Healthcare spending account (HSA)

Your HSA is like a tax-effective benefits bank account, and is a key part of your CWBR Trust benefits plan. It’s important to understand how it works – so you can take advantage of its flexibility to manage your overall healthcare.

How it works

Each year on January 1, the Trust will deposit $2,000 into your HSA, to help pay for healthcare expenses not otherwise covered by the plan. When you submit a claim to Manitoba Blue Cross (MBC) for an eligible medical, drug, dental or other healthcare expense not fully covered by the plan, the remaining amount will be automatically submitted to your HSA on your behalf. For example, if you buy glasses that cost $500, you submit the expense to the plan and get $300 covered through your vision care benefits. The remaining $200 is automatically paid through your HSA.

You can also spend HSA money as you see fit. The only requirement is that you spend it on prescription drug, medical and dental-related expenses that are not covered under your CWBR Trust plan (or any other private or government healthcare plan), but that are allowed under the Income Tax Act.

Key features of the HSA:

  • Your HSA can be used to offset the cost of a wide range of medical, drug and dental expenses not covered (or not fully covered) under your plan.
  • You can use your HSA to cover eligible expenses for you and your dependants. Even better, when it comes to your HSA, the definition of eligible dependants is expanded, as defined by the Canada Revenue Agency.
  • The plan will automatically submit eligible healthcare expenses to your HSA for reimbursement. When you submit a claim for an eligible medical, drug, dental or other healthcare expense not fully covered by the plan, the remaining amount will be automatically submitted to your HSA on your behalf.
  • You can also manually submit an HSA claim online at mb.bluecross.ca or by paper.
  • Any money deposited into your HSA must be used by the end of the year – otherwise, it will be forfeited.

    For example, if money is deposited into your HSA for 2024, you must spend that money by December 31, 2024. You have up to 90 days after the end of the year to submit your claim(s) to Manitoba Blue Cross.

  • You cannot carry forward an expense from one year to the next. In other words, if you incur an expense in one year, you cannot use money deposited in your HSA for the next year to cover that expense.

    For example, if you incurred an expense in October 2024, but don’t have enough money left in your HSA from your 2024 deposit to cover that expense, you cannot use money deposited in your HSA for the 2025 plan year to pay for it.

Eligible dependants

When it comes to your HSA, the definition of eligible dependants is expanded. It includes your spouse and dependent children, as well as anyone who is recognized as your dependant by the Canada Revenue Agency. For example, a grandchild, parent, grandparent, brother, sister, aunt, uncle, niece or nephew of you or your spouse will qualify, provided they:

  • depend on you for financial support, and
  • normally live with you in Canada (unless away at school).

Eligible expenses

If you are manually submitting an HSA claim, eligible HSA expenses must be received by Manitoba Blue Cross within 90 days of the end of the year in which the expense was incurred. This usually means March 31 of the following year (unless a leap year — then March 30). Keep in mind, it’s always good practice to submit your claims as soon as possible, so you don’t forget or lose your receipts.

For example, if you incurred an eligible expense in October 2024, you must submit your claim by March 31, 2025. Only money deposited in your HSA for 2024 can be used to pay that claim — money deposited for 2025 cannot be used.

If you are manually submitting an HSA claim, you can submit your HSA expenses to MBC the same way you submit any other health and dental expense, either online at mb.bluecross.ca or by using a paper form. You just check the “Health Spending Account” box to specify that the claim is to be paid from your HSA.

Need some help to know what eligible expenses you can pay for with your HSA?

Have a look at the sample list here.

Keep in mind: In most cases, to qualify as an eligible expense, the service, procedure or supply in question must be provided or prescribed by a medical practitioner who is licensed according to the laws of the province in which he or she is practicing.

For a complete list of covered expenses, refer to subsection 118.2(2) of the Income Tax Act. Additional information on many of these expenses can be found at www.canada.ca in the Income Tax Folio S1-F1-C1: Medical Expense Tax Credit section.

If you can claim an expense under another plan (such as the Trust’s health and dental plan, your spouse’s benefits plan or a government drug plan), you must do that first before submitting your claim under the HSA.

HSA claims

When it comes to your HSA, the definition of eligible dependants is expanded. It includes your spouse and dependent children, as well as anyone who is recognized as your dependant by the Canada Revenue Agency. For example, a grandchild, parent, grandparent, brother, sister, aunt, uncle, niece or nephew of you or your spouse will qualify, provided they:

  • If you’re submitting an HSA claim that is the uncovered amount of another claim, then you can submit online — you simply check the box that says, “Pay uncovered amount through HSA”.

    Example: If you buy glasses that cost $500, you submit the expense to the plan and get $300 covered through your vision care benefits. The remaining $200 can be paid by your HSA.

    HOWEVER:

  • If your claim is to be paid entirely from your HSA, then you must use a paper form and mail in your claim. MBC hopes to offer an online option for this soon.

Tax advantages

In addition to reducing your out-of-pocket expenses, using the HSA can help reduce your tax hit (see example below).

This is because you don’t pay income tax on the money when it is deposited, or when it’s claimed from your HSA. That can make a huge difference in how much money you have available to spend on health and dental-related expenses.

If you live in Quebec, the tax rules are a bit different. Any amounts claimed from your HSA will be considered a taxable benefit. You’ll sidestep the federal tax hit, but provincial income tax will apply.

The bottom line is, the HSA offers a clear tax advantage regardless of where you live in Canada.

Example: The HSA tax advantage
Let’s say you have physiotherapy expenses. Your plan covers up to $500 per year. If that leaves you with, say, $350 that’s not covered by the plan, you have two options:

  • You can pay the cost using $350 in pre-tax dollars from your HSA (assuming you have enough remaining for the year).
  • You can pay the cost out of your own pocket. If you pay out of pocket, you’ll be using after-tax dollars. Assuming a 20% tax rate, you would have to earn $438 to have enough after-tax dollars to pay the $350 bill from physiotherapy.
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