Q:  With the holidays and a crazy year-end, I completely forgot about $300 that was left in my FSA through my employer.  Did I just kiss this money goodbye, or can I somehow use it?

A:  While your Flexible Savings Account cutoff for incurring the medical care was likely 12/31 (you may want to check on this through your HR -- 12/31 is the most common but not a hard and fast rule), you will likely have three to four more months to send in the documentation and get reimbursed for 2009 expenses.  Think back to your 2009 and determine if there are things that you could get reimbursed for -- deductibles, prescriptions, therapy, over-the-counter medical supplies and the like.  Chances are you'll be able to come up with $300 of unreimbursed medical expenses.  If, however, you can't, you are right -- you would lose the dollars.  That is the difference between a Flexible Savings Account and a Health Savings Account (HSA).  In an HSA, you would roll the dollars over to the new year.

How much should you contribute to your Health Savings Account (HSA)? That depends on a variety of factors, each of which will vary between families and individuals. An HSA is meant to be two things at once: A short-term savings account for near-term medical expenses, and a longer-term vehicle to build a substantial sum for future medical expenses. As with most things financial, perhaps the key is balance.

First, begin with the maximums. The most that an individual in 2009 can contribute to an HSA is $2,900, and for a family the max is $5,800. That equates to $241 per month on the individual side, and $483 per month for a family. If you are in a position to contribute the maximum, and do so without getting late on other bills, using credit cards, or cutting back on necessities, consider padding your HSA at the outset so you have a nest egg to draw upon.

For many of us, simply contributing the maximum may not be smart or feasible. In that case, there are a few levers to use as you determine the right amount to contribute:

1. How much do you think you'll use on medical care annually. It makes sense to at least save as much as you expect to use annually on medical care, and if possible more. Remember, an HSA doesn't have a use-it-or-lose-it provision like the more common FSA.
2. How large you want your HSA to become. The easy answer is "as large as possible." Realistically, though, determine if you want your HSA to always have just a bit more than you think you'll need each year, of if you want your HSA to become a nest-egg of sorts for future health care expenses.
3. Time and Interest. Like with any investment, the number of years you are invested for and the expected interest rate will impact the growth of the account balance over time. If you are an aggressive investor, keep in mind that you could just as easily see a 20% drop in value as you could a 40% increase.
4. Your tax rate. The higher tax bracket you are in, the more advantageous a break you'll get on invested HSA dollars.

For more specific analytical help, we recommend you access an online calculator geared specifically toward HSA. The best one we've found so far is this one at Wachovia.

Since three in four health plans include some provision for choosing in-network or out-of-network medical care, the majority of patients covered by health plans in America need some basic understanding of what their healthcare network is and what happens if they go outside of it. In general, HMOs, PPOs, and other Managed Care plans use a provider network, while basic Indemnity Plans (where the insurance plays a flat 80% of charges, for example) do not.

A network, or a provider network, is a group or listing of healthcare providers (doctors, clinics, hospitals, etc.) that has contracted with your insurance company to provide medical care. Because those providers have agreed to accept discounted reimbursement rates from your health plan, your plan wants you to go to them for your medical care, and may penalize you if you don't.

Fortunately, most provider networks are pretty expansive. With many health plans, you'll find that the list of in-network doctors, for examples, includes nearly everyone in your area who you would ever consider going to. Many times, the contracting is done at the group practice or hospital level, so every physician practicing with that group or (in less cases) that hospital is automatically part of your network.

Some provider networks, however, are stringent and may force you to make a difficult decision: Seek your medical services from providers whom you would typically not go to, or pay potentially significant out-of-pocket costs for going to a non-network provider.

If having to research your health plan's network for preferred providers wasn't enough, there is vagueness around complex cases. What happens when you go to an ER that is a thousand miles away from home where, very likely, you won't find any in-network providers? What happens when you have a major surgery and only four of the six doctors involved are part of your network? Hopefully, a good benefi ts department at your employer has already thought about these possibilities. In all too many unnerving cases, however, the patient ends up with either a surprisingly large bill or months of phone calls to clear everything up.

The bottom line: If you are part of a health plan that uses a provider network, do your homework and know about the network. Next, we'll look at a few strategies for being an astute user of your network.