Members
Member Resources
Look here for quick and easy access to helpful information about your MSA plan’s high-deductible health coverage and bank account components.
Questions Frequently Asked by Members
Have a question we haven’t yet answered? Call our Member Services team at 1-866-766-2583 (TTY: 711).
Download answers to our most commonly asked questions.
Download Now (opens in new window)Find a Provider
MSA plans don’t have a network of providers, so you choose your health care services and providers. Most providers accept the MSA. Providers can decide at every visit whether to accept the Plan and agree to treat you, however, you cannot be denied emergency care due to your insurance plan.
MSA plans are not as common as other Medicare plans, so it's understandable that some providers may not be aware of Lasso Healthcare MSA. Lasso Healthcare is outreaching to providers across the US, educating them on the MSA, and why it's important they see you as a Lasso Healthcare MSA member. Thousands of providers already accept the Lasso Healthcare MSA, including some of the largest and most renowned systems. Some providers may be reluctant to accept MSA and other high-deductible plan patients, as they believe the patients will not pay their portions of the service cost. Please pay any owed amounts to your providers timely and fully. Your cooperation in paying will ultimately help more providers accept more high-deductible plan patients.
Before you receive any services, we encourage you to share our detailed provider guide brochure with your providers and confirm they'll accept our Plan. Multiple printed copies of the guide are included in our enrollment and member materials, and it is also available electronically on our website. Providers may also call our Provider Services team for assistance; the phone number is on the back of your Member ID card and on our website.
You can get the most value out of your MSA plan by choosing Medicare-participating and accepting providers, as service charges for Medicare-covered services are capped at 100% Medicare Fee-for-Service (FFS) rates and count toward your plan deductible. If you see a Medicare-non-participating provider, they may "balance bill" you, where allowed by state law, up to a "limiting charge" that may be higher than Medicare FFS rates; these excess charges are not reimbursed by the Plan and do not count toward your plan deductible. If you see a provider opting out of Medicare, this becomes a private contract between you and the provider; any service charges are not reimbursed by the Plan and do not count toward your plan deductible.
If your provider has any questions or is reluctant to accept Lasso Healthcare MSA, please ask your provider to call us, or you may call us and request we speak to your provider. We will work with your provider and request they see you. You can also try to be seen as a self-pay patient. In this instance, you will pay for/be billed for the entire service. You then submit the claim/service information to us. We’ll determine if the amount you paid was within the Medicare-approved amount and apply the appropriate amount toward your plan deductible. If you’ve met your deductible, we’ll reimburse you the Medicare-approved amount. Once we process your claim, we will send you an Explanation of Benefits (EOB), which explains the processing of the claim and can be used to seek any reimbursement for overpayment.
Provider Guide
A brief guide for providers to understand how MSA clinical access rules are the same as Original Medicare.
updated: 07/23/2020
download Provider Guide DownloadAll documents can also be found on the documents page.
Contact Lasso Healthcare MSA Member Services at 1-866-766-2583 (TTY: 711) 8 a.m. to 8 p.m., seven days a week from Oct. 1 through Mar. 31, and M-F from Apr. 1 through Sep. 30.
MSA plans are not as common as other Medicare plans, so it's understandable that some providers may not be aware of Lasso Healthcare MSA. If your provider has any questions or is reluctant to accept Lasso Healthcare MSA, please ask your provider to call us at 1-800-579-0254, or you may call us and request we speak to your provider. We will work with your provider and request they see you.
Pay for Healthcare
At the time of service
Don’t show your Medicare card. Instead, show your Lasso Healthcare MSA member ID card and tell your provider to file the claim with Lasso Healthcare. The claims submission information is listed on the back of your member ID card and in the Contact tab. It’s important a claim is filed with us even if you have not met your plan deductible so we can 1) ensure the service is within the Medicare-approved amount and 2) help track your progress to your deductible.
In most instances, no copays, coinsurance or other payments are due at the time of service if you receive care from a Medicare participating/accepting provider.
After the service
Once we receive the provider’s claim, we process it and determine your coverage. We mail you a monthly Explanation of Benefits (EOB) showing the coverage decision, progress toward the deductible and any amount you need to pay the provider. We also share that same coverage and payment due information with your provider. If you’ve reached your plan deductible, we will pay the provider directly for any Medicare-covered expense on the claim.
The provider then sends you a bill or invoice for any portion of the claim you owe. It is good practice to compare the provider’s bill with your EOB to match the billed amount to your determined liability. If your provider asks you to pay an amount different than the amount shown on the EOB (above the limiting charge for a non-participating provider, if applicable), please contact them directly to determine what documentation they need; if the issue remains unresolved, please contact our Member Services team for additional assistance.
Paying the provider
You choose to pay with your MSA bank account funds, your own money or a combination of both. If you no longer have funds in your MSA account, you will need to pay out of your own pocket until you reach the plan deductible amount.
Optum Bank provides a convenient debit card to use that’s linked to your account balance. If you’ve switched to another financial institution, use whatever access method they’ve provided you.
If your provider does not accept debit cards as a form of payment, you will need to pay in whatever payment method they do accept and, subsequently, reimburse yourself from your MSA bank account.
Requesting reimbursement from Lasso Healthcare
Did you pay for a service directly (either with MSA funds or out-of-pocket) instead of having your provider file a claim? Don’t worry. Simply fill out our Member Reimbursement Form in the Documents tab to provide us with documentation of the service and your payment. Return the completed form to us via one of the methods listed on the form, and we’ll determine if the amount you paid was within the Medicare-approved amount and apply the amount you paid toward your plan deductible. If you’ve met your deductible, we’ll reimburse you. If you overpaid the provider, you can use the EOB we will provide to seek reimbursement directly from your provider.
Member Reimbursement Form (Application for Payment Consideration)
Member application for payment consideration when payment was made directly to provider.
updated: 02/14/20
download Member Reimbursement Form (Application for Payment Consideration) DownloadAll documents can also be found on the documents page.
For further questions, please call Lasso Healthcare MSA Member Services at 1-866-766-2583 (TTY: 711) 8 a.m. to 8 p.m., seven days a week from Oct. 1 through Mar. 31, and M-F from Apr. 1 through Sep. 30.
Claims can be mailed to Lasso Healthcare MSA, P.O. Box 261709, Plano, TX 75026; providers may also submit claims via electronic clearinghouse at https://goo.gl/FCxy3m(opens in new window) (online payer ID# 10550).
If you received an EOB from Lasso Healthcare, but your provider is requesting you pay a different amount, contact your provider first to ensure they have the most recent EOB (or to verify if for limiting charge, if applicable). If the discrepancy remains unresolved, please call Lasso Healthcare MSA Member Services for further assistance.
Manage MSA Bank Account 2021
The deposit
The deposit amount is prorated based on when your enrollment begins. If you enroll during the current calendar year, the prorated amount(opens in new window) is deposited into your MSA bank account the first month your coverage begins. Otherwise, the full, non-prorated annual deposit amount is deposited into the bank account once at the beginning of the calendar year.
Current regulations prohibit you from adding funds to your MSA bank account. Only Lasso Healthcare can deposit money into your account.
Portability
Lasso Healthcare’s banking partner is Optum Bank. Once we make the initial deposit into the Optum Bank account, you are free to move your MSA funds to a custodial account offered through a financial institution of your choice. However, any custodial fees, minimum balance amounts and other fees waived under our partnership with Optum Bank will be your responsibility.
Fees, interest and investment options
While you hold the account with Optum Bank as a Lasso Healthcare MSA plan member, the account will be interest bearing and will not accrue custodial fees. Please note there is a fee for receiving paper statements, so we recommend receiving electronic statements. You can invest funds in excess of $2,000 in various investment vehicles offered through Optum Bank. For more information, please visit www.optumbank.com.
However, if you move the account to a different financial institution, you will be responsible for any fees charged. Also, your institution may or may not offer interest and/or investment opportunities.
Accessing the deposited funds
If you’ve kept your MSA bank account with Optum Bank, they provide a special debit card you can use to access your MSA funds. If you’ve moved your MSA account to a different institution, they will provide you with a card, checks or mechanisms of their choosing.
Ownership of the MSA funds
You determine whether to spend, save and/or invest the deposited funds.
If your MSA bank account balance is positive/greater than $0 at the end of the plan year, that balance is yours and “rolls over” into the next year, regardless of whether or not you renew enrollment with Lasso Healthcare for the next calendar year.
If you leave the plan before the end of the plan year (December 31), you will need to pay part of the most recent yearly deposit back to Lasso Healthcare MSA. The repayment amount is prorated(opens in new window) based on the number of months left in the current year. Any funds in your MSA bank account accrued from previous plan years are yours to keep and do not need to be repaid.
If you should pass away during the plan year, Lasso Healthcare MSA is required by CMS to collect part of the most recent yearly deposit from your estate. Any funds in your account accrued from previous plan years become property of your estate and/or beneficiary. If the beneficiary is your spouse, there are no tax implications; if the beneficiary is not your spouse, ordinary income taxes apply, subject to IRS rules.
$0 balance
Once you deplete your MSA funds for the plan year, you will need to pay out-of-pocket for any additional healthcare services you incur until you have met the deductible. If you remain in Lasso Healthcare the following year, a new annual deposit will be funded into your account.
Bank account transactions, balances, investment options, etc.
Lasso Healthcare does not have access to your MSA bank account, even if you keep the account at Optum Bank, and cannot answer any questions related to bank account balance, transactions, investment options, etc. Instead, please contact your MSA bank account administrator for assistance with these inquiries.
Questions or problems with your Optum Bank account
Federal regulations require Optum Bank to obtain, verify, and record information, including social security number, that identifies each person who opens a new account. In some cases, applicants must go through a vetting process which requires additional information to be submitted before a bank account can be opened in their name. If you have received a vetting letter or have any problems with your Optum Bank account, please contact Optum Bank Customer Service.
Optum Bank MSA Failed Vetting Letter
This notice is sent to members when additional information is needed to open the MSA account.
updated: 01/01/2019
download Optum Bank MSA Failed Vetting Letter DownloadOptum Bank MSA Debit Card
This card is sent to members to access their MSA funds.
updated: 01/01/2019
download Optum Bank MSA Debit Card DownloadOptum Bank MSA Welcome Kit
Information regarding newly opened Optum Bank MSA accounts.
updated: 10/01/2020
download Optum Bank MSA Welcome Kit DownloadAll documents can also be found on the documents page.
For further questions, please visit www.optumbank.com(opens in new window) or call Optum Bank at 1-855-893-2300. If you’ve selected a different financial institution to administer your MSA bank account, please contact that institution directly.
Request Member ID Card
Lasso Healthcare Member ID cards and replacements
You will receive your Lasso Healthcare Member ID card in the mail shortly after you enroll. If you do not receive the ID card or need a replacement card, contact our Member Services team. Please continue to use this ID card each year. New ID cards will only be issued if there is a change to your benefits.
MSA bank account cards and replacements
The financial institution administering your MSA bank account will provide you with access cards or checks. If you do not receive those or need replacements, contact your MSA bank account administrator directly.
Lasso Healthcare MSA ID Card
This card is sent to members to access their Lasso Healthcare MSA benefits.
updated: 09/01/2020
download Lasso Healthcare MSA ID Card DownloadAll documents can also be found on the documents page.
Contact Lasso Healthcare MSA Member Services at 1-866-766-2583 (TTY: 711) 8 a.m. to 8 p.m., seven days a week from Oct. 1 through Mar. 31, and M-F from Apr. 1 through Sep. 30.
Contact your MSA bank account administrator directly for replacement bank account cards, etc.
Update Personal Info
Changes in name, address, contact methods, and more
If any of your personal information changes during the plan year, please let us know as soon as possible. You should also notify your MSA bank account administrator.
You may also designate someone else to be your authorized representative by filling out the Authorization to Use/Disclose PHI form.
download Authorization to Use/Disclose PHI Download Authorization to Use/Disclose PHIAuthorization to Use/Disclose PHI
Form to allow member to designate someone else to be their authorized representative.
updated: 09/26/2018
download Authorization to Use/Disclose PHI DownloadAll documents can also be found on the documents page.
Contact Lasso Healthcare MSA Member Services at 1-866-766-2583 (TTY: 711) 8 a.m. to 8 p.m., seven days a week from Oct. 1 through Mar. 31, and M-F from Apr. 1 through Sep. 30.
You will also need to keep your MSA bank account administrator aware of any personal information changes. Please contact them directly.
Understand the Plan 2021
The deposit
The amount Lasso Healthcare deposits into your MSA bank account is prorated based on when your enrollment begins. If you’re enrolling during the calendar year, the prorated deposit amount(opens in new window) is deposited into your MSA bank account the first month your coverage begins. Otherwise, the full annual deposit amount is deposited into the bank account once at the beginning of the calendar year.
If you leave the plan before the end of the plan year, you will need to pay part of the most recently deposited amount back to Lasso Healthcare MSA. See more specifics under the Manage MSA Bank Account section.
The deductible
A deductible is a specific amount that you must pay before an insurer pays a claim. Under the Lasso Healthcare MSA plan, you do not pay a monthly premium to us, but your plan coverage does not begin until you meet your deductible.
It is important that claims are submitted to Lasso Healthcare, even if you know you haven’t yet reached your deductible, so we can help track your progress toward the deductible.
Each of our plans, or plan benefit packages, has a different deductible amount. Your specific plan benefit package, or PBP, number is located on your Lasso Healthcare MSA Member ID card. PBP 001(Growth MSA) = $5,000. PBP 004 (Growth Plus MSA) = $8,000.
You can use the funds Lasso Healthcare deposits into your MSA bank account to help pay your way to meeting the deductible. As the plan deductible is greater than the amount deposited into your MSA bank account, you will need to pay out-of-pocket before Lasso Healthcare begins paying for additional Medicare-covered services. The difference between the deductible and the deposit amount is called the “Member Responsibility” amount. PBP 001 (Growth MSA) = $3,000 and PBP 004 (Growth Plus MSA) = $5,000.
Until you meet your plan deductible, you pay up to 100% of the Medicare-approved amount for Medicare-covered services of inpatient hospital coverage, outpatient hospital coverage, primary and specialist doctor visits, preventive care, emergency care, urgent care, diagnostic labs and imaging, hearing services, dental services, vision services, mental health services, skilled nursing facility, physical therapy, ambulance, transportation and Medicare Part B drugs.
Only Medicare-covered healthcare expenses count toward your plan deductible. It doesn’t matter if you paid for those expenses with your MSA funds, out-of-pocket or a combination of both. See the Evidence of Coverage on the documents page, and linked below, for more information on what expenses Medicare covers. You can also find many expenses covered by Medicare in the Medicare and You handbook(opens in new window) or at https://www.medicare.gov/coverage/is-your-test-item-or-service-covered(opens in new window). Neither MSA funds nor out-of-pocket funds spent on non-Medicare-covered expenses count toward your plan deductible.
Once you reach your plan deductible, Lasso Healthcare will pay 100% of any additional Medicare-covered expense you incur. Any non-Medicare-covered expenses remain your responsibility to pay for, even after you meet the plan deductible.
Enrollment and disenrollment
Enrollment in the MSA is generally for the entire year. Annual Election Period (AEP) and Initial Coverage Election Period (ICEP) are the only two times you can enroll into an MSA plan.
If you qualify for one of the limited special circumstances to disenroll during the year, you will need to pay part of the most recently deposited amount back to Lasso Healthcare MSA.
Disenrollment is limited to the Annual Election Period (AEP) from October 15 through December 7 each year, if you permanently leave the plan’s service area, or if you no longer meet the qualifications for an MSA plan. Information on rights and responsibilities upon disenrollment can be found on the documents page.
Prescription drugs and other non-Medicare-covered expenses
MSA plans are prohibited from offering prescription coverage. You are able to enroll in any standalone Medicare Prescription Drug Plan (PDP) offered in your service area. While you cannot use your MSA funds to pay for your PDP premium without incurring tax and penalties, you can use the funds tax and penalty-free to pay for your Part D deductible, copays and coinsurances. MSA funds used for these types of expenses do not count toward your MSA plan deductible.
CMS regulations prohibit you from obtaining or using other insurance that covers Medicare-covered expenses. However, you can purchase additional limited benefit policies for expenses not covered by Medicare such as vision, dental, long-term care and more. While you cannot use your MSA funds to pay for those supplemental plan premiums (except for long-term care policies) without incurring tax and penalties, you can use the funds tax and penalty-free to pay for any plan deductibles, copays or coinsurances. MSA funds used for these types of expenses do not count toward your MSA plan deductible.
Prior authorizations and referrals
Prior authorizations and/or physician referrals are not required under the Lasso Healthcare MSA.
Coverage decisions, appeals and grievances
As a member of Lasso Healthcare, you have the right to request decisions about your coverage or appeal decisions you disagree with and/or file complaints/grievances. See the coverage decisions, appeals & complaints section for further information.
2021 Summary of Benefits
A brief overview of benefits, eligibility, availability, and other plan information.
updated: 10/01/2020
download 2021 Summary of Benefits Download2021 Evidence of Coverage
This booklet gives you the details about your Medicare health coverage.
updated: 10/01/2020
download 2021 Evidence of Coverage DownloadRights & Responsibilities - Disenrollment
Information, rights, and responsibilities upon discontinuing enrollment.
updated: 10/15/2019
download Rights & Responsibilities - Disenrollment DownloadAll documents can also be found on the documents page.
For further questions, please call Lasso Healthcare MSA Member Services at 1-866-766-2583 (TTY: 711) 8 a.m. to 8 p.m., seven days a week from Oct. 1 through Mar. 31, and M-F from Apr. 1 through Sep. 30.
Prepare for Tax Time
Minimize tax and penalties
MSA funds spent on Qualified Medical Expenses (opens in new window)IRS-deemed Qualified Medical Expenses are not taxed or penalized.
Filing taxes
To make tax-time preparations easier, keep receipts and any paperwork/documentation related to your healthcare and MSA funds usage throughout the plan year.
If you use MSA funds for any expense (qualified or non-qualified), you must file both IRS Forms 8853(opens in new window) and 1040(opens in new window), even if you are not otherwise required to file an income tax return.
You should receive an IRS Form 1099-SA(opens in new window) from the financial institution housing your MSA bank account by January 31 of the following year. The 1099-SA reports distributions, or expenditures, from your MSA account for the past tax year. In addition to notifying you, the financial institution is also required to report that information to the IRS.
Disclaimers
You must file Form 1040, ‘US Individual Income Tax Return,’ along with Form 8853, ‘Archer MSA and Long-Term Care Insurance Contracts’ with the Internal Revenue Service (IRS) for any distributions made from your Medicare MSA account to ensure you aren’t taxed on your MSA account withdrawals. You must file these tax forms for any year in which an MSA account withdrawal is made, even if you have no taxable income or other reason for filing a Form 1040. MSA account withdrawals for qualified medical expenses are tax free, while account withdrawals for non-medical expenses are subject to both income tax and a fifty (50) percent tax penalty.
Tax publications are available on the IRS website at http://www.irs.gov(opens in new window) or from 1-800-TAX-FORM (1-800-829-3676).
Always refer to (opens in new window)www.irs.gov or your tax advisor for the most recent tax forms and guidelines.
For further questions, please contact your tax advisor.
You may also find assistance at (opens in new window)https://www.irs.gov/help/contact-your-local-irs-office.
If you did not receive an IRS Form 1099-SA by January 31, please contact the financial institution housing your MSA bank account.
Manage your Health
For Your Health Program
All members will receive a Lasso Healthcare Rewards Program kit with instructions, activity forms, and reward forms.
The program consists of three activities for members to complete. The materials for each activity are color-coded and consist of a health form and gift card request form.
Upon completion of each activity, members may choose from a wide selection of gift card brands or Visa pre-paid card and can choose to have a physical card mailed or have an e-code emailed.
Activities to be Completed
There are three activities members can complete to earn rewards:
1. Health Survey
The survey should take approximately 10-15 minutes to complete. Responses provided will assist Lasso Healthcare with supporting you on your healthcare journey.
2. Lab Work
This form will need to be completed by you and your medical or lab provider after lab work.
3. Annual Wellness Visit
This form will need to be completed by you and your provider after an annual wellness visit.
Earning Rewards is as Easy as 1-2-3
1. Mail the completed, color-coded health form and reward form in one of the provided envelopes.
2. We’ll process your gift card order.
3. Repeat this process for all three activities to earn $250 in rewards.
Program incentives, reward brands and amounts are subject to change. Please allow up to three weeks from time of reward request receipt for mail delivery of your physical gift card reward. For faster delivery, choose e-code as your delivery method. Rewards cannot be replaced if lost or stolen. Rewards are non-redeemable for cash.
All documents can also be found on the documents page.
Contact us by phone at 1-800-918-3859 Monday through Friday, 9 a.m. to 5 p.m. or email us at wellness@lassohealthcare.com.
Mail the activity forms and reward requests to: Lasso Healthcare 2605 Interstate Drive, Suite 300, Harrisburg, PA 17110
Getting Help from an Independent Government Organization
State Health Insurance Assistance Program (SHIP)
While we’re always available to help you, we recognize you may want help or guidance from someone not connected with us. The Evidence of Coverage, available on the documents page, provides more information on government organizations that can help you.
State Health Insurance Assistance Program (SHIP) is not connected with us or any insurance company/health plan and has trained counselors in every state that provide assistance free of charge. Contact information for your state’s SHIP can be found on the documents page.
State Health Insurance Assistance Program (SHIP)
Contact information for each State Health Insurance Assistance Program (SHIP) in our service area, which provides free help regarding health insurance to Medicare beneficiaries.
updated: 09/21/2020
download State Health Insurance Assistance Program (SHIP) DownloadAll documents can also be found on the documents page.
Contact Lasso Healthcare MSA Member Services at 1-866-766-2583 (TTY: 711) 8 a.m. to 8 p.m., seven days a week from Oct. 1 through Mar. 31, and M-F from Apr. 1 through Sep. 30.
Coverage Decisions, Appeals & Complaints
Coverage decisions & appeals
Our coverage decisions and appeals processes have been approved by Medicare and have a set of rules, procedures and deadlines that must be followed by us and by you to ensure fairness and prompt handling of your concern.
A “coverage decision” is a decision we make about your benefits and coverage or about the amount we pay for your medical services. If you want to know if we will cover a medical service before you receive it, you or your provider can ask us to make a coverage decision for you.
If you disagree with the coverage decision, you can make an appeal. An “appeal” is a formal way of asking us to review and change a coverage decision we have made.
Please see the Evidence of Coverage for more information regarding these processes.
Lasso Healthcare maintains information on how many coverage decisions and appeals are filed with us. If you would like to obtain this information, please contact Member Services.
Grievances/complaints
Our complaints process has been approved by Medicare and has a set of rules, procedures and deadlines that must be followed by us and by you to ensure fairness and prompt handling of your concern.
A “complaint” covers concerns outside of our plan benefits, coverage or payment. It can encompass concerns such as quality of the medical care you received, privacy issues, waiting times, poor customer service and others. Another term for “making a complaint” is “filing a grievance.”
Please see the Evidence of Coverage for more information regarding these processes.
You may contact Member Services or submit a complaint directly to Medicare by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048, or by submitting the Medicare Complaint Form(opens in new window).
Lasso Healthcare maintains information on how many grievances/complaints are filed with us. If you would like to obtain this information, please contact Member Services.
Appoint a Representative
You may name another person to act as your representative to ask for a coverage decision, make an appeal or file a grievance by completing the Appointment of Representative form located on Medicare’s website at: www.cms.hhs.gov/cmsforms/downloads/cms1696.pdf(opens in new window). The form must be signed by you and by the person who you would like to act on your behalf.
2021 Evidence of Coverage
This booklet gives you the details about your Medicare health coverage.
updated: 10/01/2020
download 2021 Evidence of Coverage DownloadRights & Responsibilities - Disenrollment
Information, rights, and responsibilities upon discontinuing enrollment.
updated: 10/15/2019
download Rights & Responsibilities - Disenrollment DownloadAll documents can also be found on the documents page.
To file a coverage decision, appeal, or grievance/complaint, please contact Lasso Healthcare directly by phone or in writing:
By phone: Call our Member Services team at 1-866-766-2583 (TTY: 711) 8 a.m. to 8 p.m., seven days a week from Oct. 1 through Mar. 31, and M-F from Apr. 1 through Sep. 30.
In writing: Lasso Healthcare MSA, P.O. Box 261115, Plano, TX 75026