Anyone with high deductible health insurance plan

can have Health Saving Account (简称HSA); 可以在公司开，也可以自己找brokerage firm 开；我常常帮客户开；特别是balance 比较高的客户还可以用户头里的钱投资。

HSA 和IRA有点类似；yearly contribution is tax deductible. 用于medical related expenses 免税。只要取钱出来（一般开户公司会给你信用卡或支票本），brokerage firm 就会报备IRS, 你在报税时要声明"it is for medical related expenses", so it is reportable but not taxable.

开户完放在里面的钱在未来任何时候都可以用；in the years you change the medical insurance to non-high- deductible, 你只是不能contribute, 但还是可以用户头里以前放的钱。

看病时哪些items are covered, how much % is covered, 和你的medical insurance contract 有关；和HSA 一点关系都没有。high deductible plan 要注意医生的billing code. 都是体检，preventative is covered 100% and diagnosis needs to pay deductible portion. 比如有些人血糖较高，年检医生会多勾几个，于是变成diagnosis , 这时你会收到帐单，可以用HSA的钱付