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Don't forget you can also invest the money in your HSA and it grows tax free!
I have not combined HSA account so I can't tell you anything about that.Using my HSA is easy - works just like am FSA. I have a debit card I can use to make payments when I am billed by the provider or I can send in my explanation of benefits and get reimbursed from my HSA account.
A1-say if you forgot to bring your HSA debit card to the Doctor's and had to pay with your credit card, how do you get that reimbursed with HSA?
If the doctor files a claim with your insurance company then you can typically pay the deductible / co-insurance that isn't covered via credit card when the doctor bills you - so you use your debit card.
If you pay with personal funds and need to be reimbursed for those costs (like you have to pay a co-pay for an office visit), you can send in a payment request using the EOB that you get from your primary insurance company. We do ours online, funds are direct deposited.
If you pay the whole cost up front, you would first want to send the claim to your insurance to have them pay the allowable portion and then submit the remaining balance to be reimbursed from your account (eg, you pay the doctor $100, insurance covers $60, which they send to you with and EOB, then send the EOB to your HSA to get reimbursed $40). This tends to be rare, since most doctors will process the claim for you.
It sounds more complicated than it really is.
Thanks A1!