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I have an HSA account that I currently have setup through my employer to do that max bi-weekly contribution possible, however, I have recently had some medical issues come up, and I have nearly drained the account.

I have a CT scan coming up on Monday, and I'd like to use the HSA to pay for it so I get those sweet, sweet tax benefits, but I won't have enough money in it to do so.

Is there a way for me to put some money that I have in a savings account into the HSA and still get the tax benefits? And if so, then do I have to lower my bi-weekly contribution?

Or would it be better for me to do some sort of reimbursement from the HSA (not 100% sure how that works) after a bit when there is enough in the HSA to cover the reimbursement?

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  • Does your CT scan have to be paid for up-front and out-of-pocket? This could help an answer, eg billed later and pay later after the HSA fills up again.
    – Freiheit
    Mar 26 at 13:59
  • If you have an HSA, then you must also have an HDHP (by law). How much of your deductible/out-of-pocket-max has this burned through? It's possible that this bill is no longer your problem (or that future bills won't be, at least for the rest of the year).
    – Kevin
    Mar 27 at 7:44
  • I have an HDHP, with a 2k deductible and 20% after, with a 4k out-of-pocket max. I've burned through $1,900 so far this year (all out-patient, pre-CT scan), so the CT is actually slightly cheaper than my typical (specialist) dr visit, but since I've only had this job since August, I have yet to amass a very large HSA. I didn't max it out last year due to paying down some high-interest CC debt, and now that the debt is paid off, I am putting in the max bi-weekly contribution to the HSA, but until the next paycheck, I only have $64 in the account.
    – Reid
    Mar 30 at 15:15
23

If you go the route of transferring money from your bank account to the HSA, the money will still have been taxed for FICA. The only way to skip this is to go directly from the paycheck.

Another way to do handle this bill is to pay the bill, when it is due, from your bank account. Then when the balance in the HSA gets large enough, submit the Explanation of Benefits (EOB)/Bill to HSA custodian with the "pay me back" option. You will have to provide more paperwork, the EOB, because you have to document and prove the expense; but the money will then be transferred to your bank account. At the end of the year, there is nothing tricky related to your tax forms, and all the money has avoided FICA.

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  • This is the way I went. I'll hopefully have enough to cover the CT scan (and subsequent Drs visits) in the next month or 2 assuming they don't find anything bad.
    – Reid
    Mar 30 at 15:09
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Yes, you can contribute a lump sum to your HSA, either in cash, or a one-time transfer from an IRA, both of which are governed by the annual limits. They will make your tax return a little more complex, though.

Another option would be to work out a payment plan with the provider so you don't have to pay out of pocket - I'm betting they've dealt with situations like your before.

A third option, if your plan allows it (mine does), is to go ahead and pay the full amount from your HSA even if you haven't contributed that much. My plan allows for "on-demand" access that will let me overdraw so long as I don't go over 75% of what I'm expected to contribute for the year based on the current contribution level. Obviously if you change it or leave your employer you'd be expected to make up any shortfall. Check with your benefits department or the HSA provider and see if that is an option.

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    I’ve never come across your 3rd option, that’s an interesting benefit.
    – quid
    Mar 27 at 17:51
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Is there a limit on how much your HSA will cover? I'd talk to your personnel office. Also, I believe that money left over at the end of the annual cycle goes away, but that's another question for personnel

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  • 2
    You're thinking of an FSA.
    – chepner
    Mar 27 at 16:43

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