Medical Savings Account Plan (MSA Plan) Law and Legal Definition

A medical savings account plan (MSA plan) is a type of medicare advantage plan option available for getting medicare healthcare benefits. MSA plan combines a high-deductible health insurance plan with a medical savings account which a beneficiary uses to pay his/her health care costs. MSA plan is optional and only those who live in an area that offers medicare MSA plans can opt for such plan. MSA plans are similar to health savings account (HSA) plans available outside medicare.

According to 42 USCS § 1395w-28 (b)(3)(A), the term "MSA plan" means a Medicare + Choice plan that:

(i) provides reimbursement for at least the items and services described in section 1852(a)(1) [42 USCS § 1395w-22(a)(1)] in a year but only after the enrollee incurs countable expenses (as specified under the plan) equal to the amount of an annual deductible (described in subparagraph (B));

(ii) counts as such expenses (for purposes of such deductible) at least all amounts that would have been payable under parts A and B [42 USCS §§ 1395c et seq. and 1395j et seq.], and that would have been payable by the enrollee as deductibles, coinsurance, or copayments, if the enrollee had elected to receive benefits through the provisions of such parts; and

(iii) provides, after such deductible is met for a year and for all subsequent expenses for items and services referred to in clause (i) in the year, for a level of reimbursement that is not less than:

(I) 100 percent of such expenses; or

(II) 100 percent of the amounts that would have been paid (without regard to any deductibles or coinsurance) under parts A and B [42 USCS §§ 1395c et seq. and 1395j et seq.] with respect to such expenses, whichever is less.