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Account Set-up and Maintenance Forms for Health Savings Accounts

Contribution Forms for Health Savings Accounts

HSA Transfer/Rollover Forms

Miscellaneous Forms

Qualified Medical Expenses

Contribution Limits

Limits
Single
Family
Minimum Deductible 2019: $1,350
2020: $1,400
2019: $2,700
2020: $2,800
Maximum Out-of-Pocket 2019: $6,750
2020: $6,900
2019: $13,500
2020: $13,800
Contribution Limit 2019: $3,500
2020: $3,550
2019: $7,000
2020: $7,100
Catch-up Contribution (55 or older) 2019/20:
$1,000
2019/20:
$1,000

Frequently Asked Questions

A Health Savings Account (HSA) is a tax-exempt trust or custodial account you set up with a qualified HSA trustee (First American Bank) to pay or reimburse qualified medical expenses you and your family incur. You must be an eligible individual to qualify for an HSA.
To be an eligible individual and qualify for an HSA, you must meet the following requirements. 1) You are covered under a high-deductible health plan (HDHP) on the first day of that month 2) You covered under an HSA qualified High Deductible Health Plan (HDHP) and have no other health coverage except what is permitted under “Other health coverage” 3) You are not enrolled in Medicare 4) You cannot be claimed as a dependent on someone else’s tax return.
A high-deductible health plan (HDHP) is a health insurance plan with lower premiums and higher deductibles than a traditional health plan. Being covered by an HDHP is also a requirement for having a health savings account. To view limits, visit our HSA page.

Deductibles and out-of-pocket expenses index annually, adjusting for inflation. All qualified medical expenses are used to reduce the plan's deductible, before the insurer starts paying claims (preventive care excluded). HSAs help reduce the overall cost of the plan's deductible due to their tax advantages and long-term savings/potential growth.
Yes. The HDHP must limit out-of-pocket expenses. To view these limits click here.
These amounts index annually, adjusting for inflation.
It is a checking account.

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