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Medicare Medical Savings Account (MSA) Plan

What is an MSA Plan?

What is a Medicare Medical Savings Account (MSA) Plan?

A Medicare Medical Savings Account Plan is a type of Medicare Advantage plan that combines a high-deductible health insurance policy with a medical savings account (MSA). MSAs differ from regular Medicare Advantage plans in several key ways, which are detailed below.

But just like any other Medicare Advantage plan, the enrollment window to switch to a different plan — including an MSA plan if one is available in your area — runs from October 15 to December 7 each year. This window also allows you to enroll in a stand-alone Part D plan, which you’ll need to purchase in addition to the MSA plan since those do not include integrated Part D coverage.

How do MSA plans work?

In some ways, the concept of an MSA plan is similar to the HDHPs and HSAs that are available for people who aren’t yet covered by Medicare. But HSA contributions can be made by an employer, the account owner, or anyone else who wants to contribute money to that person’s account. MSA deposits, on the other hand, are made by the Medicare Advantage plan using funds that Medicare has given the insurer — enrollees cannot contribute their own money.

The person enrolled in the Medicare MSA plan can then use the money in the MSA if and when they have medical expenses during the year. MSA withdrawals are not taxed as long as they’re used for qualified medical expenses (including out-of-pocket costs for Medicare-covered services as well as services that aren’t covered by Medicare). But if the money is withdrawn for anything other than a qualified medical expense, it would be subject to income tax plus a 50% penalty.

As is the case with HSAs, unused money remaining in the MSA at the end of the year will roll over to the next year. If the person keeps the MSA plan, the next year’s deposit will be added to the money that’s already in the account from the prior year’s deposit.

How do I get drug coverage with a Medicare MSA plan?

Unlike most Medicare Advantage plans, MSA plans do not include Part D prescription drug coverage. But beneficiaries can purchase a separate stand-alone Part D plan in addition to the MSA plan. And beneficiaries are allowed to use money in the MSA to pay out-of-pocket costs under the Part D plan, if they choose to do so.

How high are deductibles on Medicare MSA plans?

The maximum allowable deductible for an MSA is $15,750 in 2023, although many plans have deductibles well below this limit. In 2024, the maximum allowable deductible for MSAs will be $16,000.

These deductible limits are much higher than the overall maximum out-of-pocket limit for other Medicare Advantage plans, which is $8,300 in 2023 and will be $8,850 in 2024.

Of course, the insurer’s contributions to the MSA itself will obviously help to reduce the enrollee’s actual out-of-pocket costs, since they can use the MSA money to cover some of their expenses. But the amount that an insurer contributes to enrollees’ MSAs varies quite a bit from one plan to another, so it’s important to understand the out-of-pocket costs for the plan you’re considering, as well as the amount that will be deposited into your MSA.

What doctors can I see if I have an MSA plan?

Unlike other Medicare Advantage plans, MSA plans do not require you to stay within the insurer’s provider network. You can see any doctor who accepts Medicare anywhere in the country, as is the case for people who are enrolled in Original Medicare.

How can I tell if an MSA plan is available in my area?

There are only a few MSAs available as of 2023, but they are available in the majority of the states. You can see if any MSAs are available in your area by reaching out to a health insurance broker who is certified to offer Medicare Advantage plans, or by using Medicare’s plan finder tool.

(If you’re using the Medicare plan finder tool: After entering your zip code, you’ll select Medicare Advantage plans, skip the question about drug costs, and then you’ll get to a screen where there’s a box near the top that says “plan type.” That will have a drop-down menu, and if MSAs are available in your area, they’ll be one of the options in that drop-down menu. If MSA isn’t listed, it means there aren’t any available where you live.)

What's the difference between a Medicare Medical Savings Account (MSA) and a Medicare Savings Program?

As described above, a Medicare Medical Savings Account (MSA) Plan is a type of Medicare Advantage plan that combines a high-deductible health plan with a Medical Savings Account funded by the health plan. A Medicare Savings Program is very different, and is a way for low-income Medicare beneficiaries to qualify for financial assistance with their Medicare premiums and out-of-pocket costs.

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