Investing General Discussion

Captain Suave

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what I would say is happening is your insurance company is substantiating your HSA spend against your actual insurance claims

That's entirely plausible. In the years I've withdrawn from my HSA I've had bills through my insurance which exceeded my HSA contribution limit.
 

Khane

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Well you can't contribute to an HSA without a high deductible health plan, and when switching plans almost everyone rolls their existing HSA into the new plan HSA because it's just way easier to manage. Its entirely possible to not do that and have an existing HSA that is no longer tied to a health plan but that is not the norm (and you can't contribute to that particular HSA anymore). So by and large your insurance company has access to all your HSA spend data and obviously has access to your insurance claim data so it's very easy for them to substantiate.
 

Aychamo BanBan

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Outside of years where paying all my medical expenses from taxable income would be inconvenient, my general approach is to contribute the max and let it sit. Given that you're almost guaranteed to spend the money eventually it's basically an extra IRA without income limits.

Absolutely. I'm not correcting you, I'm just adding to this for anyone who reads the forum that doesn't know:

The “sweet spot” age for HSAs, as it relates to retirement, is 65 or older. HSAs behave similarly to Traditional IRAs after the age of 65. If you still have an HSA balance after the age of 65, you can take withdrawals out of your HSA for non-medical expenses penalty free. Taxes may still be applicable to your withdrawal amounts, similar to Traditional IRA withdrawals, but you would avoid the 20% penalty from the IRS. (this is copy pasted from the web)
 

Aychamo BanBan

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Did you write a check against the account? Because there's still that verifiable, easily substantiated audit trail. I did specifically talk about cash transactions.

If these are actual medical procedures why wouldn't you just use the card or ACH transactions?

It's perfectly fine to reimburse yourself from your HSA for qualified medical expenses. You don't have to explicitly have transactions out of the HSA with a card at a medical office or anything like that. Just keep your receipts!
 

Aychamo BanBan

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Well you can't contribute to an HSA without a high deductible health plan, and when switching plans almost everyone rolls their existing HSA into the new plan HSA because it's just way easier to manage. Its entirely possible to not do that and have an existing HSA that is no longer tied to a health plan but that is not the norm (and you can't contribute to that particular HSA anymore). So by and large your insurance company has access to all your HSA spend data and obviously has access to your insurance claim data so it's very easy for them to substantiate.

What??

For me, I am free to open my HSA anywhere I want, and it's not associated with my BCBS health insurance plan at all. I host my HSA at Fidelity. BCBS has none of the details on my HSA, has no idea if I have one or not, or anything else. Is this really not the norm? I've never met anyone with a HSA that is tied to their health insurance plan. Maybe this is state dependent?
 

Khane

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It's perfectly fine to reimburse yourself from your HSA for qualified medical expenses. You don't have to explicitly have transactions out of the HSA with a card at a medical office or anything like that. Just keep your receipts!

Of course it is. That's not the point I'm making. HSA accounts are almost always tied to a current HDHP so it doesn't really matter how you spend or reimburse, the insurance company has all the data they need to substantiate.
 

Khane

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What??

For me, I am free to open my HSA anywhere I want, and it's not associated with my BCBS health insurance plan at all. I host my HSA at Fidelity. BCBS has none of the details on my HSA, has no idea if I have one or not, or anything else. Is this really not the norm? I've never met anyone with a HSA that is tied to their health insurance plan. Maybe this is state dependent?

Alright, I guess I'm being a bit obtuse here. HSA administrators and insurance providers trade data. For most Americans, they don't do what you are doing, but even when they do, companies like mine have their data. It is actually tied to your health plan whether you realize it or not, because it's an IRS regulation. You can't open an HSA or contribute to one without a qualifying HDHP. So how do you think they keep track of that? Furthermore you can only open an HSA account with an IRS designated "trustee".

 
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Khane

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Basically, if you have a health plan through your employer you're going to have a hell of a time trying to skirt the system. If you have an individual health plan it may be a bit easier but why try to fuck with the IRS, banks, insurance providers and (if you use your card) card processors?

The more you try to play outside the rules the more letters and receipt requests you are going to get.
 
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Locnar

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I have a HSA offered through my work and I use it as a additional limit increase to my 401k. My HSA allows the funds to be placed in stocks/indexes so I use my HSA for the "small-cap" index in my investment portfolio. I'm absolutely going to just let it grow and treat it as a extension of my 401k for retirement (or I suppose catastrophic medical issue if that were to happen).

Before I had a flexible spending account (FSA) and since that does not roll over each year I did use that as a tax free way to pay for medical related stuff. But ANYTHING I did with it over a certain amount, I had to upload receipts to the administrator for approval. It was a huge pain in the ass. Even using the card to pay for a operation or a doctors office visit, they STILL made me upload paperwork. That is when I said the hell with this and went over to a HSA that I can just forget about and use as a 401k.

As someone who really did not start saving for retirement until 40 y/o, I'm feverish about tucking away the max on any and all tax advantages accounts I can. Luckily house/farm is paid off and I can devote myself to catching up.
 

fris

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i switched to HSA a few years ago at work and didn't use it till i got another kidney stone last summer, which drained what i had in there. that's when i started looking into it more and really regret not putting anything into it myself (work puts in ~$750 a year).

it's the only account that's untaxed 3 ways. the money that goes in reduced your taxable income. what you spend isn't taxed. the growth isn't taxed. and if you have anything in it at 65(59.5?), you can spend it anything (not just health related), a la ira/401k.
 

Keystone

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yea, think they got the point across well already, but the question shouldn't be how to get money out, it should be why would you want to? Unless you have a definitive plan for that money it's better off growing in your HSA unless you have shit choices as far as investment opportunities within it
 

Aychamo BanBan

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Since we are on HSAs, and how to get money out: you *can* open a self-directed HSA account (or Roth IRA or 401k, etc), and that would let you spend your HSA money on atypical investments. Lets say you wanted to get into real estate, you could use your money in an HSA to buy a property, however all expenses/profits are confined to that HSA account, so you can't access them early. Or if you want to buy property, but can't pay for it all with your self-directed HSA, you can find a bank that offers a non-recourse loan to buy the property. Most seem to do like a 60-50% loan-to-value.
 

Furry

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How the hell can you have trouble justifying HSA spending? You can literally spend the money on vacations if your job makes you too stressed and a doctor recommends you relax more... or home upgrades you say are disability related... The justifications are so easy to make you have to be tarded not to use the system to withdraw for everything as needed. Go to a nutritionist and get a diet plan. Suddenly all your food is medical expenses.

Come on now.