I'm willing to give HSA a try but have hard time getting answers from the HR Dept.

So if you're picking up your prescription medication at the pharmacy - and your deductible (if any) hasn't been satisfied:
- do I pay full price at the register
- or Pharmacy might submit claim and/or wait for EOB and apply discounts (again if any) later?

It seems to depend on the services offered by your HSA administratoor.

Most plans seem to have you pay full price up front then get reimbursed later. However, I have heard of HSA plans that have provider claims submission (which would get a discount) or a Debit card (usually full price).

You have to get more details from HR. The are required to give you an SPD which is supposed to give adequate info, and they are also supposed to have other documents which you are allowed to see upon request. I am not sure that the HSA must have a Plan Document but it must have an SPD.

I trust that you do realize that in order to have the HSA you must also change you health insurance to a high deductible plan. An HSA/HDHP is not something that is tried, it is something that you fully consider and calculate before making the choice.

Thanks, that's the sad part I can't get no response.
SPD says: In Network 90%, Preventive Care RX, 10/25/40 copays to all others once deductible is met. Do birth control pills fall into "preventive"?



Yeah that's what I'm considering for the next year, joining this forum is my last resort - there is only one employee in the entire company who used the plan before, and he's of no help - he's paying cash for everything and utilizing HSA for the retirement and to lower his gross income.

SPD = Summary Plan Description. Sort of like a super Outline of Coverage.

You should have received something similar for your other benefits especially the cafeteria plan and health insurance.

Have you looked to see the list of available Drs etc that you will have under the HDHP ? The High Deductible etc is not what seems to concern most people as much as the paying full price plus the restrictions on Drs and hospitals. BTW the paying full price up front can also be an issue with Drs and Hospitals. The calculation of your share is often done using full price.

Make sure that you research and understand what you are getting into. Pen and paper using scenarios could be helpful.

Thanks GBurns !

Usually the pharmacy can give you the discounted price on the spot. That's what I've been told by HR. Knock on wood, I have not had to use my HSA for any Rx yet.

You can pay for them by
1. using a check from your HSA account
2 using the debit card from your HSA account or
3. paying out of your own pocket and then reimbursing yourself using a check from your HSA account.

Be sure to keep a file will all bills and receipts for payments made from your HSA for each year. If you are audited and cannot provide backup, the distributions can be taxable income.

I find that the main reason plan participants have problems is because they relied on what someone is HR or Benefits said.

Why not just call a pharmacy or Dr and ask about the pricing ? It seems much better to hear it in advance from the person who is going to do it.

Yes, tried that before. What I've found out that each individual company have deviations from vanilla plan. There are some additional tweaks to save few bucks - and in my last year's dealings I found out little too late that certain medications were specifically excluded from the plan.
HR mgr had no clue about that, ... or so he claims

So go figure...

Have you ever talked to pharmacy clerk directly? They take 30 minutes at a time looking into monitor - only to render their clueless opinion "Your insurance does not cover it!" And all of that while the line behind you growing to double digits.

We all have different circumstances I guess.

BTW anybody knows if BC pills are qualifying "preventive care Rx" ?