video transcript:

Welcome to The Fenyx Health Group MSA 101: Lesson 2 – How MSAs Work.

MSAs – Uncommon but Simple

MSAs may be less common than other plans like HMOs and PPOs, but they operate in just five simple steps.

Step 1

First, we load your selected deposit amount into your special MSA bank account.

If you’re familiar with plans like Health Savings Accounts, Flexible Spending Accounts or Health Reimbursement Accounts, think of the MSA deposit like the contribution or monies going into the account. The main difference is that in an MSA, the contribution or deposit comes solely from Medicare, not from you or your employer.

Step 2

You decide how to spend, save or invest the deposit money. It’s the only Medicare plan type where you can grow money to use for future healthcare expenses.

Step 3

Our simple benefit structure means no confusing copays, coinsurance or other cost sharing. You pay 100% of covered costs below the plan deductible. You can use the provided deposit to reduce the amount of your own funds needed to reach the deductible.

Step 4

Once you’ve met the deductible, Fenyx Health pays 100% of plan-covered costs.

Step 5

Any deposit money remaining at year-end belongs to YOU for future healthcare needs. It is not use it or lose it. Instead, it rolls over and is yours to keep, even if you move to another plan type in the future.

But, if you stay in the MSA plan for the next calendar year, you receive another year’s deposit into your account.

Now THAT is simple health insurance!

Watch the next video to see how easy it is to use the Fenyx Health Group MSA when you need care.

video transcript:

Welcome to The Fenyx Health Group MSA 101: Lesson 3 – Accessing Care in an MSA.

MSAs Offer Broad Access to Providers and Services

Many Medicare Advantage plans limit the providers you can see and restrict the kinds of care you can freely access. But MSAs are different, offering broad access to providers and services.

Access to All Medicare Providers

The Fenyx Health Group MSA has no provider network. Instead, members can access ANY Medicare-participating and accepting provider across the entire U.S.

No Prior Authorizations or Referrals

And, there are no additional prior authorization or referral requirements beyond what Medicare requires. This means you get the care you want, from the providers you want, when you want it.

Provider Guides to Share

We mail you special provider guides, and encourage you to share them with your providers before needing care. The guides explain our plan, how your provider can submit claims and receive payment, and how to contact us.

Show Your Fenyx Health Member ID Card

When you need care, simply show the provider your Fenyx Health member ID card.

Providers Send Us Claims

We don’t require any copays or other payments at the time of service. Have your provider send us the claim. They can find the submission information on the back of the ID card, on the provider guides and on our website.

We Process Claims

Once we receive the claim, we confirm its for a covered service or item, reprice it to the Medicare-allowed amount and then determine whose liability it is to pay – yours or ours.

Special Financial Program Benefits You and Your Providers

A feature unique to Fenyx Health is that we pay the provider for the full Medicare-allowed amount, even when we determine the liability is yours to pay. This simply means that if you haven’t yet reached your deductible, you’ll receive a bill from us instead of from your provider.

Repay us in full or spread payments out over time. Pay with your MSA bank account, personal accounts or a combination of both.

You receive more time and flexibility when repaying us, and your providers get paid quickly and in full. Now that’s a valuable win-win!

Speaking of value, watch the next video for more information on what costs look like in the MSA and other financial features.

video transcript:

Welcome to Fenyx Health Group MSA 101: Lesson 4 – The Financial Value of the MSA.

MSAs Combine Health Benefits and Valuable Financial Features

The MSA is a special one-two punch of health benefits plus valuable financial features. Let’s learn more about the financial opportunities in the Fenyx Health Group MSA.

MSAs Use Medicare’s Low Rates

As an MSA plan member, you receive your Parts A and B services and items at Medicare’s rates, which are usually the lowest rates available.

While Medicare pricing is complex, here are typical costs for some common A and B services.

With these low rates, your dollars go further in the MSA!

Members Decide How to Use the MSA Deposit

MSAs are all about choice. YOU decide how to use your MSA funds – spend, save or invest the deposit as you see fit.

The Only Medicare Plan Option Where You Can Grow Monies for Future Use

Any deposit money remaining at the end of the year belong to you and roll over. It’s the ONLY Medicare plan option where you can grow monies from Medicare for future use. Stay in the plan for multiple years and get a new deposit added to your account each year!

You can also select certain investment options offered by our MSA banking partners to potentially grow your money even more.

MSAs Enjoy a Triple Tax Advantage

MSAs enjoy a triple tax advantage, just like Health Savings Accounts or HSAs, do. Your funds are not taxed when deposited into your account, as they grow in your account and when you use them on qualified medical expenses.

Members and Providers Win With our Special Financial Support Program

The Lesson 3 video discussed our special financial support program that pays providers on your behalf for under-deductible liabilities. This gives you more time and flexibility when repaying us for those liabilities.

Access to Financial Education and Empowerment

All Fenyx Health Group MSA members receive access to our financial education and empowerment program. Get help planning and achieving your financial goals through unlimited one-on-one sessions with independent financial counselors, educational tools and more at no cost to you.

With its unique financial opportunities, you can grow your health AND wealth in the Fenyx Health Group MSA.

Watch the next video to learn more about the main components of an MSA plan.

video transcript:

Welcome to the Fenyx Health Group MSA 101: Lesson 5 – The Main Components of an MSA.

3 Main Components

The MSA is a simple health benefits plan with just three main components. Understanding how these components work together is key to unlocking the power of the MSA.

The Deductible

A deductible is the total amount of money a member must pay before the insurance company starts to pay. Many types of insurance plans, like auto insurance and homeowners insurance, have deductibles.

Not all costs you incur count toward a deductible, only certain ones the insurance plan has agreed to cover. In an MSA, the plan-covered costs are Medicare Parts A and B expenses obtained from a Medicare-participating provider.

You can think about the MSA deductible as the maximum amount you will pay for covered services and items.

The Deposit

The deposit is money from Medicare that we place into your special MSA bank account. Medicare intends the deposit to be applied toward your plan deductible expenses, but YOU ultimately choose how to spend, save or invest the funds.

MSAs are the only Medicare plan option that provide a deposit.

You can use the deposit funds on anything – Medicare A/B services, other qualified medical expenses or non-medical expenses. However, deposit funds spent on other qualified medical and non-medical expenses DO NOT count toward the plan deductible. And, deposit funds spent on non-medical expenses are subject to tax and penalty.

The Covered Expenses Out-of-Pocket

Many types of plans require out-of-pocket costs. Copays, co-insurance, premiums and deductibles are all examples of out-of-pocket costs.

MSAs do not have premiums, copays or co-insurance. You are responsible for one hundred percent of plan-covered costs below the deductible. If you subtract the deposit from the deductible, the result is what we call the MSA covered expenses out-of-pocket. It’s the minimum amount of out-of-pocket funds needed to reach the plan deductible.

Or, put another way, you use fewer of your own funds to reach your deductible if you apply your deposit toward covered expenses. Let’s go through a quick example to illustrate this.

Both Kaye and Leon are members of Fenyx Health Group MSA 50, with a $2,800 deductible, $600 deposit and $2,200 covered expenses out-of-pocket.

Both received a $600 deposit to their MSA bank account. And, both spent their full deposit on health care before experiencing a short hospitalization. Kaye spent her deposit on Medicare A and B services, which counted toward her deductible. Leon spent his deposit on dental services, which are IRS qualified medical expenses but not plan-covered expenses, and did not count toward his deductible.

Both Kaye and Leon experience a short hospitalization later in the year, which is a plan-covered expense, at a cost of $4,500. As Kaye applied her deposit to plan-covered expenses, she pays $2,200 out-of-pocket to reach her $2,800 deductible. Leon’s deposit was spent on non-covered services, so he pays $2,800 out-of-pocket to reach his $2,800 deductible.

In both instances, Fenyx Health paid the remaining $1,700 of the hospitalization as Kaye and Leon met their plan deductible.

Again, you pay less out-of-pocket when you use your deposit funds on plan-covered expenses.

MSAs are Calendar Year-based

MSAs are based on a calendar year, and the deductible, deposit and covered expenses out-of-pocket are yearly amounts. Your deductible resets each year. And, each year you’re a member, you receive a new deposit.

MSAs are Flexible and Can Be Changed Each Year

MSAs are the ultimate plan for flexibility, allowing you freedom to choose how best to use your deposit, given your health and financial situation, each year. You can save your deposit one year and spend it the next – it’s totally up to you. You can move between our different MSA plans from year-to-year. And, you can move to an entirely different plan like an HMO, PPO or Original Medicare in the future, if and when it makes sense for you.

Watch the next video to see who can do well in an MSA plan.

video transcript:

Welcome to the Fenyx Health Group MSA 101: Lesson 6 – Who is an MSA for?

MSAs Can Work for Many People

With a wide variety of features and benefits, MSAs can work for a wide variety of people:

• Those in control of their health and who like driving their own healthcare experience,
• Travelers who enjoy open access to providers,
• Fans of Health Savings Accounts and triple tax advantages,
• Anyone who wants to save money now to have for future healthcare expenses, and more!

MSA Eligibility

To join our MSA, you must:

• Be eligible to receive benefits from the employer or group offering our plans,
• Be eligible for and enrolled in both Medicare Parts A and B,
• Reside in our service area of the 50 states plus D.C. for 183 days or more during the year,
• Not have other coverage that duplicates the MSA deductible (such as TRICARE, VA benefits or other employer coverage),
• Not currently receiving Medicare hospice benefits, and
• Not be eligible for Medicaid.

MSA Members are Smart Savers and Care Seekers

As it’s the only Medicare option where you can grow money for future use, many MSA members join the MSA plan for it’s unique financial opportunities. Members who have MSA deposit funds left over at year-end usually share a few common characteristics. They typically:

• Seek smart preventive care vs avoiding care,
• Have 3 or fewer well-managed chronic conditions, and
• Have minimal inpatient and Part B drug spend.

So, who is an MSA for? Lots of different people, including YOU! Speak with your group’s Fenyx Health sales agent to learn more about the MSA and see if it’s the right plan for you.