Top 10 Reasons Your HSA Does Not Match Your Deductible #1

1. Your prescriptions have not be submitted to your insurance

One of the most common reasons that HSA accounts do not match up with medical deductibles is because a prescription has not been run through the insurance (and therefore not applied to the deductible) but paid for with HSA funds. Whether a pharmacy has old insurance information, offer a cheaper generic alternative that is not submitted through insurance, or confuse running an HAS card (that has the insurance emblem on it) as running the charges through insurance, our team is seeing this as a common reason that deductibles and HSA accounts become uneven.

For instance, let’s say that you have a $1500 deductible and start the year with $1500 in your HSA account. You fall ill one evening and go to the hospital. The hospital examines and treats you, releasing you the next morning with even medication for a week. However, you have instructions to go get more medication once you are out. The hospital submits the claim for your visit and medication, and it processes towards your in network deductible for $1400.  You go to pick up your prescription, which your pharmacist tells you will cost $150. You pay with your HSA funds, leaving you with $1350 in your account, and go on your way. The next week, you receive the bill for the hospital stay. The bill is for $1400, but you only have $1350 in your account. It seems that your new pharmacist forgot to run your prescription through your insurance, leaving you with uneven HSA funds and deductible.

You go to the pharmacy and ask the pharmacist to reprocess your prescription through your insurance. They resubmit it, and find that you only owed $100 to meet your deductible. They refund the extra $50 to your account, leaving you with $1400 in your HSA. You are now able to pay for your hospital bill in full and have met your $1500 in network deductible.

Want to know to rest of the top 10 reasons your HSA does not match your deductible? Check out the McGohan Brabender checklist and look for upcoming and previous articles explaining the other reasons!