3

I currently have a high deductible healthcare plan and max out my HSA. I am looking for a primary care doctor and have decided to use a concierge doctor. On the doctor's website it says:

Insurance does not cover the cost of a concierge medicine fee. It is an out-of-pocket expensive. However, healthcare saving accounts such as HSA and FSA can be used towards the cost.

However, when I have googled if this cost is HSA eligible I find all sorts of conflicting information. Even with a concierge doctor I will not be changing my health insurance and plan on keeping my HDHP and contributing to my HSA. How do I find out if the fee is actually eligible to be reimbursed or not?

1 Answer 1

2

The expenses eligible for HSA are generally the same expenses eligible for deduction. The HSA-related IRS Pub. 969 refers to the IRS Pub. 502 on deductible expenses for that matter.

It is unclear what "concierge medicine fee" means. Is it some kind of plan administration fee? Additional insurance cost? Club membership fee? From this article it seems to be a membership fee, and I'm not sure if it would be deductible as such. The IRS Pub 502 explicitly lists "Health club dues" as not allowable.

Without knowing exactly what that means, it's hard to decide whether it is an allowable expense or not. You may want your tax adviser go over this with you.

6
  • 1
    Thanks, it says on the site, "In a Concierge Medicine Model, an extended service fee is charged to patients, which covers the cost of patient care management not covered by insurance, such as increased access and availability." Basically you pay a fixed amount per year and get unlimited access to your doctor. You pay for things like labs but not office visits, telehealth visits, you have electronic messaging with your doctor for free, etc. Mar 9 at 21:21
  • 1
    @user1723699 Yeah, I'm not sure if that's not what "health club" describes in the instructions. You're not paying for treating a specific condition, which is probably going to make it not allowable. Unless they can frame themselves as an HMO, you're probably out of luck
    – littleadv
    Mar 9 at 21:26
  • Thanks, I figure I'll just save my receipts anyway, by the time I'd ever reimburse myself I'll have a CPA for my taxes so I'll run it by them then. It is just quite confusing when a google search can bring up a lot of conflicting information Mar 9 at 22:29
  • 2
    Health club, in the US, usually means exercise facility or something like it. But checking the exact definition might be a good thing. Outside of that: I've never experienced any significant difficult getting to see my PCP when I need to, so I'm still confused about what this program is providing. But I've always been on a corporate health plan, and am currently looking toward a company-sponsored Medicare Plus plan which seems to have roughly similar coverage, so I admit I may be spoiled compared to most Americans. (We need a health system. We have a health insurance system. Not even close.)
    – keshlam
    Mar 10 at 2:10
  • @keshlam It's bringing an HMO model to a wider group. A capitated HMO plan pays a primary care physician a monthly per-patient fee, which covers office visits and some basic services like labs and x-rays. The doctor gets a more constant revenue stream (typically, flu season is a huge peak and summer is a low) and is incentivized for preventive care (nagging you to take flu shots). "Concierge" is basically the same thing but out-of-pocket to the patient. A sign you are under a capitated plan is that you're required to select a PCP and report it to the health plan.
    – user71659
    Mar 10 at 21:31

You must log in to answer this question.

Not the answer you're looking for? Browse other questions tagged .