The Medicare Prescription Drug, Improvement and Modernization Act of 2003 included a provision that permits self-employed individuals or individuals who are employees to establish Health Savings Accounts (HSAs) beginning in 2004. HSAs are custodial accounts or tax exempt trusts that are created to pay qualified medical expenses for the account holder, their spouse and dependents. Contributions to HSAs are tax deductible if made by an eligible individual or not included in an individual’s gross income if contributions are made by their employer. Distributions from the HSA are tax-free if they are used to pay for qualified medical expenses.
To qualify for an HSA, the individual must be covered under a high deductible health plan (HDHP). A qualifying HDHP for 2005 must have an annual deductible of at least $1,000 for individual coverage and $2,000 for family coverage and a maximum annual out-of-pocket expense limit of $5,100 for individual coverage ($5,000 for 2004) and $10,200 for family coverage ($10,000 for 2004).
The maximum annual contribution to an HSA for 2005 is 1) the lesser of the annual deductible of the HDHP or 2) $2,650 for individual coverage ($2600 for 2004) or $5,250 for family coverage ($5,150 for 2004). Individual policyholders and covered spouses who are 55 or older are allowed an annual catch-up contribution. For 2005, the catch-up amount is $600 ($500 for 2004) and will increase $100 each year until it reaches $1,000 for 2009 and thereafter.
An eligible individual can establish an HSA with a qualified trustee or custodian by executing the agreement in Form 5305-B for a trust account or Form 5305-C for a custodial account. A qualified trustee or custodian is any bank or insurance company, or any other person already approved as a trustee or custodian for IRAs or Archer MSAs. The trustee does not have to be the provider of the high-deductible health coverage.
Contributions can be made to an HSA at any time prior to the filing of the individual’s tax return, not including extensions. Contributions made by an individual are deductible in determining the individual’s adjusted gross income; that is, they are deductible “above the line.” Form 8889 must accompany the Form 1040 to claim the deduction. A self-employed individual will be able to claim the self-employed health insurance deduction in addition to the deduction for contributions made to an HSA.
There is no “use-it or lose it” provision for HSAs so any unused contributions can be carried forward and used for eligible medical expenses in later years. Any investment earnings of the HSA are not taxable. Any distributions used for non-medical expenses are taxable and subject to a 10% penalty.
To determine if any HSA will work for your situation, check with your tax advisor. More information concerning the provisions affecting HSAs is available in IRS publication 969.