For questions about health insurance policies, including relevant terminology, types of policies, how to evaluate a health insurance policy, etc. Questions should be tagged with a country-specific tag in most cases, e.g. "united-states" or "canada".

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14
votes
2answers
2k views

how to deal with involuntary out-of-network charges

A covered family member had to be transferred to another hospital during an emergency medical situation. Both hospitals were in network, but the ambulance that the hospital insisted on using was out ...
12
votes
2answers
380 views

What will the penalties be for someone without insurance after Affordable Care Act takes effect?

If I currently don't have health insurance will I have to buy a plan? If I do not what will the penalties be?
11
votes
1answer
170 views

Why do insurance companies in the United States have an enrollment period?

Normally with health insurance in the United States, you can only change the coverage you're getting during a single multi-week period in the year. That is unless there's a life qualifying event such ...
10
votes
1answer
8k views

“Out of Pocket Maximum” and health insurance plan terminology & calculation?

I'm trying to understand the terminology on my health plan. I've read numerous websites, which have only confused me more, as they fail to use examples (more than one should be required) for people ...
10
votes
1answer
2k views

Does the Affordable Care Act (Obamacare) require insurance to be paid with pre- or post-tax dollars?

I would like to continue paying for health insurance with pre-tax dollars. But, according to this Washington Post article, buying healthcare through the Affordable Care Act (Obamacare) requires ...
9
votes
1answer
844 views

Can I use HSA money to pay for family member that isn't covered by an HDHP?

If I'm in an HDHP, but my wife is on a different plan (non-HDHP), can I use money from my HSA to pay for her costs until she reaches her deductible?
8
votes
1answer
183 views

What happens to an HSA when I am no longer eligible to contribute?

Can I still make qualified distributions from an HSA (Health Savings Account) if I am no longer eligible to contribute? Otherwise, what happens to any remaining balance in the HSA? Example: Say I ...
8
votes
1answer
817 views

Can my employer change wage rates based upon medical coverage choices?

Prior to this year my employer used to reduce our hourly rate if we elected to enroll in one of the employer sponsored medical plans available. This reduction in rate was in addition to any weekly ...
8
votes
3answers
373 views

Calculating cost effectiveness of a medical plan

I am evaluating new medical plans, and I'd like to figure out a formula that will give me some idea of the potential benefits of one vs another vs another.. etc.. I have these variables: Cost Per ...
6
votes
2answers
3k views

Comparing HDHP vs PPO Plans: Am I missing something?

It's that time of year at work that we're needing to renew our insurance carrier. HR decided to continue the two PPO plans we previously had available, while adding an HDHP + HSA plan. I've compared ...
6
votes
1answer
223 views

How do I evaluate a health insurance policy that covers a specific disease?

I know that medical emergencies could be fatal for emergency funds and other personal finance aspects. How can you evaluate a cancer insurance policy? What are the aspects that makes one policy ...
6
votes
1answer
2k views

Domestic Partnership Health Insurance and Tax implications

My girlfriend and I are moving to NYC. She is self employed and comparable health insurance in NY will cost her 2x as much as in Texas, where we are now. If we register as domestic partners it seems ...
6
votes
1answer
124 views

Rules about spouse's HSA

My spouse and 2 kids have high deductible insurance, but I do not. If my spouse contributes to an HSA, could that money be used for my medical expenses, or only for expenses for the rest of the ...
6
votes
1answer
87 views

Will I lose a lot on health insurance by changing employer? (Yearly OoP Max)

I am considering leaving my current employer. Hypothetically, assume my new employer has a different health insurance provider (although, it probably doesn't matter, since it would be a different ...
5
votes
3answers
224 views

Bill to expect after receiving basic emergency services at out-of-network hospital

Edit: follow-up question w/ resolution info and another billing-related concern. Recently I broke a finger while playing sports. The finger was clearly broken/disformed. Also I received a minor head ...
5
votes
4answers
431 views

Which is better: Employer-sponsored HSA or opening an HSA individually?

So I know that: Employer-sponsored HSA's allow you to deduct contributions directly from your paycheck, pre-tax With individual HSAs, you must contribute using post-tax dollars, then deduct those ...
5
votes
3answers
147 views

How is my employer affected if I have expensive claims on my group health insurance?

Suppose, for the sake of discussion, that I work at ACME, Corp, a USA company. As part of my compensation, ACME makes me a member of their group health insurance through Aetna, a USA health insurance ...
5
votes
1answer
179 views

Comparing pre-tax versus post-tax health expenses?

I understand the concepts from this question and everything I have read says that the benefit of pre-tax expenses are that they reduce your taxable income. But to keep the math simple, let's say ...
5
votes
2answers
279 views

Expensive Pre-Tax Health Plan or Cheaper After Taxes Private Insurance

I currently have two options for health insurance, and I'm having trouble figuring out which one will actually save me more money. Option 1: Employer sponsored Health Insurance for Family ...
5
votes
1answer
108 views

Am I on the hook for medical bills by people that are on my health insurance?

I provide insurance for my ex-wife. Let's says the insurance pays 80% of the cost and they bill her for the rest. Am I liable for the remaining 20% if she doesn't pay? P.S. This is not a ...
5
votes
1answer
298 views

HSA qualification and contributing with multiple HDHPs?

So I've read the IRS publications and I'm still kind of confused. I have single coverage on my employer's health plan with a qualified HDHP and along with an HSA. This is pretty clear cut. I am ...
4
votes
3answers
119 views

How does the importance of a cash emergency fund change when you live in a country with nationalized healthcare?

In one of the answers to this question, it was mentioned that the primary cause of bankruptcy in the US is related to health expenses, and this is one reason to keep an emergency fund. Since most of ...
4
votes
1answer
129 views

Do I have to wash money through HSA account?

I paid for my eligible health expenses from my regular account at the end of 2014 and beginning of 2015 because I did not have enough money on my HSA account. Now that I realize that I can contribute ...
4
votes
3answers
304 views

I'm getting gouged on prices for medical services when using my HSA plan. How to be billed fairly?

I had never given a second thought to the details of the bills that my health insurance (HI) company used to send me until I moved to a HSA plan. My typical (before the HSA plan) bill claim would be ...
4
votes
3answers
484 views

Health insurance allowed benefits: different for different plans from same insurer?

Let's say I have a choice between two plans, both offered by the same insurance company. Plan A is a high-premium, low-coinsurance, low-deductible plan. Conversely, Plan B is a low-premium, ...
4
votes
2answers
124 views

How to pay for Alzheimer's care?

My mom is on the early stage of Alzheimer's, but I'm aware of the fact that "early" won't be forever. What are some of my options for financing the cost of my mother's care when the time comes? I am ...
4
votes
0answers
431 views

Can I claim a parent receiving Medi-Cal benefits as a dependent on my tax return?

My mother got her green card this year. She won't work here. All her expenses will be paid by me. Since she is 67 years old, I am planning to apply for Medi-Cal health coverage for her. My question ...
3
votes
5answers
1k views

Is this HSA too good to be true?

I am grandfathered into this PPO plan which we have one more year before they get rid of it. I think the HSA plan is better now for me but wanted to check. Is this HSA plan better for me? If I ...
3
votes
1answer
204 views

What are my HSA contribution limits if one, but not all members of the family are covered by an HSA-eligible plan?

My understanding is that when a person enrolls in an HSA-compatible health plan, he may contribute $3300 to an HSA. For example, if Adam is enrolled in an HSA-compatible plan, he may contribute $3300 ...
3
votes
2answers
142 views

Does it make sense to look for medical plans outside “Obamacare”?

Does it make sense to look for medical plans outside of the ACA Exchanges (such as the https://calheers.ca.gov/ in California), or are those as good as it gets? If it's illegal for the insurer to ...
3
votes
2answers
102 views

How do “family” deductibles work on US health insurance policies?

In the past, I have had individual health insurance. If I had a $1000 deductible, that meant that I had to pay the first $1000 of my health expenditures each year. Next year, I expect to have a ...
3
votes
2answers
99 views

Tips for insurance coverage for one-man-teams

I'm a solo software developer and would like to find some reasonable health insurance for myself. My wife has a job which allows me an opportunity to participate in her insurance group, but it is a ...
3
votes
1answer
90 views

Can I pay past expenses using an FSA opened midyear?

In my old job I had a HDHP and HSA. Midyear, I started a new job and switched to a standard insurance plan and an FSA. Can I submit receipts for expenses from January to the FSA that I just opened in ...
3
votes
1answer
206 views

What kind of insurance would cover death/disability for organ donors?

Let's say I'm going to be a living donor for a relative. I'm about to willingly undergo major surgery with known (albeit low) risks. I will be taking on significant debt to pay for the whole thing. I ...
3
votes
1answer
391 views

Switching From Employee to Independent Contractor

I've read a few different questions on here regarding the breakdown of employee vs independent contractor, but my situation has details that are quite different, hence, the question. When I was ...
3
votes
1answer
65 views

When must a health insurance plan provide contraceptive coverage under PPACA?

I'm having a hard time deciphering PPACA as it relates to contraceptive coverage. It seems that all plans that begin after August 2012 must provide it, but there is a "grandfather" clause that allows ...
2
votes
2answers
240 views

Continuing group health benefits from old employer after resigning

I will be resigning from my current employer next week and moving to another company: the new employer is a much smaller fabrication company and does not have as good health insurance. For example, ...
2
votes
2answers
111 views

Having two different employer healthcare plans

I currently have two healthcare plans, one is United Health Care and one is Anthem Blue Cross. I'm able to get my health insurance in full from my old job which is why still have it(ABC). Anthem Blue ...
2
votes
1answer
57 views

Health care billing concerns

Over the past year I had my first experience with health care billing issues other than just paying my monthly bill. Something happened billing-wise recently that concerns me. I'd like to get feedback ...
2
votes
1answer
2k views

What are some FSA eligible expenses that can be used for baby care?

I signed up for a Flexible Spending Account (FSA), and am now trying to figure out what all is covered under it. I know some of the basic products like band aids and glasses are, but I'm really ...
2
votes
1answer
31 views

Interaction between health exchange and under-65 Medicare coverage

I purchased platinum-level family coverage on the healthcare exchanges this year. Shortly after the start of the year, my wife's disability application was approved (after ~2 years in progress) and ...
2
votes
2answers
117 views

How can I budget for medical expenses when the medical billing process is so haphazard?

I've got fairly decent health insurance. But it seems like medical insurance companies always find some way to "scrooge" you. Example 1: Company switched carriers, was promised that we would get ...
2
votes
1answer
150 views

How to Deduct Family Health Care Premiums Under Side Business

I am an employee of a company and I have health insurance through them, pre tax. My company only pays for me so I have private insurance for my wife and kids. I also have a side business, and was ...
2
votes
1answer
107 views

American (Private) Ankylosing Spondalytis Health insurance costs compared to the British NHS

I'm a sufferer of Ankylosing Spondalytis, and a resident of the UK - my health care is handled by the National Health Service (NHS). Now in the UK seems to be increasing move to privatise it's health ...
2
votes
2answers
135 views

Calendar year changes and Out-of-Pocket reset

I have been with a School District for three years. This last year I had major surgery. I met my deductible and by August I reached my OOP max. In September the district got a new plan. They made ...
2
votes
1answer
257 views

Time limit for health-insurance to pay doctor bill and send EOB

I'm in the middle of another dispute between an in-network doctor's billing office and my health insurance company (HIC). My health insurance has not yet paid the bill due to a dispute with over some ...
2
votes
0answers
76 views

Can a person who has Medicaid buy a discounted dental insurance plan?

We live in Arkansas. My dad has Medicaid. However, it turns out most dentists do not accept Medicaid, and those that do, provide a limited number of services . So, I tried to purchase a dental plan ...
1
vote
1answer
70 views

Are health insurance premiums obtained through ACA deductible for the self employed?

This IRS article, and this answer on money.se seem to indicate that health insurance premiums are deductible for the self employed. However, turbo tax, when entering this deduction, specifically warns ...
1
vote
1answer
69 views

HSA contribution and self HDHP

I enrolled in HDHP plan starting 2014 Nov 3rd. I also have an employer sponsored HSA plan, where my employer contributed $250 towards the 2014 limit in Jan 2015. Before this I never had an HSA ...
1
vote
1answer
126 views

Avoid Paying COBRA Premiums When Unused

I would like to avoid paying for Cobra insurance for a month between jobs if I do not use the insurance. It would not be a lapse in coverage for preexisting condition purposes. Basically for the ...