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Question about HSA plans, Max OOP, etc
Old 01-02-2016, 03:42 PM   #1
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Question about HSA plans, Max OOP, etc

This is my first year on a HDHP w HSA. And boy did I pick a bad year... My kids had multiple injuries/broken bones this past spring.

Ok - so I thought I was all done with 2015 billing... And a bill dated 12/27 arrives today...

Will this bill count on my 2015 max OOP/deductible stuff - or on 2016. Obviously it will be paid in 2016 - since it didn't even show on their system online when I checked mid week.

Note - all of the services were provided earlier in the year - in fact some of them date back to March!!!!! Not sure why I'm just getting billed now. I need to go through all the old bills and cross reference... it seems like there may be some double billing...

Regardless - since the services and bill were issued in 2015 - it should all be on the 2015 deductible and max OOP... right?
(We're very close to the family deductible - and this pushes us past it... which is not reflected on this bill.)

One more question - but it might be too far in the weeds. I had a minor procedure done on Thursday (NYE) that will require pathology. Will the pathology count under 2015 or 2016? It probably wasn't processed that day - which means the pathology report won't be done in 2015... but the minor surgery was done in 2015. I'm guessing the pathology will be in my 2016, but doctor and facility fees in 2015. Is this a good guess?

Thanks in advance for any wisdom on this.
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Old 01-02-2016, 04:16 PM   #2
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In my experience the date of medical service, not the bill date, determines its insurance year.
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Old 01-02-2016, 04:26 PM   #3
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If the service was rendered in 2015, it hits the 2015 deductible and OOP cap. If rendered in 2016, it should go into 2016. If you visited the doc for a procedure in 2015 but the pathology won't be performed until 2016, yes, I'm pretty sure the procedure will hit 2015 and the pathology 2016.

In reality this has nothing to do specifically with an HDHP or HSA. Pretty much any insurance model would work the same way.
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