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 on the cost of membership. 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.
When it comes to using your HSA or FSA, you probably want to know: Are concierge doctor fees eligible for your HSA or FSA?
As one of the leading concierge medicine practices in the United States, we answer this question frequently. Here's what you need to know.
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 $1,500 for self-only coverage and $3,000 for family coverage (as of 2023).
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.
For the 2023 tax year, people who file independently can invest $3,850 in an HSA, while families can contribute up to $7,750.
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.
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 2023, you can invest up to $3,050 of untaxed income into a bucket that covers living expenses. However, you also can’t roll over more than $610 (20%) of unspent balance until next year.
Again, check with your employer on details, but, it’s generally a use-it-or-lose-it system. There are two types of FSAs:
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.
HSAs and FSAs 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 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.
HSAs and FSAs are viable options 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.
At PartnerMD, our concierge doctors see patients from offices in Richmond, VA; Baltimore, MD; McLean, VA; Greenville, SC; and Atlanta, GA.