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HSAs and Home Health Care

By Joanne Kaldy / November 19, 2018

Companies could have wider benefits to offer employees in the future as legislators ramp up efforts to add home health services to health savings accounts (HSAs).

Congress may be adding a new option for employees who choose to support a health savings account (HSA) within their benefits plan.

The Homecare for Seniors Act (H.R. 6813) proposes to allow HSA funds to be used tax-free to cover qualified, contracted home health services as well as medical care. In order to be considered qualified, the home care service would need to contract three or more activities of daily living: assistance with eating, toileting, mobility, bathing, dressing, maintaining continence or taking medications correctly.

If the bill passes, the new rule would add important benefit leverage for employees, especially as long-term care insurance options continue to evaporate nationally. While healthcare’s economic model is increasingly shifting less-acute patients away from traditional professional settings and toward satellite and at-home care settings, home care has struggled for recognition on the payer side, often leaving the patient to pay for it themselves. The bill also would include a government education campaign to spread awareness of the new ability to use HSA funds for home healthcare.

The bill has the support of PHI, the Caregiver Action Network and the National Association of Home Care & Hospice, among a dozen others. But, as the days of the 155th Congress tick away, many feel the concept will have to wait until next year.

HSAs have been around for more than a decade, yet only about 20% of eligible employees take advantage of them, notes AARP. Yet, as interest grows, more employers are getting creative about bringing HSAs to the fore, including tying wellness incentives to HSA contributions. It’s also a great way to engage younger employees, since HSA funds can only be used prior to becoming a Medicare beneficiary, which often happens at age 65.

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