An HSA is a special, tax-advantaged account — meaning money goes in tax free, earns interest tax free and is not taxed when it's withdrawn to pay for qualified expenses.
You or your employer — or both — may make contributions to your HSA.
Your HSA dollars earn interest, tax free.
At the end of the year, any money remaining in your HSA rolls over to the next year.
You own your HSA, so you keep the funds even if you change jobs or health plans.
You can withdraw money directly from your HSA using your Aetna HSA Visa® debit card or checks to cover qualified expenses. Or, allow the account to grow over time and use it to help pay for future health-related expenses — like long-term care insurance premiums, TCC/COBRA premiums and certain retiree expenses.
A high-deductible health plan (HDHP) is a health plan product that, when combined with an HSA, provides insurance coverage and a tax-advantaged way to help save for future medical expenses. The Aetna HealthFund HDHP with HSA gives you greater flexibility and discretion over how you use your health care dollars.
HDHPs have a higher annual deductible than traditional health plans.
To be eligible to fund an HSA, you must be covered by an HDHP; you cannot have other health insurance coverage (including a spouse's plan) that is NOT a high-deductible health plan; and you may not contribute any more money to an HSA once you are enrolled in Medicare. See question 3 below for more information.
To fund an HSA, you must be covered by a HDHP. You can have no other health insurance coverage other than that permitted (including a spouse's plan) that is NOT a high-deductible health plan and you may not be claimed on someone else's tax return.
Some examples of other coverage that would cause ineligibility are a health care flexible spending account (HCFSA), a spouse's FSA, a spouse's family enrollment in an HMO, other non-high deductible health insurance coverage, TRICARE, Medicare, or receipt of VA medical benefits within the previous three months. You are responsible for notifying us of any changes that would cause you to become ineligible.
4. If I enroll in Medicare am I still eligible to contribute to the HSA?
No, you may no longer contribute to your HSA, but you may continue to use the funds in your account. If you no longer qualify for an HSA, we will enroll you in our HDHP with a Health Reimbursement Arrangement (HRA).
Aetna HealthFund HDHP with HSA is a health plan product that provides traditional health care coverage and a tax-advantaged way to help you build savings for future medical needs. An HDHP with an HSA is designed to give greater flexibility and discretion over how you use your health care benefits. As an informed consumer, you decide how to use your Plan coverage with a high deductible and out-of-pocket expenses limited by catastrophic protection. And you decide how to spend the dollars in your HSA.
To understand how the Plan works, let's review its components.
The Health Savings Account
The Plan will automatically deposit $62.50 per month/Self Only or $125 per month/Self and Family into your HSA. (That is $750/Self Only or $1,500/Self and Family annually.)
You can make voluntary contributions to your HSA. The annual statutory maximum (plan contributions plus voluntary contributions) for 2008 is $2,900/Self Only or $5,800/Self and Family so you may voluntarily deposit up to $2,150/Self Only or /$4,300 Self and Family. If you or your spouse are age 55 or older, you may make a catch-up contribution of up to $900 for 2008.
When you have a qualified expense (e.g., doctor visit, prescription refill, dental procedures), you may withdraw money from your HSA, tax free, to be reimbursed for this out-of-pocket expense, including what you pay toward the deductible. Or, when you have a claim, you can choose to pay from other funds and allow your HSA to grow over time and use it for future health-related expenses.
Any unused dollars roll over year after year.
You own your HSA, so you keep it even if you change health plans or jobs.
Fund the HSA every year. This will lower your taxes and help you build a larger savings for future health care expenses.
The Medical and Prescription Drug Plan
In addition to the HSA, your Aetna HealthFund HDHP Plan provides traditional health benefits after you have met your deductible. You can seek care from any licensed health care professional or hospital for covered services — without a referral. Precertification is required for hospitalization and certain procedures.
Preventive Care - The Plan includes in-network preventive care coverage (e.g. routine physicals, immunizations, screenings and cleanings at the dentist) — covered at 100 percent — to encourage you to receive these important services
Deductible - The Plan includes an annual deductible — the amount you pay out of pocket before the medical coverage begins payment for covered expenses — of $1,500/Self Only or $3,000/Self and Family for in-network service and $2,500/Self Only or $5,000 Self and Family for out of network service per year. Remember, you may use money from your HSA for pay for qualified health care expenses which helps satisfy your deductible.
Medical Coverage - When the deductible is met, the medical coverage (90% in network, 70% out of network) begins for covered expenses. The medical plan also includes an annual out-of-pocket maximum to limit the amount you pay out-of-pocket in a given year — meaning once you reach the maximum, the Plan pays 100 percent of your covered medical expenses for the remainder of the year.
Prescription Drug Coverage - When you fill a prescription, you will pay the cost of the prescription, until the deductible has been met. At Aetna participating pharmacies, your prescription drug price may be lower because we have negotiated pricing on behalf of our members. Once the deductible has been met, you pay a copayment for each prescription you fill that is covered under your Plan. Refer to your Federal Plan brochure for additional details.
6. What are the key features of Aetna's HDHP with HSA?
The Aetna HealthFund HDHP with HSA is an innovative health plan that gives you more control over how you spend your health care dollars, or save for future health care expenses within a tax-free HSA.
Additional Plan features are:
Affordable, low premiums with automatic monthly deposits into your HSA of $62.50 for Self Only enrollments and $125 for Self and Family enrollments
100% coverage for in-network preventive care (medical, dental and vision) that does not reduce your HSA
No-fee Aetna HSA Visa debit card to access your funds when you use a Chase or Bank One ATM
Your voluntary HSA contributions are tax deductible
Interest earned on your account is tax free
Investment options for HSA balances of $2,000 or more
Tax-free withdrawals may be made for qualified expenses
Unused funds and interest are carried over, without limit, from year to year
You own the HSA and it is yours to keep – even when you change health plans, jobs or retire
A $100 allowance for eyeglasses or contact lenses every 24 months
Nationwide coverage with the freedom to choose your providers
Traditional medical plan coverage of 90% in network and 70% out of network once the Plan deductible has been met
A cap that limits the amount of your annual out-of-pocket exposure
If you are looking for a plan with 100% coverage for in-network preventive care, nationwide coverage in and out of network, and where part of the premium you pay is deposited into an HSA that is yours, then Aetna HDHP with HSA could be right for you. Consider the following:
Review your past year's medical services use and expenses.
Estimate any expected changes in your medical expenses for the coming year.
Compare the out-of-pocket costs (employee contributions, deductibles, coinsurance, etc.) for Aetna HealthFund HDHP with HSA and other health insurance plans available to you.
Consider whether you are ready to participate in an HDHP, knowing that you may save through tax-free payments on health expenses.
Enrollment procedures vary by agency. Detailed instructions and information on the Federal Employees Health Benefits Program enrollment process is available at Enroll Now. You will need to know the enrollment code for the Aetna HealthFund HDHP with HSA which is 224 for Self Only coverage and 225 for Self and Family coverage.
Visit Aetna Navigator to see the resources and information available to you when you enroll. Click on Site Tour and enter the following user name and password:
User name: federal3
Password: federal3
Visit the Office of Personnel Management's HSA website. This website has extensive information about HSAs including FAQs, worksheets, comparison charts, etc.
You must live or work in our service area to enroll in our plan. See our rate calculator to find plans available in your area. Once enrolled in the HDHP plan, covered medical services received overseas would be considered out-of-network. You may use money in your HSA to pay for qualified medical and dental services prior to meeting your deductible. After your deductible has been met, we pay 70% out of network for covered medical services. See Section 7 of our federal brochure for more information on how to submit overseas claims.
2. Does the money in my HSA earn interest and what investment options are available?
Yes, the money in your HSA earns interest. Interest earned on your HSA is not included in your income for federal tax purposes. There is no minimum balance required to earn interest.
The HSA interest rate currently tracks interest rates offered by JPMorgan Chase Bank, N.A. to high balance depositors in its retail branch banking business. This HSA rate will typically be determined based on interest rates of the last business day of the month and will typically be constant through the course of a month. JPMorgan Chase Bank, N.A. reserves the right to reset the rate to react to market interest rate conditions. The interest rate for August of 2007 is 3.96 percent. This is provided for informational purposes only and does not represent or guarantee future interest rate performance.
For HSA balances of $2,000 or more, HSA investment services are available through JPMorgan Institutional Investments Inc. The HSA investment services allow HSA account holders to take advantage of a key feature associated with HSAs – the ability to accumulate funds in a tax-advantaged manner and share in the potential upside of returns in excess of the interest rate paid on the cash account. See the Federal Plan brochure for more details.
4. What happens to my HSA if I leave my health plan or job?
You own your account, so you keep your HSA, even if you change health plans or jobs. Aetna can continue to administer your HSA account if you choose. If you are no longer enrolled in an HDHP, you are not eligible to make new contributions to your HSA, but you do not lose your balance and can continue to withdraw funds for qualified expenses.
5. What are the survivor benefits associated with my HSA?
You may arrange to have your HSA transfer to your surviving spouse tax free using a beneficiary designation form. Otherwise, your HSA balance becomes part of your estate in the event of your death.
You may authorize funds to be deducted from your designated bank account through electronic funds transfer (EFT), or you may make a lump sum contribution at any time, in any amount up to the maximum limit. You can claim your total voluntary contribution for the year as a tax deduction when you file your income taxes. You have until April 15 of the following year to make HSA contributions for the current year. An EFT/direct deposit form {link to EFT form} is included in your Welcome Kit.
Starting in 2008, federal employees who are enrolled in High Deductible Health Plans (HDHP) will be able to make pre-tax allotments to HSAs through The Federal Flexible Benefits Plan (FEDFLEX). The Office of Personnel Management has worked with payroll providers and employee self service systems to provide this service. By January 1, 2008, all eligible employees will be able to make these allotments to their HSAs. Please contact your payroll office to determine when this feature will be available for your agency.
7. When will contributions to my account be available for withdrawal?
HSA contributions will be available for withdrawal when funds are deposited. Voluntary HSA contributions may be made from your designated bank account through electronic funds transfer (EFT) or on a lump sum basis at any time during the plan year. The availability of funds depends on how funds are contributed and varies by individual.
Once contributions have been made to your account, you can use your no-fee Aetna HSA Visa® debit card or checks to get instant access to your HSA dollars to pay for qualified out-of-pocket expenses quickly and easily. Use your Aetna HSA Visa® debit card or checks, not your cash. There is a fee to purchase checks. You may also elect to have your money automatically withdrawn from your HSA for covered expenses claims using our convenient AutoDebit feature.
Your HSA can be used to pay for "qualified expenses," as defined by IRS Code 213(d). These expenses include, but are not limited to, medical plan deductibles, diagnostic services covered by your plan, health insurance premiums if you are receiving federal unemployment compensation, over-the-counter drugs, LASIK surgery and some nursing services. You can request a copy of IRS-allowable expenses (IRS Publication 502) by calling 1-800-829-3676, or visit the IRS website.
You can also use your HSA funds to pay premiums for TCC/COBRA continuation coverage. When you become age 65, you can use the account to purchase any health insurance other than a Medigap policy. You may not, however, continue to make contributions to your HSA once you are enrolled in Medicare.
Remember to keep receipts for your HSA purchases to show that you used your HSA funds for qualified expenses. If you are audited and your HSA expenses are questioned, your receipts provide the best proof. Under HSA regulations, you are responsible for determining which expenses are considered "qualified expenses." Please consult your tax advisor for guidance.
10. Can I use my HSA to pay for non-health-related expenses?
Yes. You may withdraw money from your HSA for items other than qualified expenses, but it will be subject to income tax (unless you are age 65 or disabled) and an additional 10 percent penalty tax on the amount withdrawn.
11. Are there any HSA administrative or maintenance fees?
The administrative fee to maintain your HSA is included in your premium. If you are not enrolled in our HDHP, we will deduct a monthly $3.00 administrative fee from your HSA.
12. Are there any fees associated with using the Aetna HSA Visa® debit card?
You will not incur ATM withdrawal or point-of-service transaction fees. If you use a Chase or Bank One ATM you will not incur a service fee. Other ATM operators may assess a service fee (typically between $.50 and $2.00) for use of their machine.
13. Are the Plan deposits to the HSA monthly or is it done in one lump sum?
Deposits to the HSA by the Plan are made monthly. The monthly deposit is $62.50 per month for Self Only coverage and $125 per month for Self and Family coverage.
If you enroll during open season and remain covered during the year, the Plan will deposit the following to your HSA over the course of the year:
You may contribute the following to your HSA assuming a January 1, 2008 effective date:
Up to $2,150 per year for a Self Only enrollment
Up to $4,300 per year for a Self and Family enrollment
If you enroll in the HDHP after January 1st, you can contribute up to the maximum statutory contribution amount, provided that you maintain coverage for a 12-month “testing period.” (The testing period begins with the last month of the taxable year in which you enrolled and ends on the last day of the 12-month period following such month.) If you do not maintain continuous HDHP coverage for the testing period (other than for reason of death or disability), any HSA contributions made in the months preceding the month in which you enrolled in the HDHP will be included in your gross income and subject to a 10% income tax percent penalty. Consult your tax advisor for more details.
Individuals age 55 and older may make an additional "catch-up" contribution of $900 per year in 2008 (this amount increases $100 per year until 2009 when it will be $1,000).
15. Is there an annual "cap" or maximum amount that may be contributed to my HSA?
Yes. The annual statutory maximum (Plan contributions plus voluntary contributions) for 2008 is $2,900/Self Only or $5,800/Self and Family per year. You may voluntarily deposit up to $2,150/Self Only or /$4,300 Self and Family.
For example, if you have Self Only coverage and you join during open season, the Plan will contribute $750 from premium (prorated $62.50 per month) and you may make up to a $2,150 voluntary contribution for a total of $2,900, if your HSA effective date is 1/1/08. If you have Self and Family coverage, the Plan will contribute $1,500 from premium (prorated $125 per month) and you may make up to a $4,300 voluntary contribution for a total of $5,800 if your HSA effective date is 1/1/08.
Individuals age 55 and older may make an additional "catch-up" contribution of $900 per year in 2008 (this amount increases $100 per year until 2009 when it will be $1,000). Spouse catch-up contributions must be established in a separate HSA account from that of the employee.
If you enroll in the HDHP after January 1st, you can contribute up to the maximum contribution amount, provided that you maintain coverage for a 12-month “testing period.” (The testing period begins with the last month of the taxable year in which you enrolled and ends on the last day of the 12-month period following such month.) If you do not maintain continuous HDHP coverage for the testing period (other than for reason of death or disability), any HSA contributions made in the months preceding the month in which you enrolled in the HDHP will be included in your gross income and subject to a 10% income tax percent penalty. Consult your tax advisor for more details.
16. What happens if my medical expense exceeds the amount in my HSA? Can I submit a withdrawal later on in the year when my balance is higher?
If the amount of your medical expense exceeds the amount in your HSA you would be responsible for paying that expense out of pocket. You may partially reimburse yourself from your HSA with the amount available by making a withdrawal from an ATM using your HSA debit card and can reimburse yourself as additional funds are available.
17. I joined the Plan during Open Season and my coverage is effective on January 6, 2008. Why didn't the contributions to my HSA from Aetna start until February?
The law states that the HSA is effective on the first day of the month following the effective date of the health plan coverage, unless the effective date of the health plan coverage is the first day of the month. For most federal employees who enroll during Open Season, the effective date of the health plan is the first day of the first pay period, which in 2008 is January 6, 2008 for most people. With a January 6, 2008 health plan effective date, the HSA is effective February 1, 2008. The first Plan contribution would be made in February. Employees whose effective date is January 1, 2008 will have an HSA effective date of January 1, 2008.
18. I joined the Plan during Open Season and my coverage is effective on January 6, 2008 (Self Only enrollment). Will the Plan contribute the full $750 to my account the first year?
Yes. The first Plan deposit would be made in February and monthly thereafter. There will be two deposits made in December 2008 to bring you up the full $750.
19. Can I make voluntary contributions via payroll deduction?
Starting in 2008, federal employees who are enrolled in High Deductible Health Plans will be able to make pre-tax allotments to HSAs through The Federal Flexible Benefits Plan (FEDFLEX). The Office of Personnel Management has worked with payroll providers and employee self service systems to provide this service. By January 1, 2008, all eligible employees will be able to make these allotments to their HSAs. Please contact your payroll office to determine when this feature will be available for your agency.
You may also have funds direct deposited to your HSA on a post tax basis from your personal checking or savings account by completing a direct deposit/form.
20. I read that I can pay Long Term Care (LTC) insurance premiums from my HSA account. Does the amount I use for LTC premium count towards my catastrophic limit?
You can use funds from your HSA to pay for LTC insurance premiums. The amount you withdraw from your HSA to pay LTC premiums would NOT count toward your catastrophic limit nor toward your deductible because it is not a covered expense under the health Plan.
The Plan deposit to your HSA is made and reflected on Aetna Navigator each month. The timing regarding posting of withdrawals (or debits) and voluntary deposits to your HSA will vary depending upon the method used (Electronic Funds Transfer (EFT), debit card, check, etc.).
2. How do I deduct voluntary HSA contributions from my taxes? Do I have to itemize?
JPMorgan Chase Bank, N.A. will send a Form 5498-SA that will list your contributions to your HSA and a Form 1099-SA that will list the distributions from your HSA. You will need to complete a Form 8889 to report HSA contributions. See the IRS website for more information.
1. How can I keep track of my HSA balance and my deductible?
You can check your HSA balance online using the Aetna Navigator™ self-service member website; request to receive a monthly paper statement; or you can call Aetna Customer Service as directed on your Aetna HSA Visa® debit card.
You may check the status of your deductible by using Aetna Navigator.
3. What do I pay when I go to the doctor's office?
Generally, when you visit a participating provider for covered preventive care, you pay nothing because eligible in-network preventive care (medical, dental, vision) is covered at 100%. When you visit a participating provider for other covered care you will be responsible for the Aetna-negotiated cost of the visit. If you visit a nonparticipating provider for any covered care you will be responsible for the full cost of the visit. Generally, providers will submit a claim to Aetna on your behalf.
In most instances you will not make a payment when you receive service. You should wait for the medical claim to be processed through our claim system. We will apply the appropriate discounts to the services and apply that amount towards your deductible. The participating doctor's office will send you a bill requesting payment at the Aetna-negotiated rate. You should write your Aetna HSA Visa debit card number on the doctor's bill and submit for payment or use an HSA check (if purchased). If you have already met your deductible, you will be billed for the difference between the billed charges and the amount covered by the medical plan.
If you elect the AutoDebit feature, the claim will automatically be paid from your HSA.
4. When I visit a participating provider, how can I be sure I am getting Aetna's negotiated rate?
Participating providers should bill Aetna members the Aetna-negotiated rate, so it is important for you to identify yourself as an Aetna member and show your Aetna ID card. You may use the online Cost of Care tools on our Aetna Navigator website to estimate the cost of service at the negotiated rate. Your Explanation of Benefits, which can be viewed on Aetna Navigator, will also show the "submitted charges" and the "negotiated or allowable amount" so that you can be sure you are being billed the Aetna-negotiated rate.
Yes. You may use your available HSA funds to reimburse yourself for any qualified expenses (per IRS). If you satisfy the Plan deductible and access care overseas using the traditional coverage of the Plan you would be using out-of-network providers and Aetna pays 70% of covered benefits.
6. What services fall under the preventive care benefit?
The Plan covers preventive care at 100% when you visit participating providers. Some preventive services included are routine physicals, routine immunizations, routine screenings, prophylaxis (cleaning of teeth), fluoride treatment, routine eye exam, etc. Please see your Federal Plan brochure for frequency limitations and other details.
7. What online resources are available to help me use my Plan?
Aetna Navigator- Your personalized, self-service website packed with health and benefits information. When you register, you can order ID cards, check eligibility or claim status, check HSA balance and much more. Here are just a few highlights:
Estimate the Cost of Care – compare in-network and out-of-network provider fees, the cost of brand-name drugs versus their generic equivalents, and the costs for services such as routine physicals, emergency room visits, lab tests, X-rays, MRIs, etc.
Hospital Comparison Tool – see how hospitals in your area rank by factors important to you.
Simple Steps To A Healthier Life® Program – assess your potential health risks, develop a personalized action plan for better health, track your progress and much more.
Aetna InteliHealth® and Healthwise® Knowledgebase websites – Health information sources to help you make better decisions about your health care and treatment options.
Personal Health Record - captures important health information in one place, helping you stay healthy with personalized alerts and reminders and allowing you to print and share your health history with your doctors.
DocFind® online provider directory – lists participating physicians, hospitals and other health care providers. It also includes important provider credentials like education, board certification and languages spoken.
Yes. Our DocFind® online directory lists participating physicians, hospitals and other health care professionals. DocFind® also includes important provider credentials like education, board certification and languages spoken.
1. How are routine dental cleanings/visits treated under the Plan?
Prophylaxis (cleaning of teeth) two times per calendar year is covered at 100% when you use a participating provider. Find participating providers by using our DocFind® online provider directory. Please see your Federal Plan brochure for more information about covered dental preventive care.
The Plan only covers in-network preventive dental care at 100%. You are also entitled to discounted rates from Aetna PPO dentists for services that are not covered by the Plan. Find participating providers by using our DocFind® online directory.
There is no coverage for out-of-network dental care. You may choose to use funds from your HSA to pay for non-covered dental care. As long as the services are considered IRS-qualified expenses, your HSA withdrawal would not be taxed. For the complete list of IRS-allowable expenses, you can request a copy of IRS Publication 502 by calling 1-800-829-3676, or visit the IRS website.
4. How do I pay for prescriptions? When will I be subject to a prescription copayment and when am I charged full cost for prescription medications?
Until you meet your deductible, you will pay the entire cost of the prescription (Aetna's negotiated rate at a participating pharmacy). It is important for you to identify yourself as an Aetna member and show your Aetna ID card to get the negotiated rate. If you have funds available in your HSA, you may use your Aetna HSA Visa debit card to purchase the prescription. Once you meet your deductible, you will be subject to a prescription copayment.
5. Can I use funds from my HSA for an over-the-counter drug?
Yes, you may use funds from your HSA for the over-the-counter drugs. Over-the-counter drugs are not covered by the Plan but may be considered as a qualified medical expense by the IRS. If the over-the-counter drug is considered a qualified expense by the IRS, your HSA withdrawal would be tax free. However, the cost of a non-covered drug would not apply to your annual deductible. For the list of IRS-allowable expenses, you can request a copy of IRS Publication 502 by calling 1-800-829-3676, or visit the IRS website.
6. How do I go about making a claim for vision care?
One routine eye refraction every 12-month period is covered at 100% when you visit a participating provider. Your provider would submit the claim to Aetna and you would pay nothing. Members are also eligible for a $100 eyewear reimbursement every 24 months and discounts on frames, lenses, LASIK procedure, etc., through the Aetna Visionsm Discount program. If you use a participating location, they will take the $100 eyewear reimbursement off at the point of sale. If you use another eyewear provider, simply mail the receipt along with your member ID number to:
Aetna
PO Box 14089
Lexington, KY 40512-4089
You can find participating locations by using our DocFind® online directory.
For other covered vision services, your provider will generally submit the claim to Aetna on your behalf. If you use a nonparticipating provider you may have to submit a claim. Claim forms are available on Aetna Navigator our member website.
1. What should I do if I have not received my ID card or Welcome Kit?
Call 1-800-537-9384. Tell the customer service representative that you enrolled in the Aetna HealthFund HSA Plan and have not received your ID card and Welcome Kit. The representative will tell you whether your enrollment information has been received from your benefit office.
This material is for informational purposes only. See your federal brochure for a complete description of benefits, exclusions, limitations and conditions of coverage.
HDHP w/HSA Features:
NEW – Lower Premiums
NEW – Decreased in-network deductible.
Use your tax-advantaged HSA to pay for eligible expenses.
Dental and vision included
Nationwide coverage both in and out of network
100% preventive care coverage when you use participating providers
