The new Medicare drug law that was enacted in late 2003 makes two changes that supporters of the law say should make it easier for today's workers to prepare to pay the medical bills they will confront in retirement: prescription drug benefits (the new Medicare Part D) and health savings accounts (HSAs). This paper examines the impact of Medicare Part D on savings needed for insurance premiums to supplement Medicare, Medicare Part B and D premiums, and out-of-pocket expenses in retirement, and examines the viability of using HSAs to save for these expenses. It presents a wide range of estimates based on various ages at the time of death, because longevity risk is a major threat to retirement income security. This range of estimates also varies with various assumptions regarding health insurance premium inflation rates and out-of-pocket expenses. Projecting the amount needed for medical expenses in retirement is tentative and complex because it requires conclusions about the range by which medical inflation will exceed consumer prices generally, as well as assumptions about whether medical practices will change in a way that makes Medicare coverage for a given ailment more or less likely.

This paper examines the savings needed to cover health insurance premiums and out-of-pocket expenses for health care services in retirement and evaluates the use of health savings accounts (HSAs) to save for those expenses. Proponents of HSAs often tout them as a vehicle for funding future retiree health care costs. But, while HSAs represent an important option for consumers seeking more control over their health care spending, statutory contribution limits make it unlikely that these accounts will play more than a minor part in savings for health care costs in retirement. This research shows that while HSAs can be used to save for health care expenses in retirement, the maximum savings that can be accumulated in an HSA will be far from sufficient to fully cover the savings needed in retirement for insurance premiums and out-of-pocket expenses. One of the difficulties in using an HSA to save money for premiums and out-of-pocket expenses during retirement is that individuals also can (and may need to) use the money in the account to pay for health care services during their working years or to pay COBRA premiums and insurance premiums during periods of unemployment. The PDF for the above title, published in the August 2008 issue of EBRI Notes, also contains the fulltext of another August 2008 EBRI Notes article abstracted on SSRN: quot;The Impact of Immigration on Health Insurance Coverage in the United States, 1994-2006.quot.

This paper examines the savings needed to cover health insurance premiums and out-of-pocket expenses for health care services in retirement and evaluates the use of health savings accounts (HSAs) to save for those expenses. Proponents of HSAs often tout them as a vehicle for funding future retiree health care costs. However, statutory contribution limits mean that they are unlikely to play more than a minor part in savings for health care costs in retirement. If an individual age 55 in 2009 were to contribute $3,000 to his or her HSA and also contribute the $1,000 catch-up contribution each year for 10 years, $48,300 would be in the account after 10 years at a 2 percent interest rate. And if the interest rate was 5 percent, $55,100 would be accumulated at the end of 10 years. Such savings levels by themselves are inadequate to cover health costs in retirement. A man age 55 in 2009 would need between $144,000-$290,000 by the time he reached age 65 in 2019 (depending upon his use of prescription drugs in retirement) to have a 50 percent chance of being able to cover premiums and out-of-pocket expenses for Medigap and Medicare Part D. Thus, a 55-year-old man would be able to use an HSA to accumulate between 16-32 percent of needed savings for insurance premiums and out-of-pocket expenses in retirement for a 50-50 chance of having enough savings. For a 90 percent chance, the maximum HSA savings would cover between 7-16 percent of the necessary savings amount. Women, who live longer than men on average, will need more. The PDF for the above title, published in the April 2010 issue of EBRI Notes, also contains the fulltext of another April 2010 EBRI Notes article abstracted on SSRN: “Tax Expenditures and Employee Benefits: Estimates from the FY 2011 Budget.”

“Let’s get the consumer in the game. The idea behind HSAs is a ‘supercharged IRA’ for health care...No other program is as tax advantaged.” –John W. Snow, Treasury Secretary “...HSAs can drastically lower an employer’s costs of providing employee health benefits. This may allow more small businesses to offer such benefits.” –Fed Brock, The New York Times “These accounts give workers the security of insurance against major illness, the opportunity to save tax-free for routine health expenses, and the freedom of knowing you can take your account with you whenever you change jobs.” –President George W. Bush “Laing’s new book (The Small Business Guide to HSAs) lives up to its name...an excellent explanation of how HSAs work...” –Greg Scandlen, The New York Post The Consumer’s Guide to HSAs answers the question “What’s in it for Me?” But responsibility doesn’t stop there. You must read your medical reports, check statements, and count your pills carefully. Ask questions. Keep records for future use, and soon you will realize as much of the benefits of consumer-driven health care and HSAs as possible.

A health savings account (HSA) can help you lower your taxes, pay for health care more easily and even save for retirement. HSAs are only available with high-deductible health plans. You can use HSA funds to pay for eligible health care expenses and for out-of-pocket costs your health plan doesn't cover. This book is the owner's manual that did not come with your HSA. If you follow the advice in this book, you'll keep your HSA in compliance with current HSA rules and regulations. You'll also learn about sources of updated information as the IRS releases new rules and interpretations and as the Department of Health and Human Services issues health care reform regulations that impact HSAs. Your HSA trustee may offer similar information, but probably not in an easy-to-understand format and certainly not in a single volume.