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 1-833-925-2776 (TTY: 711).
Download answers to our most commonly asked questions.
Download Member FAQs (opens in new window)Find a Provider
Lasso Healthcare 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 the Lasso Healthcare MSA. We are 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 with your providers and confirm they'll accept our Plan. Click the Documents tab to download an electronic copy. 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, your Provider card and on our website.
You can get the most value out of your MSA plan by choosing Medicare-participating 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, 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: 07/04/2022
download Provider Guide DownloadAll documents can also be found on the documents page.
Contact our Member Services team at 1-833-925-2776 (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 the Lasso Healthcare MSA. If your provider has any questions or is reluctant to accept Lasso Healthcare, please ask your provider to call us at 1-833-925-2776, or you may call us and request we speak to your provider.
Pay for Healthcare
At the time of service
Don’t show your Medicare card. Instead, show your Lasso Healthcare MSA member ID card along with your provider 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, your provider 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 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 your 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 funds, your own money or a combination of both. If you no longer have funds in your medical savings account, you will need to pay out of your own pocket until you reach the plan deductible amount.
Optum Financial 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 medical savings 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 Medicare-approved amount 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: 05/31/2022
download Member Reimbursement Form (Application for Payment Consideration) DownloadAll documents can also be found on the documents page.
Contact our Member Services team at 1-833-925-2776 (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 981718, El Paso, TX 79998-1718; providers may also submit claims electronically using payer ID# 10550.
If you received an EOB from us, 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.
Prepare for Tax Time
Minimize tax and penalties
MSA funds spent on Qualified Medical Expenses (opens in new window)Internal Revenue Service (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 Schedule 1(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 medical savings account by January 31 of the following year. The 1099-SA reports distributions, or expenditures, from your 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 IRS for any distributions made from your Medicare medical savings account to ensure you aren’t taxed on your account withdrawals. You must file these tax forms for any year in which a medical savings account withdrawal is made, even if you have no taxable income or other reason for filing a Form 1040. Medical savings 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 medical savings account.
Manage Your Savings Account
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 medical savings account the first month your coverage begins. Otherwise, the full, non-prorated annual deposit amount is deposited into the account once at the beginning of the calendar year.
Current regulations prohibit you from adding funds to your medical savings account. Only we can deposit money into your account.
Portability
Our banking partner is Optum Financial. Once we make the initial deposit into your Optum Financial 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 Financial will be your responsibility.
Fees, interest, and investment options
While you hold the account with Optum Financial as a Lasso Healthcare MSA plan member, you will not accrue custodial fees. Please note there is a fee for receiving paper statements, so we recommend receiving electronic statements. Your medical savings account will be interest bearing. You can invest funds in excess of $2,000 in various investment vehicles offered through Optum Financial. 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 medical savings account with Optum Financial, they provide a special debit card you can use to access your MSA funds. If you’ve moved your MSA funds 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 medical savings 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 us 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 us. The repayment amount is prorated(opens in new window) based on the number of months left in the current year. Any funds in your medical savings 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, we are required by Centers for Medicare & Medicaid Services (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 a Lasso Healthcare member the following year, a new annual deposit will be funded into your account.
Bank account questions, transactions, balances, investment options, etc.
We do not have access to your medical savings account, even if you keep the account with Optum Financial, and cannot answer any questions related to your account balance, transactions, investment options, etc. Instead, please contact your medical savings account administrator for assistance with these inquiries.
Optum Financial MSA Debit Card
This card is sent to members to access their MSA funds.
Updated: 10/01/2021
download Optum Financial MSA Debit Card DownloadOptum Financial MSA Welcome Kit
Information regarding newly opened Optum Financial medical savings accounts.
Updated: 10/01/2021
download Optum Financial 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 Financial at 1-855-893-2300. If you’ve selected a different financial institution to administer your medical savings 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 and your provider card in the mail shortly after you enroll. If you do not receive the ID cards or need a replacement card, contact our Member Services team. Please continue to use these ID cards each year. New ID cards will only be issued if there is a change to your benefits.
Medical savings account cards and replacements
The financial institution administering your medical savings account will provide you with access cards or checks. If you do not receive those or need replacements, contact your medical savings account administrator directly.
Lasso Healthcare MSA ID Card
This card is sent to members to access their Lasso Healthcare MSA benefits.
Updated: 07/04/2022
download Lasso Healthcare MSA ID Card DownloadLasso Healthcare Provider Card
This card is sent to members to show along with their Member ID card to providers to help explain the MSA.
Updated: 07/04/2022
download Lasso Healthcare Provider Card DownloadAll documents can also be found on the documents page.
Contact our Member Services team at 1-833-925-2776 (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 medical savings 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 medical savings account administrator.
You may also designate someone else to be your authorized representative by filling out the Authorization to Use/Disclose PHI form found on the Documents tab.
Authorization to Use/Disclose PHI
Form to allow member to designate someone else to be their authorized representative.
Updated: 07/06/2023
download Authorization to Use/Disclose PHI DownloadAll documents can also be found on the documents page.
Contact our Member Services team at 1-833-925-2776 (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 medical savings account administrator aware of any personal information changes. Please contact them directly.
Understand the Plan
The deposit
The amount we deposit into your medical savings 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 account the first month your coverage begins. Otherwise, the full annual deposit amount is deposited into your medical savings 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 us. See more specifics under the Manage Your Savings Account section.
The deductible
A deductible is a specific amount that you must pay before an insurer pays a claim. With the 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 us, 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 we deposit into your medical savings account to help pay your way to meeting the deductible. As the plan deductible is greater than the amount deposited into your savings account, you will need to pay out-of-pocket before we begin 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 tab, 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, we 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 us.
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 tab.
Prescription drugs and other non-Medicare-covered expenses
MSA plans are prohibited from offering prescription coverage. You are able to enroll in any stand-alone 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 with the Lasso Healthcare MSA.
Coverage decisions, appeals and grievances
As a member, 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.
2023 Evidence of Coverage
This booklet gives you the details about your Medicare health coverage.
Updated: 10/01/2022
download 2023 Evidence of Coverage Download2023 Summary of Benefits
A brief overview of benefits, eligibility, availability, and other plan information.
Updated: 03/14/2023
download 2023 Summary of Benefits DownloadRights & Responsibilities - Disenrollment
Information, rights, and responsibilities upon discontinuing enrollment.
Updated: 10/01/2022
download Rights & Responsibilities - Disenrollment DownloadAll documents can also be found on the documents page.
Contact our Member Services team at 1-833-925-2776 (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
Rewards Program
Lasso Healthcare Rewards Program
Helping you achieve a better quality of life is our top priority. That’s why we partnered with NationsBenefits®, a leading supplemental benefits company, to offer you a rewards program.
As a valued Lasso Healthcare member, you can earn rewards for completing select health and wellness activities. If it’s your first time qualifying for a reward, NationsBenefits will mail you a prepaid card. If you already have your card, the reward will be loaded automatically. Please keep the card for any future rewards until the expiration date listed.
Here’s how it works:
1. Complete one of the activities listed in your current Lasso Healthcare Rewards Program Kit
2. Submit your activity form to 303 W. Madison St., Suite 800 Chicago, Illinois 60606-3389
3. Reward dollars will be loaded onto your prepaid card
4. Use your reward dollars online through NationsBenefits or at participating locations for: utilities, transportation services, hearing aids, pharmacy purchases, restaurants, retailers, and more!
Please Note: Your card must be activated before you can start using it. You can activate your card, check your account balance, and more through your NationsBenefits member portal. To get started, please visit Members.NationsBenefits.com/LassoHealthcare.
Who is Oak Street Health?
Oak Street Health is a healthcare company serving adults on Medicare. They are dedicated to providing you with an unmatched experience. Oak Street Health's primary care providers have years of experience and expertise in preventive medicine.
Conduct your annual wellness exam virtually with Oak Street Health
To schedule your appointment, call Oak Street Health at (312) 651-4001 between the hours of 7 a.m. - 5 p.m. CST. The visit will be done in the comfort of your own home - all you need is a phone, computer, or tablet with an internet connection and a self-facing camera.
A medical assistant from Oak Street Health will send you a text message or email at the time of your visit. Just click the link in the message to join the video visit.
You’ll be asked some introductory questions about your health. If you take any medications, please have those ready.
If you are able to check your blood pressure or weight at home, you will be asked to do that.
Then, you’ll talk with a physician or nurse practitioner about your health history and any concerns you may have. The physician or nurse practitioner may order tests or prescribe medications, if necessary.
The entire visit takes about an hour. After your visit, fill out the Annual Wellness Visit form in your Lasso Healthcare Rewards Kit and return it to the address provided to receive credit on your reloadable rewards card from Lasso Healthcare!
All documents can also be found on the documents page.
If you have questions about the Rewards program, contact NationsBenefits at 888-282-6853 (TTY: 711). Member Experience Advisors are available 24 hours a day, seven days a week, including holidays.
To get more information about the healthcare services Oak Street Health provides or to schedule your wellness exam, call (888) 202-9892.
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 on the Documents tab for more information regarding these processes.
We maintain 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 our Member Services team 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).
We maintain 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.
2023 Evidence of Coverage
This booklet gives you the details about your Medicare health coverage.
Updated: 10/01/2022
download 2023 Evidence of Coverage DownloadRights & Responsibilities - Disenrollment
Information, rights, and responsibilities upon discontinuing enrollment.
Updated: 10/01/2022
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 1-833-925-2776 (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 1222 Chicago, IL 60690-1222
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 tab.
2023 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: 10/01/2022
download 2023 State Health Insurance Assistance Program (SHIP) DownloadAll documents can also be found on the documents page.
Contact our Member Services team at 1-833-925-2776 (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 .