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Joe Lasher, CFO

By: Joe Lasher, CFO on March 29th, 2022

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How to Use Your HSA or FSA for Concierge Medicine

Concierge Medicine

When it comes to financial assistance with healthcare, most of us appreciate any break that spares us a few dollars.

With concierge medicine, just like with any traditional medicine, you want to find every path toward possible savings. One resource you may want to consider is a spending account.

There are two main types of accounts — Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs). These accounts let you set aside earnings into a fund for “qualified medical expenses.”

You might be surprised by the number of items covered by HSAs or FSAs — everything from insurance deductibles and copays down to supplies such as bandages, crutches, and contact lenses.

What makes an HSA or FSA better than a traditional savings account? Taxes.

Your earnings move into these accounts without being taxed as income, and they also get protected from unemployment, Social Security, and Medicare taxes.

If the combination of tax relief and health care savings sounds good to you, we want to give you a primer on the spending accounts and how to use them to manage the cost of your concierge medicine membership.

HSA blocks under a stethoscope

HSAs: More ownership over your medical savings account.

Both HSAs and FSAs cover all qualified medical expenses, but the protections and limitations of an HSA are very different, so make sure you’re aware of the pros and cons of an HSA.

The first thing to know is that not everyone is eligible for an HSA. It’s available only to people who use a high-deductible health insurance plan, one with an annual deductible of $1,400 for self-only coverage and $2,800 for family coverage (as of 2022).

But if you qualify and choose an HSA, the account is entirely yours, not your employer’s. This means there are no concerns about job transitions or a yearly rollover limiting your access to the balance. It’s yours to use when you need it.

If you’re age 65 and older, you’re even allowed to withdraw funds to pay non-medical expenses, but you’re going to owe income tax on your withdrawal. If you’re not yet 65, you’re able to do the same, but you’re stuck with additional fees.

Another difference between an HSA and an FSA? HSAs have a higher contribution limit.

People who file taxes independently can invest $3,650, while married couples who file jointly can double that. Unlike an FSA, which requires you to set a contribution total during the enrollment period, an HSA total can be altered at any time.

That’s a lot of points in favor of the HSA, but what’s the drawback? You can’t outspend your investment. Instead of accessing the full contribution amount as of January 1, you can grab only what you’ve accumulated in your account.

FSAs: A use-or-lose account for medical expenses.

The “f” in “FSA” stands for “flexible,” but it might as well stand for “fast.” You can quickly get access to your FSA funds, but you can also quickly lose access to its funds, too.

With an FSA in 2022, you can invest roughly $2,850 of untaxed income into a bucket that covers living expenses. However, you also can’t roll over more than $570 of unspent balance from one year to the next.

Again, check with your employer on details, but, it’s generally a use-it-or-lose-it system. There are two types of FSAs:

  1. Dependent Care Flexible Spending Account, which can be spent on work-related childcare.
  2. Health Flexible Spending Account, which goes toward qualified medical expenses.

One perk to the FSA is how soon your funds become available. You must enroll in the program and set your contribution amount during the fall enrollment period, but then you have access to the entire budget as of January 1 — even if you deposit into your account throughout the year.

The drawback to an FSA is its limited protections for job transitions and yearly rollover. If you leave or lose your job midyear and you haven’t used your FSA balance in full, you likely forfeit access to it, unless you qualify for continuation through COBRA. Check with your business, though, because guidelines vary from one company to the next.

Piggy bank with FSA letters on it

How do HSAs and FSAs work with concierge medicine costs?

These spending accounts cover a wide-ranging list of medical expenses. The best part, at least in our minds, is that they typically work the same with concierge care as they do with traditional physician practices.

Your concierge membership can’t be covered by your FSA or HSA account, just like it can’t be billed to most insurance policies.

However, the general rule to remember is that, if insurance covers an expense, so does a spending account. That’s true with traditional practices and with concierge care, too.

Any co-pay, prescription, or out-of-pocket concierge expense that you can bill to your insurance company should be HSA- and FSA-eligible.

An advanced physical (sometimes called an executive physical) could potentially be applied to an HSA or FSA. Some form of physical is commonly included as part of a concierge membership, but many of the more medically advanced screenings require an out-of-pocket payment.

Depending on your individual plan, these costs may be able to be applied to your HSA or FSA. Always check with your plan to ensure you have a clear understanding of what kind of expenses can be applied to your HSA or FSA.

Health savings adding up

HSAs/FSAs & Concierge Medicine: Ask for receipts.

While you cannot use your HSA or FSA funds to cover the cost of your membership, there may be services included as part of your membership that are reimbursable. Let’s look at a PartnerMD-specific example to illustrate.

Your membership fee for PartnerMD includes one-on-one access to our certified health coaches. When you have an appointment with your coach, neither you nor your insurance will be billed because you’ve paid for these services as part of your membership.

However, depending on your HSA or FSA plan, health coaching could be a covered expense.

Therefore, when you use the service, PartnerMD can issue you a receipt for the health coaching visit that can be submitted for reimbursement to your HSA or FSA. Keep in mind that there are some limitations. For example, a coaching visit may require certain elements to qualify.

Because each concierge practices offer different benefits and perks, be sure to ask about any reimbursable services that may be included within your membership fee. Then ask for receipts when taking advantage of these benefits.

Learn more about spending accounts and concierge care.

HSAs and FSAs are a viable option for you to minimize the cost of having great dedicated care through concierge medicine.

As we talk about these accounts, all the standard disclaimers apply. Policies can vary. Check your specific plan for details.

But you now know the general rules of what expenses these accounts cover.

  • If insurance covers it, a spending account likely does too.
  • Concierge memberships can’t be covered, but treatment can.
  • Ask about receipts for treatment services, like health coaching, that are built into your membership, because they may be applied to your FSA or HSA.

Is there more you want to know about concierge costs and services? We’re here to help. Download our free guide to Understanding Concierge Medicine to learn more about potential savings and everything concierge medicine has to offer.

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