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Health Savings Account Plan Document Question & Answers

2014 March 16
by Sarah Fields

David asks…

Health Insurance type?

I am trying to sign up for Health Insurance and I have HRA, HSA, PPO to choose from, but I don’t know which one would be best. I’ve tried comparing/contrasting, but that’s not helping. It is just my wife and and I and she’d be using it for a Thyroid checkups every few months. Any suggestions?

Sarah Fields answers:

It’s not that easy. You need to understand the basics of what you are comparing.

A PPO health insurance policy describes the doctor network and the way you can access a medical provider. You use network doctors for the best cost share but you can go outside of the network if you are willing to pay more. You do not need a referral to see a specialist.

An HSA is a high deductible plan that the IRS qualifies to be used with a Health Savings Account. Nearly all HSA plans are actually PPO’s which may be where the comparison breaks down. I have come across a few HSA plans that use HMO or POS network designs but those are rare. The HSA account generally is more cost effective, especially if you have minor health conditions but to explain more about the plan you may get I’d need to actually look at the plan, because there are hundreds of different plans available. The HSA account can be funded by your funds, the employer funds, or both, and you pay medical charges out of those funds.

An HRA is a Health Reimbursement arrangement. These are employer funded and cannot use your funds like the HSA can. The HRA is usually combined with a PPO or an HMO health insurance policy, but not always.

Here is a link to the IRS document explaining how the HSA and HRA plans work: Remember, that in most cases the HSA and HRA are used with a PPO plan. In most cases the PPO plan used with these plans are not as robust as a “stand-alone” PPO plan but the premium is lower. The HSA and HRA give you tax advantages which can make up the difference

You’ll want to speak with the insurance rep or your HR department rep to get more information because there can be hundreds of different options used with each of those “types” and therefore nobody without access to the information can advise you.

Ruth asks…

Baby Mama Drama (Again)?

Okay, here’s the run-down…(Sigh) I have a two year old daughter. Beautiful little girl, that lives in the states. I currently live in Germany, I’m enlisted in the Air Force. Okay, so…there was drama, and then I got an assignment to come to Germany. I signed my rights away because she didn’t want me in their lives and I had to cover my ass so she doesn’t come to me two years later talkn bout I owe her back child support. I asked for a paternity test, and she refused. That’s the reason why I signed the notarized document. Now, legally…(She doesn’t know this) I can’t sign away rights that I don’t have. Meaning, I’m not on the birth certificate, so that document is void. Now, recently I asked her to put me on the birth certificate, since she called and asked me for money. I happily accepted and started paying her $300 monthly from my own will. No courts, no lawyers…nothing. Now she refused to put me on the certificate because she says she raised the baby for two years on her own, and I have no rights? I said, I’m paying you child support, plus I visited my daughter and established that introduction about 6 months ago. Now, maybe I’m asking for too much too soon…but as a military member, I’d get more benefits if she did put me on the certificate. Like, extra money…which I’d send half to her($50). And free health insurance for my daughter. Now, this girl works at a hardware store making chump change. And I’m just trying to make her life and my daughters life easier. She says I wouldn’t be able to come and just pick my daughter up for a weekend cuz she wouldn’t feel comfortable. My question is…should I stop the payments and take her ass to court and put the money in a savings account until a decision is made….or should I just go along with it, and just understand her feelings and emotions and all that shit?

Sarah Fields answers:

I think you should stop sending her money, put it in an account for your daughter, and take the mom to court. You already said it! Sounds like a logical enough plan. Without knowing your background, I will not judge, but I will say that I’m glad that you are attempting to be a part of that little girl’s life right now. It may be hard, but it’s never too late to try to be a parent. The fact that the mother does not want you on the birth certificate, won’t get a paternity test, but wants your money is suspect… good luck with that one!

Lizzie asks…

Starting an Activist Group for Universal Health Care… Free of charge.?

Hi guys! I’m starting an activist group for Universal Healthcare. Please express your opinions… and if you would like to be apart of it please email me… I plan on taking this as far as possible. Just email me at… and those of you with medical horror stories too please! This is not survival of the fittest, nor should our credit be ruined over a heart attack or cancer. If you are reading this I ask that you at least consider shedding some light on the situation.
Sweety I said u could join the activist group free of charge, not universal Health Care. lol… Universal Health Care helps everyone, your family, your children, and maybe even you in your time of struggles. I leaves no one behind.
lol It is not socialized medicine either… maybe you should do some research too my friend

Sarah Fields answers:

There is something FAR superior to UHC on every level.

One author did her research and devised a COMPREHENSIVE plan that is voluntary, free market, and offers choice. That’s what I’d implement.
That means preventative care (physical with follow up). Real medication (no Medicare “donut holes” the really ill are ripped off again.) No bogus ridiculously low “caps” on needed medical procedures. No abuse of the ER. No paying for the silly with the sniffles to go to the doc for free. No more bankruptcies over medical bills. I want THIS plan that ends abuse of the taxpayer, takes the burden off employers, provides price transparency, and ends the rip-off of the US taxpayer at the hands of greedy insurance CEOs (which has been repeatedly documented).


Read the PDF, not the blurb, for the bulk of the plan. Book is searchable on
Cassandra Nathan’s Save America, Save the World
Basically what you get is the Medicare, Medicaid, SCHIP programs all rolled into one and OPENED UP to all US citizens and legal residents.
Everyone on it gets:
one physical
one follow up visit
IF needed one ER visit
with co-pays per year
DISCOUNTED prescription meds based on negotiation and bulk buying–savings passed on.

Because it is TRULY affordable, the PREMIUM, CO-PAYS, and what constitutes “catastrophic expense” are ALL needs-based. Therefore, the retired poor, disabled (who are usually poor), and working poor could find that $2K in a year is THEIR catastrophic trigger. Someone with an excellent job and benefits could find his level is $10K–so if he is hit with a heart attack or cancer he won’t go bankrupt.
Funding IS explained in the book and resolves taxpayer abuse right now. No new taxes for people. No employer mandates. No fines. None of that nonsense is needed.

Nathan would also REQUIRE price transparency–prices MUST be posted for procedures. People can shop around and get the best deal as they do with EVERYTHING else in life–NO more surprises.

All private insurance can still exist–doesn’t change that at all. However ALL insurance plans MUST abide by contract law which is ROUTINELY violated with impunity now with legit claims being denied.
Antitrust laws would also be enforced–but, again, with this new insurance, that would make a massive positive change.

KEY point: we would greatly increase the number of slots to MED school, as well as nursing and other allied health fields. NOW we turn away THOUSANDS of well-qualified students. That is stupid. It leads to a great evil that the world pays for–we fill 25% of our residencies with grads from foreign med schools. That means we STEAL from poorer countries who probably PAID the med school ed of the student and will NEVER get a doctor out of the bargain. We also end up with non-native speakers unfamiliar with American culture and mistakes and problems arise. VERY bad policy all around–no one wins. We also ROUTINELY RAID nurses from other countries–with a worldwide shortage of nurses, this is WRONG.
IF we lacked qualified Americans you might want to try to justify this idiocy. We don’t. It’s immoral AND costly to everyone.
Nathan discusses making the ed more affordable as well.
Anyone LEGALLY here (such as foreign students) would be eligible for the plan.
Illegals are NOT to be covered or given any benefits, but there is something addressing their bills. As ER abuse is addressed in general, they wouldn’t be getting away with stiffing the taxpayer like they do now anyway AND you’d see a reduction in the accounting games that hospitals pull as well.

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