My child was covered by HDHP back in 2015 to 2018 and at that time I maxed out my HSA account at family limit. Starting in January of 2019 my child was switch from my insurance to their step mom insurance which is not HDHP. I am still covered by my old insurance and I maxed out my individual HSA account in 2019 and will again in 2020.
During 2015-2018 I had two different HSA accounts at two different banks (changed jobs). During 2019 my current company changed HSA bank and at one point in July 2019 I had 3 HSA accounts at 3 different banks. Since then, I consolidated two inactive accounts to Fidelity and still have my current company's HSA account for payroll deductions. Except for $2,000 cash at my current job's HSA account, everything else in that account and entire Fidelity account are invested. I pay for my OOP medical expenses from my normal cash flow. I pay for my child's regular appointment copays $30 also OOP. I save my medical receipts/invoices for future HSA claims. I don't bother to do anything with my child's copay since they are so small. However for the purpose of possibly needed to use HSA funds this year or in the future (saving receipts eligible for reimbursement from HSA) I have this situation.
My child had a very expensive evaluations done in Fall of 2019. The hospital and provider are in network for child's current insurance (step mom's), however, the hospital told us that this insurance routinely rejects these eval claims from them as "not necessary" or some such bullshit. According to the hospital, the rejection rate is about 90%. We are still waiting to see what insurance will say on this matter, however, we are prepared to pay for the eval OOP. The hospital rate for this eval is $4,300, however we will get a 'friends and family' discount on this. I still don't know the final OOP price for "family", but I was told that the absolute lowest hospital will accept is $1,800. So I think if insurance doesn't come through we will end up with somewhere between $1,800 and $2,500 OOP. If insurance actually agrees to cover this eval, it will cost us $30 copay, but this is a pipe dream.
Now, as a result of this eval, the child will need ongoing weekly/bi-weekly therapy and follow up appointments for some time (6-18 months). The provider who we will most likely use (for various reasons) does not accept any insurance, so all appointments will have to be paid for in cash and then submitted to insurance for reimbursement.
My ex-H has contacted insurance to get an idea of how much we can be expected to be reimbursed for these appointment and from what we gathered the reimbursement rate should be fairly reasonable, however until we go to the appointment, pay for it, and get an invoice with medical codes to submit to insurance, we won't know how much we will be reimbursed in the end. Yes, there are other providers that are in network, however, we will try this one first due to narrow specialty, high recommendations, and other reasons.
At the end of all of this, all OOP medical costs (actual net cash paid for medical expenses including regular copays and such) are split 50-50 between me and my ex-H. The insurance is under his wife's name. They will be getting all bills and EOB, which I can get copies of of course. Payment for therapy appointments most likely will be charged to my credit card since I will be there (yey for travel rewards!). But reimbursements from insurance will be sent to step mom (her name, her address).
The question is, can I reimburse myself for any of these net OOP expenses from my HSA account? And if yes, which ones? What documentation should I request/keep for future reimbursements? As of now, I don't plan to use HSA at all, but I'd like to know if I can save these expenses for future reimbursements and in case I actually need to pull money out of HSA.
