Additional Information About LASSO HEALTHCARE MSA
Prescription drugs and other non-Medicare-covered expenses
MSA plans are prohibited from offering prescription coverage. You are able to enroll in any standalone Medicare Prescription Drug Plan (PDP) offered in your service area.
While you cannot use your MSA funds to pay for your PDP premium without incurring tax and penalties, you can use the funds tax and penalty-free to pay for your Part D deductible, copays and coinsurances. MSA funds used for these types of expenses do not count toward your MSA plan deductible.
CMS regulations prohibit you from obtaining or using other insurance that covers Medicare-covered expenses. However, you can purchase additional limited benefit policies for expenses not covered by Medicare such as vision, dental, long-term care and more.
While you cannot use your MSA funds to pay for those supplemental plan premiums (except for long-term care policies) without incurring tax and penalties, you can use the funds tax and penalty-free to pay for any plan deductibles, copays or coinsurances. MSA funds used for these types of expenses do not count toward your MSA plan deductible.
The amount Lasso Healthcare deposits into your MSA bank account is pro-rated based on when your enrollment begins.
If you’re enrolling during the calendar year, the pro-rated deposit amount is deposited into your MSA bank account the first month your coverage begins.
Otherwise, the full annual deposit amount is deposited into the bank account once at the beginning of the calendar year.
If you leave the plan before the end of the plan year, you will need to pay part of the most recently deposited amount back to Lasso Healthcare MSA. See more specifics under Manage MSA Bank Account.
A deductible is a specific amount that you must pay before an insurer pays a claim. Under the Lasso Healthcare MSA plan, you do not pay a monthly premium to Lasso, but your plan coverage does not begin until you meet your deductible.
It is important that claims are submitted to Lasso Healthcare, even if you know you haven’t yet reached your deductible, so they can help track your progress toward the deductible.
Each one of Lasso's three plan benefit packages for 2020 has a different deductible amount. Your specific plan benefit package, or PBP, number is located on your Lasso Healthcare MSA Member ID card and is determined by where you live. Contact us for specific deductible amounts.
You can use the funds Lasso Healthcare deposits into your MSA bank account to help pay your way to meeting the deductible.
As the plan deductible is greater than the amount deposited into your MSA bank account, you will need to pay out-of-pocket before Lasso Healthcare begins paying for additional Medicare-covered services. The difference between the deductible and the deposit amount is called the “Member Responsibility” amount.
Until you meet your plan deductible, you pay up to 100% of the Medicare-approved amount for Medicare-covered services of inpatient hospital coverage, outpatient hospital coverage, primary and specialist doctor visits, preventive care, emergency care, urgent care, diagnostic labs and imaging, hearing services, dental services, vision services, mental health services, skilled nursing facility, physical therapy, ambulance, transportation and Medicare Part B drugs.
Only Medicare-covered healthcare expenses count toward your plan deductible. It doesn’t matter if you paid for those expenses with your MSA funds, out-of-pocket or a combination of both. See the Evidence of Coverage on the douments page, and linked below, for more information on what expenses Medicare covers. You can also find many expenses covered by Medicare in the Medicare and You handbook or at https://www.medicare.gov/coverage/is-your-test-item-or-service-covered. Neither MSA funds nor out-of-pocket funds spent on non-Medicare-covered expenses count toward your plan deductible.
Once you reach your plan deductible, Lasso Healthcare will pay 100% of any additional Medicare-covered expense you incur. Any non-Medicare-covered expenses remain your responsibility to pay for, even after you meet the plan deductible.
Prior authorizations and referrals
Prior authorizations and/or physician referrals are not required under the Lasso Healthcare MSA.
Minimize tax and penalties
MSA funds spent on IRS-deemed Qualified Medical Expenses are not taxed or penalized.
To make tax-time preparations easier, keep receipts and any paperwork/documentation related to your healthcare and MSA funds usage throughout the plan year.
You should receive an IRS Form 1099-SA from the financial institution housing your MSA bank account by January 31 of the following year. The 1099-SA reports distributions, or expenditures, from your MSA account for the past tax year. In addition to notifying you, the financial institution is also required to report that information to the IRS. Please note you will not receive a 1099-SA form for the 2018 tax year.
You must file Form 1040, ‘US Individual Income Tax Return,’ along with Form 8853, ‘Archer MSA and Long-Term Care Insurance Contracts’ with the Internal Revenue Service (IRS) for any distributions made from your Medicare MSA account to ensure you aren’t taxed on your MSA account withdrawals.
You must file these tax forms for any year in which an MSA account withdrawal is made, even if you have no taxable income or other reason for filing a Form 1040. MSA account withdrawals for qualified medical expenses are tax free, while account withdrawals for non-medical expenses are subject to both income tax and a fifty (50) percent tax penalty.