A Medicare Medical Savings Account (MSA) Plan might provide the right Medicare coverage for your health and financial needs.
MSA plans combine high-deductible health coverage with a special medical savings account. With a Medicare MSA plan, the insurance company deposits money from Medicare into the member’s savings account. The member then decides what health services to spend it on. The member can choose to save and/or invest the funds for future health expenses.
Medicare MSA plans have many attractive features. By Medicare rule, MSA plans must have a $0 premium. You still pay the premium for Medicare Part B. There is no network so members can use any doctor who accepts Medicare assignment and agrees to accept the plan. There is not a requirement for prior authorization or physician referrals. Any unspent deposit money at the end of the year is yours to keep and can accrue over time.
Medicare MSA plans have a deductible. A deductible is a specific amount that you must pay before an insurer pays a claim. With MSA plans, only Medicare Parts A & B covered services count toward the plan deductible. Until a member meets their plan deductible, they pay up to 100 percent of the Medicare-approved amount for Medicare-covered services. After the deductible is met, the plan pays 100 percent of expenses for Medicare covered services.
To help cover a part of the deductible, the MSA plan deposits money into a savings account at the beginning of each year. Any funds in this bank account accrued from previous plan years are the members to keep and do not need to be repaid. Per IRS rules, MSA plan members can use their MSA funds on a tax-free basis to pay for their Part D deductible, copays and coinsurance. However, the funds used to pay for these expenses will not count toward their plan deductible.
The difference between the deductible and the deposit is referred to as the member responsibility. This amount may be less than you are currently paying for your Medicare Supplement premium. The member responsibility on an MSA plan also may be less than the maximum out of pocket on a Medicare Advantage plan. The member responsibility provides a cap on expenses for Medicare MSA plan members that does not exist on Original Medicare only.
CMS, the organization that oversees Medicare, designed MSA plans to be consumer-driven. MSA plans have the benefit of a $0 premium while still having access to any Medicare provider. With an MSA plan, you can choose your own drug coverage through a stand-alone Part D plan. And any unspent deposit money at the end of the year is yours to keep.