3. Our mission is to improve quality of
life through convenient, affordable
chiropractic care
4. Page 1 of 34 of Publication 502 11:34 - 3-JAN-2011
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The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.
Department of the Treasury Contents
Internal Revenue Service
What’s New for 2010 . . . . . . . . . . . . . . . . . . . . . . . . 1
Department of the Treasury Contents
What’s New for 2011 . . . . . . . . . . . . . . . . . . . . . . . . 1 Internal Revenue Service
Publication 969 What’s New . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Cat. No. 24216S Reminder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Reminder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Publication 502
Health Cat. No. 15002Q Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Health Savings Accounts (HSAs) . . . . . . . . . . . . . 2
What Are Medical Expenses? . . . . . . . . . . . . . . . . 2
Savings
Medical Savings Accounts (MSAs) . . . . . . . . . . . . 10
Archer MSAs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Medical and What Expenses Can You Include This
Year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Dental
Medicare Advantage MSAs . . . . . . . . . . . . . . . . . 15
Accounts
How Much of the Expenses Can You
Flexible Spending Arrangements (FSAs) . . . . . . . 15 Deduct? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
and Other
Health Reimbursement Arrangements
(HRAs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
How To Get Tax Help . . . . . . . . . . . . . . . . . . . . . . . 19
Expenses Whose Medical Expenses Can You
Include? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
What Medical Expenses Are Includible? . . . . . . . . 5
Tax-Favored Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 (Including the Health
Coverage Tax Credit)
What Expenses Are Not Includible? . . . . . . . . . . . 14
Health Plans
How Do You Treat Reimbursements? . . . . . . . . . . 16
What’s New for 2010 How Do You Figure and Report the
For use in preparing Deduction on Your Tax Return? . . . . . . . . . . . 19
For use in preparing Child under age 27. For FSA and HRA purposes, begin-
ning March 30, 2010, coverage and reimbursement is 2010 Returns Sale of Medical Equipment or Property . . . . . . . . . 20
2010 Returns allowed for an employee’s child under age 27 at the end of
the employee’s tax year.
Damages for Personal Injuries . . . . . . . . . . . . . . . . 22
Impairment-Related Work Expenses . . . . . . . . . . . 23
Health Insurance Costs for Self-Employed
What’s New for 2011 Persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
COBRA Premium Assistance . . . . . . . . . . . . . . . . . 24
Qualified Medical Expenses. For HSA, MSA, FSA, and
Health Coverage Tax Credit . . . . . . . . . . . . . . . . . . 25
HRA purposes, a medicine or drug will be a qualified
medical expense only if the medicine or drug: How To Get Tax Help . . . . . . . . . . . . . . . . . . . . . . . 28
1. Requires a prescription, Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
2. Is available without a prescription (an
over-the-counter medicine or drug) and you get a
prescription for it, or What’s New
3. Is insulin.
Standard mileage rate. The standard mileage rate al-
This applies to amounts paid after 2010. However, it does lowed for operating expenses for a car when you use it for
not apply to amounts paid in 2011 for medicines or drugs medical reasons is 16.5 cents per mile for 2010. See
purchased before January 1, 2011. Transportation under What Medical Expenses Are Includi-
ble.
Additional tax increased. For HSA and MSA purposes,
the additional tax on distributions not used for qualified COBRA continuation coverage. If you involuntarily lost
medical expenses is increased to 20%. This applies to your job between September 1, 2008, and May 31, 2010,
distributions after 2010. you may qualify for a 65% reduction in premiums for
COBRA continuation coverage for up to 15 months. The
premium reduction is not included in your gross income.
Reminder You cannot claim the health coverage tax credit for any
month that you receive this premium. There are also spe-
cial rules for individuals who lost their health coverage
Get forms and other information Photographs of missing children. The Internal Reve- Get forms and other information because of a reduction in working hours. Also, certain
faster and easier by: nue Service is a proud partner with the National Center for faster and easier by: TAA-eligible and PBGC recipients qualify for an extension
Missing and Exploited Children. Photographs of missing of COBRA benefits.
Internet IRS.gov children selected by the Center may appear in this publica- Internet IRS.gov For more information, see COBRA Premium Assis-
tion on pages that would otherwise be blank. You can help tance, later.
Jan 14, 2011
Jan 03, 2011
5. IRS Code Section 213(d) Eligible Medical Expenses
An eligible expense is defined as those expenses paid for care as described in Section 213 (d) of the
Internal Revenue Code. Below are two lists which may help determine whether an expense is eligible.
For more detailed information, please refer to IRS Publication 502 titled, “Medical and Dental Expenses,”
If tax advice is required, you should seek the services of a competent professional.
Deductible Medical Expenses
• Abdominal supports • Elastic hosiery (prescription) • Oxygen and oxygen
• Abortion • Eyeglasses equipment
• Acupuncture • Fees paid to health institute • Pediatrician
• Air conditioner (when necessary prescribed by a doctor • Physician
for relief from difficulty in • FICA and FUTA tax paid for • Physiotherapist
breathing) medical care service • Podiatrist
• Alcoholism treatment • Fluoridation unit • Postnatal treatments
• Ambulance • Guide dog • Practical nurse for medical
• Anesthetist • Gum treatment services
• Arch supports • Gynecologist • Prenatal care
• Artificial limbs • Healing services • Prescription medicines
• Autoette (when used for relief of • Hearing aids and batteries • Psychiatrist
sickness/disability) • Hospital bills • Psychoanalyst
• Birth Control Pills • Hydrotherapy • Psychologist
(by prescription) • Insulin treatment • Psychotherapy
• Blood tests • Lab tests • Radium Therapy
• Blood transfusions • Lead paint removal • Registered nurse
• Braces • Legal fees • Special school costs for the
• Cardiographs • Lodging (away from home for handicapped
• Chiropractor outpatient care) • Spinal fluid test
• Christian Science Practitioner • Metabolism tests • Splints
• Contact Lenses • Neurologist • Sterilization
• Contraceptive devices • Nursing (including board and • Surgeon
(by prescription) meals) • Telephone or TV equipment to
• Convalescent home • Obstetrician assist the hard-of-hearing
(for medical treatment only) • Operating room costs • Therapy equipment
• Crutches • Ophthalmologist • Transportation expenses
• Dental Treatment • Optician (relative to health care)
• Dental X-rays • Optometrist • Ultra-violet ray treatment
• Dentures • Oral surgery • Vaccines
• Dermatologist • Organ transplant (including • Vasectomy
• Diagnostic fees donor’s expenses) • Vitamins (if prescribed)
• Diathermy • Orthopedic shoes • Wheelchair
• Drug addiction therapy • Orthopedist • X-rays
• Drugs (prescription) • Osteopath
6. How Health Savings Accounts (HSA’s) Will:
Save You 40% to 50% On Your Health Insurance
Make Your Medical Expenses Tax Deductible
Cut Your Taxes By Up To $1850 Or More
7. How Health Savings Accounts Work
Health Savings Accounts (HSAs) are simple and easy to understand.
A Health Savings Account is a tax-favored savings account combined with a qualifying high-deductible health
insurance plan. By allowing you to deposit tax-deductible funds into an account that you can use to cover medical
costs, HSAs enable you to take control of your own health care decisions.
First you must have a high-deductible health insurance plan that qualifies to be partnered with an HSA. These plans
are available through various insurance companies, depending in what part of the country you live. The plans are all
similar in the fact that they have deductibles between $1,200 and $5,950 for singles, and between $2,400 and $11,900
for families.
Once your insurance policy has become effective, you may fund your HSA account.
Tax-subsidized Medical Expenses
Even though you have received a tax deduction by putting your money into this account, the money is still yours to
spend tax free, as long as you spend it on qualified medical expenses. Since you have a high-deductible plan, this
would of course include any expenses you incur from going to the doctor, purchasing prescription drugs, or paying other
expenses toward your deductible. Once your deductible is met, the health insurance covers your medical expenses as
defined in the policy.
In addition to being able to withdraw your money tax free to cover these types of expenses (which might otherwise be
covered by a traditional low-deductible high-premium policy), you can use your HSA account to cover other costs that
would not normally be covered by a health insurance policy.
8. U.S. Treasury Department
Washington, DC
Who Is Eligible for HSAs?
Any individual that:
– Is covered by an HDHP
– Is not covered by other health insurance
– Is not enrolled in Medicare
– Canʼt be claimed as a dependent on someone elseʼs tax return
Children cannot establish their own HSAs
No income limits on who may contribute to an HSA
No requirement of having earned income to contribute to an HSA
Revised August 18, 2004 4
9. U.S. Treasury Department
Washington, DC
HSA Accounts
No “use it or lose it rules” like Flexible Spending Arrangements (FSAs)
– All amounts in the HSA are fully vested
– Unspent balances in accounts remain in the account until spent
– Encourages account holders to spend their funds more wisely on their medical
care
– Encourages account holders to shop around for the best value for their health
care dollars
Accounts can grow through investment earnings, just like an IRA
– Same investment options and investment limitations as IRAs
– Same restrictions on self-dealing as with IRAs
10. U.S. Treasury Department
Washington, DC
Who Is Eligible for HSAs?
What other health coverage is allowed for you to still be
eligible for an HSA?
- Disease or illness insurance and accident, disability, dental care, vision
care and long-term care insurance
- Employee Assistance Programs, disease management program or wellness program
–These programs must not provide significant benefits in the nature of medical care or treatment
- Drug discount cards
- Eligibility for VA Benefits
–Unless you have actually received VA health benefits in the last 3 months
Revised August 18, 2004
11. U.S. Treasury Department
Washington, DC
Who Is Eligible for HSAs?
What “1st dollar” medical benefits make someone ineligible
for an HSA?
–Medicare
–Tricare Coverage
–Flexible Spending Arrangements
–Health Reimbursement Arrangements
There are permitted HSA/HRA/FSA combinations
Revised August 18, 2004 6
12. U.S. Treasury Department
Washington, DC
Who Is Eligible for HSAs?
Permitted HSA/HRA/FSA combinations:
–“Limited purpose” FSAs and HRAs that restrict reimbursements to certain
permitted benefits such as vision, dental, or preventive care benefits
–“Post-deductible” FSAs or HRAs that only provide reimbursement after the
minimum annual deductible has been satisfied under the HDHP
–“Retirement” HRAs that only provide reimbursement after an employee retires
–“Suspended” HRAs where the employee has elected to forgo health
reimbursements for the coverage period
13. U.S. Treasury Department
Washington, DC
Treasury Assistance
Web site
www.treas.gov
(Click on “Health Savings Account HSA”)
Contains all Treasury guidance
Contains Model HSA trustee and custodian forms
E-mail address
HSAInfo@do.treas.gov
•Voice mailbox
–(202) 622-4HSA
14. High Deductible HSA-Qualified Health insurance Plans (HDHPs), also known as HSA
Insurance Plans, that can be paired with a Health Savings Account (HSA) are currently
available through many insurance companies.
15. High-deductible health-insurance plans grow more attractive to employers
By Michelle Andrews
Tuesday, June 22, 2010
“Plans with high deductibles -- ones that have annual deductibles of at least $1,200
for individuals or $2,400 for families if they're linked to an HSA, for example -- are
a key element in "consumer-driven health care," an approach based on the idea
that people will make smarter, less wasteful health-care decisions if they have a
bigger financial stake in their own care. The plans started going mainstream after a
2003 law created HSAs that link to some high-deductible plans. The accounts allow
people to put money aside tax-free to cover deductibles and other medical expenses.
Employers and employees alike can contribute to the accounts, but the money
belongs to the workers, who can take it with them if they leave their jobs. (Money
deposited in a flexible spending account, in contrast, disappears at year's end if it's
not used.)”
“More employers are adding high-deductible plans to the mix of health plans they
offer or using them to replace their traditional plans. In 2009, about 12 percent of
employers offered workers a consumer-driven health plan, and many more said they
plan to do so, according to an Employee Benefit Research Institute analysis. Bigger
companies were most likely to offer them: More than 40 percent of companies with
more than 10,000 workers did so. But the plans also have fans among small-
business owners because of their lower costs.”
“The plans are likely to become more popular with time. "As costs rise, it makes
the high-deductible plan more attractive, because it's one way to keep premiums
down," says Paul Fronstin, director of EBRI's health research and education
program.”
16. Utah HSA Insurance Plans
In Utah, you’ll find a large number of companies offering many great HSA-qualified health insurance plans.
The most popular HSA plans in Utah are the Humana, Blue Cross Blue Shield and Time Insurance (Fortis
Health and Assurant Health) plans
• Blue Cross Blue Shield is one of the most widely known and trusted names in the health insurance
industry. Blue Cross Blue Shield of UT has one of the most competitive HSA plans in the state of Utah.
• Humana offers an excellent value on HSA plans in many areas. It is often the most attractively priced plan for large
families or someone looking for a higher deductible. In addition to hospitalization, this plan also provides coverage for
doctor visits and prescription drugs, which is something many of the lowest priced HSA plans don't do.
• Time One Deductible HSA plans offer the nation's most popular HSA plans. Time Insurance, formerly known as
Fortis Health, is an Assurant Health member company.
17. Arizona HSA Insurance Plans
In Arizona, you’ll find a large number of companies offering many great HSA-qualified health insurance plans. The most
popular HSA plans in AZ are the SaveRight HSA plan from Time Insurance Company, the HSA Saver and HSA 100 plans from
United Healthcare. However, rates vary based on age and zip code, so we suggest you look carefully at all your options.
• Aetna is known nationwide as a leader in the health insurance industry.
• Blue Cross Blue Shield is one of the most widely known and trusted names in the health insurance industry. Blue Cross
Blue Shield has one of the most competitive HSA plans in the state of Arizona.
• Cigna Health Insurance has been helping people in AZ lead healthier, more secure lives for
more than 125 years. CIGNA offers affordably priced coverage for both HSA and non-HSA
coverage in Arizona.
• Humana offers an excellent value on HSA plans in many areas. It is often the most attractively priced
plan for large families or someone looking for a higher deductible. In addition to hospitalization, this plan
also provides coverage for doctor visits and prescription drugs, which is something many of the lowest
priced HSA plans don't do.
• Time One Deductible HSA plans offer the nation's most popular HSA plans. Time
Insurance, formerly known as Fortis Health, is an Assurant Health member company.
• United Healthcare / Golden Rule offers HSA plans designed for individuals and families willing to take
additional responsibility for routine health care expenses. In most parts of the country, Golden Rule uses the
United Healthcare PPO network, one of the nation's largest and most respected networks. In the areas in
which Golden Rule utilizes the United Healthcare network, their rates are especially competitive.
18. HSA Qualified Expenses
- Alcoholism - treatment
- Acupuncture
- Ambulance - hire
- Autoette or Wheelchair
- Birth Control Pills
- Blind Persons Services
- Braces
- Capital Expenditures -
- Car Equipment -
- Childbirth Preparation Classes -
- Chiropractors
- Nursing Services - board and Social Security
- Christian Science Treatment
- Contact Lenses - paid by taxpayers
- Obstetrical Expenses
- Crutches
- Operations - legal
- Deaf Persons
- Optometrists
- Dental Fees
- Orthodontia
- Dentures
- Diagnostic Fees - Orthopedic Shoes - excess costs
- Oxygen / Oxygen Equipment
- Diapers (adult disposable) -
- Doctor's Fees - Prosthesis
- Psychiatric Care
- Domestic Aid - rendered by nurse
- Drug Addiction Recovery - Psychologists
- Psychotherapists
- Drugs - prescription or over-the-counter *
- Reclining Chair - for cardiac patients
- Dyslexia Language Training
- Remedial Reading
- Elevator for Alleviation of Cardiac Condition
- Retarded Person- costs for special home.
- Eyeglasses and Examination Fees
- Fluoride Device - on advice of dentist - Retirement Home - lifetime medical care
- Sanitarium Rest Home - medical, educational, rehabilitative services
- Halfway House - adjustment to mental hospital
- Healing Services Fee - Schools - special, relief, or handicapped
- Health Maintenance Organization - Sexual Dysfunction Treatment
- Hearing Aids - Sterilization
- Hospital Care - Surgical Fees
- Insulin - Swimming Pool - treatment of polio or arthritis
- Laboratory Fees - Teeth - artificial
- Laetrile - by prescription - Television - closed-caption decoder
- Lead Paint Removal - Therapy Treatments - prescribed by a physician
- Transportation - essentially and primarily for medical care
- Lazer eye surgery
- Lodging (treatment related, and with restrictions, up to $50 per person) - Weight Loss Programs - as a treatment for the disease of obesity
- Wheelchair or Autoette
- Medical conference fees (relating to chronic illness; no lodging or meals)
- Medicare Parts A and B - X-rays
- Legal Expenses - authorizing treatment of mental illness - Mileage
- Lifetime Medical Care - prepaid; retirement home - Stop smoking programs
- Limbs - artificial - Vasectomy
- Mattress - prescribed for alleviation of arthritis - Vision correction
- Membership Fees - medical services, hospitalization, and clinical care - Stop-smoking programs
* Note: Over-the-counter drugs will no longer be considered qualified expenses after January
- Nursing Home - medical reasons
1, 2011
19. Maximize Your HSA: Make sure you use every HSA
qualified expense you are eligible for - don’t forget over-
the-counter meds with a prescription, eyeglasses and
contacts, and expenses for alternative care like
homeopathy or chiropractor visits. And to make sure you
stay in the best HSA insurance plan for your needs,
compare rates with competing plans at least once a year.
20. How to Establish your Health Savings Account
Once you have applied for a high deductible health insurance plan, you'll want to go ahead and set up your Health Savings
Account. You are not required to establish an HSA, but by funding the account as soon as possible you'll be able to take
advantage of the tax-deductions and tax-deferred growth that HSAs offer.
To establish your HSA, follow the steps below:
1. First, you will need to choose the bank or trustee that you would like to administer your HSA. While some insurance
companies offer to administer your account (only if you have their insurance plan), you may also choose to work with an
outside, third party administrator. For a list of companies offering HSAs, please visit our HSA Administrator page. There
you'll find information on fees, interest rates, and investment options. If you plan on keeping the money invested in an
interest-bearing savings account, you'll want to initially look at the fees that the various administrators charge, and choose
one with lower or zero fees, such as American Charter Bank. Many of our customers choose to place their HSA funds
with an administrator that offers investment options, such as HSA Resources or HSA Bank.
2. Once you have chosen your administrator, you will need to download their enrollment form. You may obtain these forms
on our HSA Administrator page by clicking on the name of the company you've chosen. At the bottom of the
administrator's web page, you can obtain their enrollment form by clicking the link that says "Open their Application."
3. After downloading the proper enrollment form, you will need to send it, along with your opening deposit, to the address
listed on the enrollment form. You will receive your introductory packet, including complete instructions on how to make
future deposits and the options you have for withdrawing your funds, in approximately two weeks.
21. How to Maximize Your Tax Benefits
An HSA plan is really a pretty simple concept. You have a high-deductible health insurance plan, which you
hope to never use. But if something big does happen, it will protect your assets and cover your medical
expenses. But there are a few things that you should know that can make a big difference in how much
money you spend, and how much money you accumulate in your account.
Because HSA contribution limits are based on the number of months during the year in which you have a
qualifying health insurance plan, you should get your coverage in place as soon as possible.
There are basically three different strategies you can take when deciding how to fund your health savings
account.
1. Put no money in the account (or the minimum amount required to open the account), except when you
incur a medical expense. This strategy allows you to legally "launder" any money used to pay medical
expenses. In other words, by depositing money into your HSA, then immediately withdrawing it to
reimburse yourself for medical expenses, you are making your medical expenses all tax-deductible.
You may want to use this strategy if you are on a tight budget and want to keep your cash outlay as low
as possible.
2. Fully fund the account, or at least put in as much as possible based on your budget. Take money out of
the account any time medical expenses are incurred, and let the rest grow tax-deferred. This strategy
will maximize your tax deduction, while making your HSA funds available to pay any non-covered
medical expenses before your deductible is met.
3. Fully fund the account, but pay all medical expenses from a non-HSA account. Reimburse yourself for
medical expenses at a later date. This strategy will allow you to maximize your tax deduction, and will
also allow you to maximize the tax-deferred growth of your HSA. You can then reimburse yourself, tax-
free, at any time in the future for medical expenses incurred over the ensuing years. (For an example
of this strategy, see Maximize Your HSA, Issue 3).
To maximize the potential growth of your funds, you may want to make your HSA deposits as early in the
year as possible. Any growth in your account is tax-deferred, like an IRA.
Once you get your health insurance plan established, you may want to set up a Health Reimbursement
Arrangement so that your business can cover the cost of your health insurance and other medical
expenses, further reducing your taxes.
22. How to Keep Your Health Insurance Premiums Low
1. Raise your deductible as your HSA account grows. When you fund your account you build up a financial "cushion"
which allows you to raise your deductible as your account grows. Every time you raise your deductible, your premium
should go down.
By the way, don't forget that every time you fund your account you get an instant tax-deduction. When you offset the tax
savings against your premiums, you'll find your net cost for an HSA plan can be very low.
The maximum allowable contribution goes up every year with the rise of the Consumer Price Index. The individual
contribution limit is $3,050, and the family limit is $6,150. So each year you can deposit greater amounts into your HSA
and continue to raise your deductible, if you choose.
2. Stay healthy, so you can switch plans. All health insurance plans have rate increases. If a rate increase happens to
you, you can switch to a different insurance company - but only if you pass their underwriting requirements. If chronic
disease develops, you may be stuck with your current plan, and its accompanying rate increases, for eternity. Or at least it
may seem that long…
If you pay attention to the pharmaceutical commercials, you learn lifestyle really has nothing to do with disease, and it is
natural and healthy to be on many medications for the rest of your life, which will then solve your health problems.
If you pay attention to the science, you know the truth is quite different. It appears lifestyle is probably 95% of the picture,
and we know the occurrence of degenerative disease can be dramatically reduced and even prevented.
We've found many HSA owners are interested in wellness, and disease prevention. After all, they're paying for their own
doctor visits if they do get sick. We also believe it is because HSA owners are "forward thinking" people, and like to plan
for their future - both financial and physical. You can improve your odds of excellent health with just a few key habits:
◦ Eat very high quantities of fresh vegetables and fruits. Shoot for 35% of your calories. This will lower your risk for
diabetes, high blood pressure, heart disease, cancer, and more.
◦ Limit your intake of sugar and starchy carbohydrates like bread and pasta. The majority of health problems in the U.S.
are related to metabolic diseases that involve insulin resistance, a direct result of eating too many processed foods.
◦ Exercise and lift weights.
