HSAs give you flexibility in managing healthcare costs, including prescription drugs. When you combine an HSA with a health sharing plan, things can get a bit tricky.
Healthshares handle prescription drug costs differently—some offer direct help, while others focus on discounts.
Knowing these differences can help you make smarter decisions when it comes to managing your medication costs.
How Does HSA Work With Prescription Drugs?
An HSA lets you set aside pre-tax money for qualified medical expenses, including prescription drugs.
Whether you’re buying name-brand drugs or generics, using your HSA can make these purchases more affordable. Even if your healthshare doesn’t share prescription drug costs directly, your HSA can step in to cover expenses that aren’t shared.
Prescription Drug Cost Sharing Varies Across Healthshares
Healthshare plans have different approaches to sharing the cost for prescription medications.
Some offer discount programs, while others share a portion of the costs directly. Below, we’ll highlight some of the most popular healthshares and explain how they manage prescription drug costs.
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Healthshares and Prescription Drug Cost Assistance
- 1Complete Solution: Employees can save on medication costs with significant prescription drug discounts provided by CitizensRx.
- Altrua HealthShare: Members receive discounts on both name-brand and generic prescriptions, helping to reduce out-of-pocket expenses.
- DPC Direct: The concierge service finds the best pricing at local pharmacies for your prescriptions. For high-cost medications, the MPB Concierge Team partners with organizations to offer the most affordable options.
- HSA Secure: Members can access MyFreePharmacy.com’s $19.95/month plan for prescription discounts. For fewer meds, GoodRx or HSA Advantage Rx may be better.
- JHS Community: ShareRx allows members on select plans to add prescription drug sharing, with costs ranging from $3,000 per member per year up to unlimited sharing.
- Medi-Share: Unlike many other healthshares, Medi-Share shares certain prescription drug costs as part of its core plan, including sharing prescription costs for up to six months for eligible medical conditions.
- netWell: netWell’s netWellRx offers 800+ generic drugs at no cost after a $4.94 enrollment fee—ideal for members needing common prescriptions.
- OneShare Health: Members can save up to 65% on prescription drugs, accepted at over 59,000 pharmacies nationwide. Availability may vary by state.
- Prosper: Prescription drug benefits are limited to medications provided during inpatient or outpatient surgical procedures.
- Sedera Health: Sedera shares prescription costs for 120 days for certain conditions, excluding cancer and transplants. Chronic meds are covered briefly.
- CARE+ Plan: While CARE+ doesn’t cover prescriptions, members can use a $19.95/month drug concierge program to save on multiple medications.
Maximizing Your HSA for Prescription Drugs Cost
Even if your healthshare plan doesn’t share prescription drug costs directly, using an HSA can help you manage these expenses. Here are some tips:
- Pair your HSA with a discount program: If you take only a few prescriptions, paying out of pocket and using a discount plan (such as GoodRx or HSA Advantage Rx) can stretch your HSA dollars further.
- Look for healthshare add-ons: Some healthshares, like HSA Secure or CARE+, offer add-on programs to help with prescription costs. If you’re on multiple medications, these programs can save you quite a bit.
- Mail-order options: Many healthshares offer mail-order pharmacy programs, which can be a more affordable way to fill maintenance medications for chronic conditions.
Health Savings Account Rules: What You Need to Know
To qualify for an HSA, you must enroll in a High Deductible Health Plan (HDHP).
You won’t be eligible if you’re on Medicare, covered by another health plan, or claimed as a dependent.
A portion of your premium goes into your HSA, with different amounts for individual or family coverage, and you can make additional tax-free contributions—up to $4,150 for individuals or $8,300 for families in 2024, plus an extra $1,000 if you’re 55 or older.
These funds grow tax-free and can be used for deductibles, out-of-pocket expenses, and other qualified medical costs.
Learn More: How To Fix The Most Common HSA Mistakes
Can You Combine an HSA with a Health Sharing Plan?
Under current law, only those enrolled in an HDHP that meets Minimum Essential Coverage (MEC) standards can contribute to an HSA.
Since health sharing plans aren’t classified as insurance, they don’t meet this requirement, excluding their members from directly accessing HSA tax benefits.
However, thanks to a new solution—HSA MEC, available through HSA for America—it’s now possible to upgrade any health sharing plan to become HSA-eligible. This innovative approach allows members to take advantage of both the cost savings of health sharing and the tax benefits of an HSA.
How to Use HSA MEC to Combine Health Sharing and HSA
- Enroll in an HSA MEC Plan: This plan meets the IRS’s MEC requirements, making you eligible to open and contribute to an HSA.
- Pair with a health sharing plan: Use the health sharing plan to assist with medical expenses not handled by the MEC plan. Health sharing plans typically offer lower monthly costs, providing additional savings.
- Maximize your HSA benefits: Contribute tax-free to your HSA and use those funds to pay for expenses like deductibles, co-pays, or prescriptions that aren’t shared by the health sharing plan.
This strategy allows you to enjoy the best of both worlds: lower healthcare costs through health sharing and long-term savings with an HSA. Federal employees can also use pre-tax payroll deductions to contribute to their HSA, further increasing savings.
Make the Most of Your HSA and Prescription Drugs Coverage
Understanding how your healthshare handles prescription costs and how to leverage your HSA effectively is key to keeping medication expenses low.
By combining an HSA with discount programs or healthshare add-ons, you can make sure that your prescriptions remain affordable without breaking the bank.
If you’re wondering how to make health sharing work for your family or have questions about prescription coverage, reach out to a Personal Benefits Manager at HSA For America. We’ll provide the guidance you need to make the best choice for your healthcare.
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FAQs
1. Can I still use GoodRx with my HSA?
Yes, you can use GoodRx or other prescription discount programs alongside your HSA. You’ll pay for your prescription using the discounted rate from GoodRx, and then you can use your HSA to reimburse yourself for the cost of the medication. This combination helps you maximize savings while keeping your HSA funds available for other eligible medical expenses.
2. How do I know if a medication is HSA-eligible?
Most prescription medications are HSA-eligible as long as they’re prescribed by a doctor. However, over-the-counter (OTC) medications are only HSA-eligible if they have a prescription from a healthcare provider.
3. Can I use my HSA to pay for healthshare plan premiums?
No, HSA funds cannot be used to pay healthshare plan premiums. However, you can use your HSA to cover qualified medical expenses that your healthshare doesn’t share, including prescription medications, out-of-pocket costs, and other eligible healthcare expenses.
4. What happens if my healthshare doesn’t share the cost of a specific medication?
If your healthshare plan doesn’t share the cost of a medication, you can still use your HSA to pay for it. This is one of the advantages of having an HSA—you have the flexibility to cover medical costs that your healthshare plan might not include. Be sure to check if there are any discount programs available through your healthshare or use services like GoodRx to reduce costs further.
For Further Reading: How Much Money Can Health Sharing Save? | The Tax Treatment of Health Savings Accounts (HSAs) | Understanding Your HSA Tax Forms
