HSA-Compatible
High-Deductible Plans

To be eligible to open an HSA you must meet the following requirements.

If you are currently participating in the General-Purpose Medical FSA, you must have a zero balance on December 31 of any calendar year in order to be HSA-eligible on January 1 of the following calendar year. That means that claims must be incurred and filed in time to be reimbursed with the last FSA check process of the year that will occur on December 31 of the initial year.

As of the effective date:

• You must be covered by an HSA-qualified HDHP and must not be covered by other health insurance that is not an HDHP. Certain types of insurance (e.g., dental, vision, disability and long-term care) are not considered "health insurance" and will not jeopardize an individual's eligibility for an HSA.

• You cannot be covered by another health plan, including Medicare.

• You cannot have an HSA if a spouse's FSA or HRA can pay for any medical expenses before the HDHP deductible is met.

• You cannot be claimed as a dependent on another individual's tax return.

• You must be 18 years of age or older.

• You are not a member enrolled through Covered California.

Even though your HSA and your HSA-compatible high-deductible health care plan are related, they are in fact two different services offered by two different service providers. Your HSA is the account that holds your HSA funds. Your HSA-compatible high-deductible plan is your health coverage under Western Health Advantage.

• Deductible: Your health care plan has a deductible. The deductible is the amount you pay each year for covered medical and prescription services and supplies before WHA becomes responsible for expenses.
• Copayments: Your plan may also require you to pay copayments after you meet your annual deductible. These are smaller, set amounts for covered services.
• OOP Maximum:Once your deductible and copayment costs reach your annual OOP maximum amount, you are done. WHA will pay 100 percent for your covered services for the remainder of the calendar year.

Western Health Advantage partners with leading service providers to ensure that our members get the best rates available. This means that you’ll enjoy consistent savings on your health care services and supplies. 

Use our medical service cost estimator (Rx pricing coming soon) to see what is the estimated cost of a specific service you intend to receive.

Yes, payments you make for prescriptions covered under your plan will apply to your deductible and OOP maximum. It’s important to note that covered prescriptions must be obtained from a participating provider and must be run through WHA’s contracted pharmacy benefit manager in order to be applied. Prescriptions obtained from a non-participating provider are limited to urgent or emergent situations.

Be sure to present your WHA member ID card to your provider. If a copayment is due at the time of service, you can use your HSA debit card to pay from funds you’ve deposited in your account. Keep all of your receipts in a safe place.

In most cases, you will be billed for covered office visits, labs and other health care services. These bills are qualified medical expenses and can be paid out of your HSA.