American Health Care Access Improvement, Portability, and Cost Reduction Act of 2008

American Health Care Access Improvement, Portability, and Cost Reduction Act of 2008 - Amends the Internal Revenue Code (IRC) to allow qualified primary care physicians or qualified nurse practitioners a tax credit of $1,000 for each month such providers provide services in a health professional shortage area.

Amends title XVIII (Medicare) of the Social Security Act to make changes to the conversion factor for FY2010 for physicians Medicare payments.

Allows a refundable tax credit for qualified health insurance coverage. Provides for advance payment of such credit.

Revises IRC provisions relating to health savings accounts (HSAs) to: (1) allow HSAs to incorporate flexible spending and health reimbursement arrangements; (2) increase the annual HSA contribution limitation; (3) permit the use of HSAs to purchase health insurance; (4) allow the payment of certain medical expenses incurred before the establishment of an HSA; (5) allow veterans eligible for service-connected disability benefits to establish an HSA; and (6) allow spouses to make increased catch-up contributions to a single HSA.

Requires the inclusion of education information about advance directives in the annual notice of Medicare benefits sent to eligible individuals.

Revises provisions concerning Medicare+Choice private fee-for-service plans related to access standards under the plans and utilization.