Group Medical Benefits in Western NY

High Deductible Health Plans in Western NY

At TPS Group Medical, we understand that choosing the right health plan for you and your family can be overwhelming. That's why we offer High Deductible Health Plans (HDHPs) that combine traditional medical coverage with a Health Savings Account (HSA) or a Health Reimbursement Arrangement (HRA) to help you save for future medical expenses while providing flexibility and discretion over how you use your healthcare dollars today.

With an HDHP, the annual deductible must be met before plan benefits are paid for services other than in-network preventive care services, which are fully covered. HDHPs also protect you against catastrophic out-of-pocket expenses for covered services.

At TPS Group Medical Western NY, we recognize that finding the perfect health plan for you and your family can be daunting. That's why, for our Western NY community, we provide High Deductible Health Plans (HDHPs) that blend conventional medical coverage with a Health Savings Account (HSA) or a Health Reimbursement Arrangement (HRA) to assist you in saving for future medical costs while granting you the flexibility and discretion to manage your healthcare spending today.

HDHPs, tailored to suit the Western NY, Maryland area, feature higher annual deductibles and out-of-pocket maximum limits compared to other health plan types. With an HDHP, the yearly deductible must be satisfied before the plan covers services beyond in-network preventive care services, which are fully paid for. HDHPs also shield you from catastrophic out-of-pocket expenses for covered services. Once your annual out-of-pocket expenses for covered services from in-network providers, including deductibles, copayments, and coinsurance, hit the pre-set catastrophic limit, the plan covers 100% of the allowable amount for the rest of the calendar year. This ensures that Western NY residents won't face additional out-of-pocket medical expenses for in-network care, such as doctor visit copayments and prescriptions, which are sometimes excluded from traditional plan's catastrophic limits.

One of the primary advantages of our Western NY-centric HDHPs is the HSA. An HSA enables you to cover current health costs and save for future qualified medical expenses on a pre-tax basis. Funds deposited into an HSA are not taxed, the balance and interest in the HSA accumulate tax-free, and that amount can be used tax-free to cover your qualified medical expenses, including your copays, coinsurance, and deductible. When you enroll in an HDHP, the health plan determines your eligibility for an HSA or an HRA based on the information you provide.

To be eligible for an HSA, Western NY residents must be enrolled in an HDHP and not covered by another health plan (including a spouse's health plan, but excluding specific injury insurance and accident, disability, dental care, vision care, or long-term care coverage).

You also must not be enrolled in Medicare, not have received VA or Indian Health Service (IHS) medical benefits within the last three months, not be covered by your own or your spouse's flexible spending account (FSA), and not be claimed as a dependent on someone else's tax return.

With an HDHP and an HSA tailored to Western NY, you can make extra voluntary tax-deductible contributions to your HSA, up to an allowable amount determined by IRS rules. Your HSA dollars earn tax-free interest. When you need preventive care, your plan will provide it at no cost to you when you use participating plan providers. For non-preventive health care, you pay the full cost of that care with funds from your HSA or out-of-pocket, up to your plan's high deductible. Health plans negotiate discounts with providers who participate in their health plan network, which is especially beneficial for the Western NY community. It's advisable to obtain your Explanation of Benefits (EoB) to know your cost share before paying your provider.

At TPS Group Medical Western NY, we believe that HDHPs with HSAs are an effective way to help you manage your healthcare costs while still providing access to quality care for our Western NY community. Our knowledgeable team is ready to answer any questions you may have about our HDHP options and how they can benefit you and your family.

Related to: Group Medical Consultants in Western NY, Employee Group Benefits in Western NY, Group Life & Health Insurance in Western NY