HSA
What does HSA stand for?
Health Savings Account
This is an amount you could owe during a coverage period for health services before your plan begins to pay.
What is your deductible.
Yes! Native Americans can apply any time all year long.
A member had a new baby 40 days ago. Can the family enroll?
Yes as long as it's within 60 days
Does HSA money grow tax free?
Yes
This is a fixed amount you pay for covered health care service, usually when you receive the service.
What is a copayment.
A member wants to enroll midyear. They are Native American but can't remember if they have any kind of proof of registration. Can they enroll?
Sort of! You could enroll them and they would have 30 days to provide you with proof of tribal status. If they can't provide it they will need a different life event.
Can you use your HSA dollars to pay for your child's braces?
Yes
This is the percentage that you must pay once your deductible has been met.
What is coinsurnace
Bronze. It will be less expensive but just as good.
If a member moves from Oklahoma to Texas, can they use that as a life event if they have not previous had coverage?
No...they could if they moved from another country but not state to state.
In 2026 you can enroll/contribute to an HSA account if you have what level of plan?
Bronze or Catastrophic ACA plan
What is Formulary
A NA member calls and wants to enroll. Their only income is tribal dividends. Will they qualify to enroll?
Most likely not, their income will send them to Medicaid. Then Medicaid will send then back for having too high of an income and then you can enroll them.
This is the day that coverage will begin for a client who calls you on 12/18/25 because they just lost their job and their insurance will end on 12/31/25.
What is 1/1/26. If they didn't have a life event their plan would begin on 2/1/25.
This amount is the most that a 57yr old, single enrolled, member could contribute to their HSA in 2026?
$5,400
A decision by your health insurer that a health care service, treatment plan, or prescription drug is medically necessary. Hint, if you don't receive this and have the service anyway you will really regret it.
What is preauthorization
You are enrolling a couple, the husband is Mexican-American and the wife is Native American. They make $30,000 together. After submitting the application for review you see that the wife qualified for a Native American $0 Cost Share. Should you enroll them on the same plan?
No! Put them on separate plans because the wife can get a better plan without her husband.
When gathering the initial consent, you need a few items for it to be legal. Name 3 things that must be in your consent statement.
1- Your name
2- Client Name
3- Date
4- Reasons why you are gathering consent
5- Ways they can revoke their consent