don't know if I can explain it any differently, but one of my frustrations with the HSAs are that the people who join up are often not aware of the policies/rules/deductibles, etc...I have young investment bankers who come in who have these HSAs thinking they can get get their yearly "free" check-up. When they come in complaining of chest pain and acid reflux and shortness of breath, they are often dismayed that the HSA won't cover it.

Frustrating.

Soma

Subject: HSATo: "'Practice Management Issues'" , Date: Sunday, September 14, 2008, 2:16 PM

I am trying to figure out why so many think HSAs are the saving grace of the healthcare system and why they are a good thing.

Example: A patient of mine was telling me about the pitfalls of her HSA. They buy their own health insurance. They received a better rate by going with a high deductible plan with an HAS. They are over 55 so they can put a little more away than younger, $3000 or $3500 instead of the $2500. They studied the list from the government on what is HSA eligible and said “oh good”. Because they don’t have dental, they don’t have vision so they thought they could use the HSA money towards this.

But, oh no. The HSA is administered by Aetna. And Aetna says they can only use their HSA money on things that are covered by the insurance plan but subject to deductibles and co-pays. So, essentially, the HSA is like Medigap insurance and is just being used on the deductibles and co-pays which they would be paying anyway.

So what is the benefit of this? Pre-tax dollars? Medical expenses are a write-off anyway, once you spend $10,000 or something write? They spend that on their health insurance. It seems like just another thing that is now under the control of the local insurance company and makes them money and that is all.

Can anyone explain it differently to me?

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypr actice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

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Kathy:

HSA allow you to put away x dollars per year. If you don't use those dollars they accumulate. When you reach a certain age and haven't spent all the $ it acts like an additional 401K.

Subject: HSATo: "'Practice Management Issues'" , Date: Sunday, September 14, 2008, 9:16 AM

I am trying to figure out why so many think HSAs are the saving grace of the healthcare system and why they are a good thing.

Example: A patient of mine was telling me about the pitfalls of her HSA. They buy their own health insurance. They received a better rate by going with a high deductible plan with an HAS. They are over 55 so they can put a little more away than younger, $3000 or $3500 instead of the $2500. They studied the list from the government on what is HSA eligible and said “oh good”. Because they don’t have dental, they don’t have vision so they thought they could use the HSA money towards this.

But, oh no. The HSA is administered by Aetna. And Aetna says they can only use their HSA money on things that are covered by the insurance plan but subject to deductibles and co-pays. So, essentially, the HSA is like Medigap insurance and is just being used on the deductibles and co-pays which they would be paying anyway.

So what is the benefit of this? Pre-tax dollars? Medical expenses are a write-off anyway, once you spend $10,000 or something write? They spend that on their health insurance. It seems like just another thing that is now under the control of the local insurance company and makes them money and that is all.

Can anyone explain it differently to me?

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypr actice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

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A few years ago when I was with my big corporate group, I took advantage of the HSA that was in addition to our excellent insurance. The advantage was that we could use the money that we put into it for things that weren't covered by our usual insurance (though the HSA was still administered by our insurance company) like acupuncture as well as things like over the counter medications. The money was pretax, even though our total expenditure was not huge. The disadvantage with the plan we had was that the money did NOT accumulate. Anything we did not spend we lost at the end of the year, so we planned in advance how much we thought we would use and contributed accordingly. It was a bit of an administrative pain for me, but overall it was worth it. People who don't have enough money to contribute each month or don't have the

organizational skills to deal with this type of plan are amongst those for whom this would not work. They might be a peice of the puzzle, but they are clearly not the answer to everything. One of my opinions regarding the problem of health care in this country is that insurance gets in the way. HSAs only make a tiny dent in this problem.

From: Kathy Saradarian <qualityfphughes (DOT) net>Subject: [Practiceimprovemen t1] HSATo: "'Practice Management Issues'" <practicemgt@ lyris.aafp. org>, Practiceimprovement 1yahoogroups (DOT) comDate: Sunday, September 14, 2008, 9:16 AM

I am trying to figure out why so many think HSAs are the saving grace of the healthcare system and why they are a good thing.

Example: A patient of mine was telling me about the pitfalls of her HSA. They buy their own health insurance. They received a better rate by going with a high deductible plan with an HAS. They are over 55 so they can put a little more away than younger, $3000 or $3500 instead of the $2500. They studied the list from the government on what is HSA eligible and said “oh good”. Because they don’t have dental, they don’t have vision so they thought they could use the HSA money towards this.

But, oh no. The HSA is administered by Aetna. And Aetna says they can only use their HSA money on things that are covered by the insurance plan but subject to deductibles and co-pays. So, essentially, the HSA is like Medigap insurance and is just being used on the deductibles and co-pays which they would be paying anyway.

So what is the benefit of this? Pre-tax dollars? Medical expenses are a write-off anyway, once you spend $10,000 or something write? They spend that on their health insurance. It seems like just another thing that is now under the control of the local insurance company and makes them money and that is all.

Can anyone explain it differently to me?

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypr actice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

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Lonna that was not an HSA that was a medical spending account The advantage ot an HSA like says is that anything you do not use you KEEP . You can only use it for health related things until you are 65 then you can use it for anything.

A few years ago when I was with my big corporate group, I took advantage of the HSA that was in addition to our excellent insurance. The advantage was that we could use the money that we put into it for things that weren't covered by our usual insurance (though the HSA was still administered by our insurance company) like acupuncture as well as things like over the counter medications. The money was pretax, even though our total expenditure was not huge. The disadvantage with the plan we had was that the money did NOT accumulate. Anything we did not spend we lost at the end of the year, so we planned in advance how much we thought we would use and contributed accordingly. It was a bit of an administrative pain for me, but overall it was worth it.

People who don't have enough money to contribute each month or don't have the

organizational skills to deal with this type of plan are amongst those for whom this would not work. They might be a peice of the puzzle, but they are clearly not the answer to everything. One of my opinions regarding the problem of health care in this country is that insurance gets in the way. HSAs only make a tiny dent in this problem.

From: Kathy Saradarian <qualityfphughes (DOT) net>Subject: [Practiceimprovemen t1] HSATo: " 'Practice Management Issues' " <practicemgt@ lyris.aafp. org>, Practiceimprovement 1yahoogroups (DOT) com

Date: Sunday, September 14, 2008, 9:16 AM

I am trying to figure out why so many think HSAs are the saving grace of the healthcare system and why they are a good thing.

Example: A patient of mine was telling me about the pitfalls of her HSA. They buy their own health insurance. They received a better rate by going with a high deductible plan with an HAS. They are over 55 so they can put a little more away than younger, $3000 or $3500 instead of the $2500. They studied the list from the government on what is HSA eligible and said "oh good". Because they don't have dental, they don't have vision so they thought they could use the HSA money towards this.

But, oh no. The HSA is administered by Aetna. And Aetna says they can only use their HSA money on things that are covered by the insurance plan but subject to deductibles and co-pays. So, essentially, the HSA is like Medigap insurance and is just being used on the deductibles and co-pays which they would be paying anyway.

So what is the benefit of this? Pre-tax dollars? Medical expenses are a write-off anyway, once you spend $10,000 or something write? They spend that on their health insurance. It seems like just another thing that is now under the control of the local insurance company and makes them money and that is all.

Can anyone explain it differently to me?

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypr actice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

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That sounds like a Flex Spending Account.

Lonna Larsh wrote:

>

> A few years ago when I was with my big corporate group, I took

> advantage of the HSA that was in addition to our excellent insurance.

> The advantage was that we could use the money that we put into it for

> things that weren't covered by our usual insurance (though the HSA was

> still administered by our insurance company) like acupuncture as well

> as things like over the counter medications. The money was pretax,

> even though our total expenditure was not huge. The disadvantage with

> the plan we had was that the money did NOT accumulate. Anything we did

> not spend we lost at the end of the year, so we planned in advance how

> much we thought we would use and contributed accordingly. It was a bit

> of an administrative pain for me, but overall it was worth it.

>

> People who don't have enough money to contribute each month or don't

> have the organizational skills to deal with this type of plan are

> amongst those for whom this would not work. They might be a peice of

> the puzzle, but they are clearly not the answer to everything. One of

> my opinions regarding the problem of health care in this country is

> that insurance gets in the way. HSAs only make a tiny dent in this

> problem.

>

>

>

> From: Kathy Saradarian <qualityfphughes (DOT) net>

> Subject: [Practiceimprovemen t1] HSA

> To: " 'Practice Management Issues' " <practicemgt@ lyris.aafp.

> org>, Practiceimprovement 1yahoogroups (DOT) com

> Date: Sunday, September 14, 2008, 9:16 AM

>

> I am trying to figure out why so many think HSAs are the

> saving grace of the healthcare system and why they are a good

> thing.

>

> Example: A patient of mine was telling me about the pitfalls

> of her HSA. They buy their own health insurance. They received

> a better rate by going with a high deductible plan with an

> HAS. They are over 55 so they can put a little more away than

> younger, $3000 or $3500 instead of the $2500. They studied the

> list from the government on what is HSA eligible and said “oh

> good”. Because they don’t have dental, they don’t have vision

> so they thought they could use the HSA money towards this.

>

> But, oh no. The HSA is administered by Aetna. And Aetna says

> they can only use their HSA money on things that are covered

> by the insurance plan but subject to deductibles and co-pays.

> So, essentially, the HSA is like Medigap insurance and is just

> being used on the deductibles and co-pays which they would be

> paying anyway.

>

> So what is the benefit of this? Pre-tax dollars? Medical

> expenses are a write-off anyway, once you spend $10,000 or

> something write? They spend that on their health insurance. It

> seems like just another thing that is now under the control of

> the local insurance company and makes them money and that is all.

>

> Can anyone explain it differently to me?

>

> Kathy Saradarian, MD

>

> Branchville, NJ

>

> www.qualityfamilypr actice.com

>

> Solo 4/03, Practicing since 9/90

>

> Practice Partner 5/03

>

> Low staffing

>

>

>

>

> ------------------------------------------------------------------------

>

>

> No virus found in this incoming message.

> Checked by AVG - http://www.avg.com

> Version: 8.0.169 / Virus Database: 270.6.21/1671 - Release Date: 9/14/2008

7:16 AM

>

>

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Maybe so, but they called it an HSA. >> From: Kathy Saradarian <qualityfphughes (DOT) net>> Subject: [Practiceimprovemen t1] HSA> To: "'Practice Management Issues'"<practicemgt@ lyris.aafp.> org>, Practiceimprovement

1yahoogroups (DOT) com> Date: Sunday, September 14, 2008, 9:16 AM>> I am trying to figure out why so many think HSAs are the> saving grace of the healthcare system and why they are a good> thing.>> Example: A patient of mine was telling me about the pitfalls> of her HSA. They buy their own health insurance. They received> a better rate by going with a high deductible plan with an> HAS. They are over 55 so they can put a little more away than> younger, $3000 or $3500 instead of the $2500. They studied the> list from the government on what is HSA eligible and said “oh> good”. Because they don’t have dental, they don’t havevision> so they thought they could use the HSA money towards this.>> But, oh no. The HSA is administered by Aetna.

And Aetna says> they can only use their HSA money on things that are covered> by the insurance plan but subject to deductibles and co-pays.> So, essentially, the HSA is like Medigap insurance and is just> being used on the deductibles and co-pays which they would be> paying anyway.>> So what is the benefit of this? Pre-tax dollars? Medical> expenses are a write-off anyway, once you spend $10,000 or> something write? They spend that on their health insurance. It> seems like just another thing that is now under the control of> the local insurance company and makes them money and that is all.>> Can anyone explain it differently to me?>> Kathy Saradarian, MD>> Branchville, NJ>> www.qualityfamilypr

actice.com>> Solo 4/03, Practicing since 9/90>> Practice Partner 5/03>> Low staffing>>>> > ------------------------------------------------------------------------>>> No virus found in this incoming message.> Checked by AVG - http://www.avg.com > Version: 8.0.169 / Virus Database: 270.6.21/1671 - Release Date: 9/14/20087:16 AM>> ------------------------------------

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Isn't that a " flexible spending account? " I think that's different

from HSA actually.TimOn

Sun, September 14, 2008 1:36 pm EDT, Lonna Larsh wrote:

A few years ago when I was with my big corporate

group, I took advantage of the HSA that was in addition to our excellent

insurance. The advantage was that we could use the money that we put

into it for things that weren't covered by our usual insurance (though

the HSA was still administered by our insurance company) like

acupuncture as well as things like over the counter medications. The

money was pretax, even though our total expenditure was not huge. The

disadvantage with the plan we had was that the money did NOT accumulate.

Anything we did not spend we lost at the end of the year, so we planned

in advance how much we thought we would use and contributed accordingly.

It was a bit of an administrative pain for me, but overall it was worth

it. People who don't have enough money to contribute each

month or don't have the organizational skills to deal with this

type of plan are amongst those for whom this would not work. They might

be a peice of the puzzle, but they are clearly not the answer to

everything. One of my opinions regarding the problem of health care in

this country is that insurance gets in the way. HSAs only make a tiny

dent in this problem.

From: Kathy Saradarian Subject:

[Practiceimprovemen t1] HSATo: " 'Practice

Management Issues' " , Practiceimprovement

1yahoogroups (DOT) comDate: Sunday, September 14, 2008,

9:16 AM

I am trying to figure out why so many

think HSAs are the saving grace of the healthcare system and

why they are a good thing.

Example: A patient of mine was telling

me about the pitfalls of her HSA. They buy their own health

insurance. They received a better rate by going with a high

deductible plan with an HAS. They are over 55 so they can

put a little more away than younger, $3000 or $3500 instead

of the $2500. They studied the list from the government on

what is HSA eligible and said “oh good”. Because they don’t have dental, they don’t have

vision so they thought they could use the HSA money towards

this.

But, oh no. The HSA is administered by

Aetna. And Aetna says they can only use their HSA money on

things that are covered by the insurance plan but subject to

deductibles and co-pays. So, essentially, the HSA is like

Medigap insurance and is just being used on the deductibles

and co-pays which they would be paying anyway.

So what is the benefit of this? Pre-tax dollars? Medical expenses are a write-off anyway,

once you spend $10,000 or something write? They spend that

on their health insurance. It seems like just another thing

that is now under the control of the local insurance company

and makes them money and that is all.

Can anyone explain it differently to

me?

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypr

actice.com

Solo 4/03, Practicing since

9/90

Practice Partner 5/03

Low staffing

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Sorry if this comes out blunt, but...Kathy, either your patients don't truly have an HSA or they're getting screwed because an insurance company has no control over how a person spends his/her HSA funds. On of the beauties of HSAs is that they can be used for non-covered services including alternative health care services such as acupuncture and chiropractic care. The guidelines for what they

Soma, a patient can use an HSA to pay for a physical exam but it is certainly not free...that patient is spending his/her own moneyLonna, I agree with the others who said that what you had was not an HSA as by definition they accumulate year after year. My use-it-or-lose-it fund through the University of California (I have a part-time non-clinical consultant job) is called a Health Care Reimbursement Account (HCRA). It's funded out of my salary but has the advantage of being pre-tax dollars

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