Duke Introduces New Health Plan with Paired Health Savings Account
Staff and faculty enrolled in the new Duke Advantage High-Deductible Health Plan will gain access to tax-advantaged savings for medical expenses
The Duke HSA is separate and different from the Health Care Reimbursement Account that will continue to be offered by Duke and administered by HealthEquity.
Here are some factors to consider when deciding whether to sign up for the new Duke Advantage health plan and how a Health Savings Account functions.
Is a High Deductible Health Plan right for me?
The new Duke Advantage plan, like all High Deductible Health Plans, requires a deductible to be met before the plan pays for any medical expense, including office visits and prescription coverage. In 2026, that deductible is $3,000 for an individual and $6,000 for family coverage for Duke Advantage in-network care. Only preventative care and a limited number of preventative medications are covered prior to reaching those thresholds.
This new plan is designed with a lower monthly premium but a higher deductible, so it might not be suitable for those who are more frequent users of health care services.
“The purpose of a High Deductible Health Plan is to promote more mindful use of health care services,” said Laura Panebianco, Duke’s Associate Director of Benefits Administration.
The new Health Savings Account (Duke HSA) paired with a High Deductible Health Plan helps offset out-of-pocket expenses before care is covered.
What's a benefit of the new High Deductible Plan?
In addition to the Health Savings Account (Duke HSA), a key benefit of the Duke Advantage Plan is access to telehealth services through MDLive, offered at no cost to members. With MDLive, members can quickly receive care for common, non-emergency conditions such as the flu, sinus infections and ear pain, as well as access wellness services and support for a range of behavioral health concerns. The telehealth visits are fully covered by the Health Plan, even before the deductible is met. This benefit is exclusive to the Duke Advantage Plan. Additional information will be available during Open Enrollment.
Broadly, what is a Health Savings Account?
A Health Savings Account is a tax-advantaged way to save and pay for qualified medical expenses. Among the major benefits are that you maintain control of the account, even if you switch employers, and unspent money in the account rolls over each year.
Withdrawals are free from federal income tax when spent on a qualified medical expense and investment growth is tax-free.
How does the Duke HSA paired with the Duke Advantage plan work?
In 2026, up to $4,400 for an individual or $8,750 for a family can be set aside pre-tax in an investment account managed by Fidelity. You can contribute to your account, withdraw money to pay for qualified medical expenses or potentially grow your funds for future medical expenses tax-free by investing in a wide array of investment options.
Duke will also contribute to the Duke HSA $200 for an individual and $500 for a family in 2026.
“The big advantage is that any money put into an HSA can be invested, so it can grow your money over time,” Panebianco said. “The second advantage is it’s your money – it never reverts back to your employer.”
More information can be found in the Fidelity videos, Getting Started with Your New HSA and How to Use an HSA.
What can the Duke HSA pay for?
Distributions from an HSA can pay for qualified medical expenses for you, your spouse and dependents. Examples of qualified expenses include:
- Health plan deductible and coinsurance;
- Most medical care and services;
- Dental and vision care;
- Prescription drugs, over-the-counter medications and insulin.
More information can be found in the Fidelity video, HSA Eligible Expenses and Ways to Pay Them.
Who is eligible for the Duke HSA that’s paired with the Duke Advantage plan?
You must be enrolled in Duke Advantage, Duke’s High Deductible Health Plan to have the Duke HSA.
Additionally, you cannot be enrolled in Medicare or covered by any other health plan that is not an HSA-eligible health plan, and you and/or your spouse cannot be enrolled in a health care flexible spending account (FSA) in the same year that you have an HSA, among other criteria.
If you open an HSA and do not meet all criteria, your contributions, any investment earnings and distributions may be subject to taxes or penalties.
For more information on eligibility, see Fidelity.
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