I've been rearranging some upcoming doctors' appoints that I made months ago, well before anyone had heard of COVID-19, much less watched as it overtook our lives.
A couple were able to be conducted as teleconferences with my physicians. Some, however, require actual in-office visits. Like getting jabbed for blood work.
I'm also rescheduling some appointments originally set for June. These are being changed not because of the coronavirus pandemic, but because of new medical insurance. The dates are now late instead of mid-summer in the hopes that the new policy transition goes smoothly and I won't have to hassle with doctors' office administrators demanding up-front pay.
HDHP options, costs, considerations: In making my health coverage change, I looked into a high deductible health plan (HDHP).
As regular readers know, this type of coverage offers lower monthly premiums in exchange for, as the name says, paying a larger out-of-pocket deductible. I mentioned the coverage just last week when the Internal Revenue Service released inflation-adjusted HDHP amount guidelines, as well as increases to this type of policy's associated health savings account (HSA).
When you get HDHP medical coverage as an employee, your payroll office takes care of taking HDHP plan premiums and any HSA contributions out of your paychecks before you get them. Even better, these tax-favored workplace cafeteria benefits choices come out of your checks before taxes are calculated, so you get that tax break up front.
However, if you're like me and are in charge finding and then paying for your health care insurance on your own, they you'll have to take care of all that yourself.
Added HSA tax tasks: I totally understand the allure of lower monthly health care premiums. If you're relatively healthy, these medical plans are a good trade-off for a higher deductible you probably won't have to worry about meeting.
But you'll pay a bit at tax time, not necessarily in dollars, but in time completing Form 8889.
You must file this form any year you or an employer contribute to your HSA. The same filing demand is made when take money from the account, regardless of whether you ultimately owe tax on the distributions.
And if you don't follow the HDHP and HSA rules, you'll also file it to pay penalties on your mistakes.
If you hire a tax professional to handle your annual filing, he or she will take care of Form 8889 for you. If you're like millions of taxpayers and use software to file on your own, that compute program, depending on which version you choose, can help you through the process.
But even if you're in those categories, it's always helpful to know what's on the form. For the sake of brevity and to not sound like one of those software programs, I'm going to hit some Form 8889 highlights below.
Part 1 HSA Contributions and Deduction: The first part of Form 8889 (lines 1-13) focus on HSA contributions and deductions.
Line 2 is where you enter the amount you contributed to an HSA. This is just what you put in as, like me, a non-salaried individual. However, if you do have a job and an HSA, this also is where you enter any HSA contributions you made in addition to the amounts taken automatically from your paycheck.
This also is where those inflation adjustments I mentioned a few paragraphs ago come into play. Line 3 tells you what they are for the applicable tax year. For 2019, the maximum is $3,500 for individual coverage or $7,000 for family coverage. If you're age 55 or older, you can add another $1,000 catch-up amount to each of those limits.
And again like me, if your insurance changes/changed during the year, the HSA cap is pro-rated for the time that you had the HDHP. Basically, you count each month you have a high-deductible policy and contribute 1/12 of the overall limit.
The form also considers situations if you're among the even smaller group of filers who has other special tax-favored accounts, as well as cases where both spouses have their own HSAs.
Line 9 is where you enter your employer's contributions to you HSA. These primarily are your payroll amounts that go directly into your HSA.
Line 10 wants to know how much, if any, money you took out of your HSA.
All your adding and subtracting will finish up on Line 13. This is your HSA deduction, or more precisely your HSA adjustment to income. This amount, per Form 8889 instructions, is transferred to line 12 of Form 1040 Schedule 1.
Part II HSA Distributions: Note the instructions in this title section. "If you are filing jointly and both you and your spouse each have separate HSAs, complete a separate Part II for each spouse."
OK, now that you know how many 8889 forms your family has to fill out, let's get to part II.
It starts with line 14a, where you let the IRS know of all your HSA withdrawals for the tax year. Subline b breaks that out further and this amount is subtracted from line a to get to the amount of applicable distributions that go on line c.
The IRS wants to know on line 15 the amount of medical expenses you paid using your HSA money. The form's instructions give you details on what applies here.
Ideally, all your medical costs count and your math on line 16 will come to 0 or less. Say, for example, you used $10,000 of your HSA to pay for $10,000 of emergency surgery out-of-pocket costs when your appendix burst. That IRS-approved operating room procedure and allowable HSA expenditure means that you don't owe any tax on your HSA distributions.
But say you opted later to have a cosmetic surgeon do a tummy tuck to get rid of a few pounds and hide the appendectomy scar. If you used HSA money for that, the expenditure would give you a plus-dollar amount that is taxable since the IRS doesn't consider such for-looks-only medical treatments tax deductible.
I know that tax-savvy readers of the ol' blog are careful to know what is an isn't an allowable medical tax break, so this segment of Part II should be an issue. But if you want a refresher just in case, you can thumb through the IRS' medical deduction (or not) list.
Part III Income and Additional Tax for Failure To Maintain HDHP Coverage: This final section of Form 8889 comes into play if you didn't have your HDHP long enough to qualify for the full HSA contribution amount in both the current tax year and the previous tax year.
Remember, as noted earlier, if it turns out that you only have partial HDHP coverage — for example, like me, you encounter a life change that led to a healthcare plan change halfway through the tax year — then you can only make a partial contribution to your HSA.
If you don't follow the limits or don't maintain your HDHP, you could face a steep penalty.
Again, while the IRS form instructions has worksheets, your tax preparer or software will walk you through this if need be.
Record keeping imperative: As will all things tax, it's crucial that you keep good records.
So the final piece of advice when it comes to completing Form 8889 (and actually all tax actions related to medical expenses and possible deductions) is to make sure you thoroughly document all your health care costs.
You also need to make sure you get and keep HSA documentation. This includes some official tax statements you'll need to complete IRS Form 8889.
Form 1099-SA details on each HSA distribution you took. Form 5498-SA tracks the contributions made to your Health Savings Account during the applicable tax year.
Yes, an HDHP and HSA is a bit of a filing pain, including adding Form 8889 to your annual tax tasks. But considering the ever-increasing costs of health care, it could be just the medical and tax prescription you need.
You also might find these items of interest:
- Make the most of tax-deductible medical miles
- Comparing tax-favored HSA, HRA & FSA medical options
- Tax help for those who lost healthcare along with their jobs