Blue Cross Blue Shield Vermont: HSA Calculator

HSA Calculator (2008)
By answering the following questions and filling in the Estimate Expenses worksheet, calculate whether your HSA savings plan will meet your needs.

Your Plan
Estimate Expenses
HSA Account
Analyze

Some information sources might include:

Healthcare Advisor, for a price guide
BCBSVT Customer Service, for a historical Explanation of Benefits (EOB)
Rx Center for drug information
Your primary care physician, for planned treatments, procedures, and office visits.

Other useful links:

IRS Publications 502 - Qualified Medical Expenses
Dept. of Treasury

Enter your estimated medical expenses for the period you will be covered:

Hospital/Facility:	Show/Hide Details

Alcoholism Treatment
Ambulance
Nursing Care
Psychiatric care
Surgical fees
X-rays

Subtotal:

Dental:	Show/Hide Details

Braces
Dental Fees
Dentures
Teeth (artificial)

Subtotal:

Doctor Expenses:	Show/Hide Details

Chiropractors
Doctor's fees
Optometrists

Subtotal:

Drugs:	Show/Hide Details

Drug Addiction recovery
Drugs (prescription)
Drugs (OTC)
Insulin

Subtotal:

Other:	Show/Hide Details

Contact Lenses
Crutches
Hearing Aid
Diagnostic fees
Dyslexialanguage training
Laboratory fees
Eyeglasses
Limbs (artificial)
Ortodontia
Orthopedic shoes
Oxygen & oxygen equipment
Smoking cessation
Wheelchair
Other

Subtotal:

TOTAL	0.00

Your maximum allowable contribution *:

(Total possible contribution)
(Employer contribution)	-

Determines whether the maximum contribution, per IRS regulation is $2900 for single, or $5800 for family.

Select Single Coverage or Family Coverage: ( ? )
Single
Family

Determines whether the individual is eligible for an $900 "catchup" contribution.

Will you be 55 or older by the end of the year? ( ? )
No
Yes

Enter your health plan's deductible. The minimum deductible, by law is determined by IRS regulation, $1100 for single and $2200 for family.

What is your plan's Deductible? ( ? )

The maximum contribution that an individual can contribute to an account is offset by the employer contribution, so that the total amount contributed to an account is no more than the IRS limit.

What is your employer's contribution to your HSA, for this year? ( ? )

You can always return to this tab and change this figure.

By law, your maximum allowable contribution is:
$xxxx
.
Please enter the amount you would like to contribute, up to this maximum. ( ? )

Unused funds from an existing Health Care Savings Account can be used in subsequent years. Select "yes" to enter a balance.

Do you have an existing Health Care Savings Account? ( ? )
No
Yes

Enter an existing balance, if applicable.

What will your anticipated Health Care Savings Account balance be, BEFORE you contribute to this new plan? ( ? )

Notice: Please select single or family coverage and enter your plan's deductible. These questions are located in the tab labeled "Your Plan". Without this basic information, we can't calculate any figures for you.

Contribution break down:

(Employee contribution)
(Employer contribution)	+

Your total estimated contributions:

Analysis: (Are you saving enough?)

Deductible:
HSA Deposits:
Expenses:

Your Deductible

Estimated Employer contributions

Estimated Employee contributions

HSA Balance from the previous year

Expenses - out of pocket

Expenses - coverage for medical expenses beyond your plan's deductible will depend upon the terms of your plan