SmartFund™ (MSA) Plan Eligibility
You are eligible to join SmartFund:
- If you are entitled to Medicare Part A (hospital) and enrolled in Medicare Part B (medical). You must continue to pay your Part B premium.
- If your legal residence is in the MVP Health Care Service Area. Our service area is: Albany, Broome, Cayuga, Chemung, Chenango, Clinton, Columbia, Cortland, Delaware, Dutchess, Essex, Franklin, Fulton, Greene, Hamilton, Herkimer, Jefferson, Lewis, Madison, Montgomery, Oneida, Onondaga, Orange, Oswego, Otsego, Putnam, Rensselaer, Rockland, St. Lawrence, Saratoga, Schenectady, Schoharie, Sullivan, Tioga, Tompkins, Ulster, Warren, Washington, and Westchester counties in New York.
You may apply for SmartFund:
- When you first become eligible for Medicare benefits, which includes:
- the 3 months before your 65th birthday month,
- the month in which you turn 65, and
- the 3 months after your 65th birthday month
- During the annual enrollment period, which runs from October 15 through December 7 each year to begin your coverage on January 1.
You cannot join SmartFund if: you have other health care coverage, including union or employer group, TRICARE or Veterans Affairs benefits, or federal employee health benefits; are eligible for or enrolled in Medicaid; have End-Stage Renal Disease (ESRD); are on hospice; or live outside of the U.S. more than 183 total days a year.
If you are enrolling in SmartFund offered through your former employer, different enrollment and eligibility rules apply. Contact your former employer for more information.
Enrollment in SmartFund is generally for the full calendar year. You may not change plans during other times of the year unless you meet certain special exceptions, such as you move out of plans service area, qualify for Medicaid or qualify for extra help with your prescription drug costs.
If you disenroll before the end of the plan year (December 31st), MVP Health Care may debit your MSA bank account for a prorated share of the current years deposit to be returned to Medicare.
SmartFund MSA® Disenrollment Rights and Responsibilities
SmartFund MSA Disenrollment Form
Important Information
MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
Medicare MSA Plans dont cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate Medicare Prescription Drug Plan.
There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan at1-800-665-7924 (TTY: 1-800-662-1220 for additional information.
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 arent 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 or from 1-800-TAX-FORM (1-800-829-3676).
MVP Health Plan, Inc. is an HMO-POS/PPO/MSA organization with a Medicare contract. Enrollment in MVP Health Plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.
Last updated: October 2017
