Questions tagged [health-insurance]

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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2answers
86 views

Accidently forgot to cancel insurance Kaiser, refund possible?

I had a personal health insurance plan from Kaiser, but I forgot to cancel it when my workplace health insurance coverage (also from Kaiser) started, so for 2 months I was charged for 2 plans. Is it ...
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0answers
40 views

Do we have to pay deductibles on medicare and medicaid separately?

My fiancé has been seeing a PTSD therapist for about five weeks, paying out of pocket for the sessions until her medicare deductible was met so she would be covered. We just got a call from the ...
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36 views

What does a negative plan discount mean on a medical insurance claim in the United States?

I saw the following medical insurance (Aetna) claim in the United States: What does the negative plan discount mean?
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1answer
70 views

Self-funded & fully-funded health insurance plans for small businesses

Imagine that a hypothetical small business in the U.S., MoneySavers, is setting up a health insurance plan that it will offer to its employees. I'm looking for clarification on any misunderstanding ...
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1answer
55 views

Can a lab collection requisition be used in two different labs and still be covered by the health insurance?

For example, let's assume that a lab collection requisition lists two tests: test A and test B (e.g., test A and test B can be some blood tests). Can the patient do test A in one lab and test B in ...
4
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1answer
58 views

If I get covered by a new healthcare plan in the middle of a month that is already covered by COBRA, will I get double coverage or a prorated refund?

I've been unemployed and have paid into the COBRA dental, vision, and healthcare plan of my previous employer, ever since being laid off from that job. I submitted my last COBRA payment on February 1, ...
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1answer
33 views

If a health insurance considers a physician with a given NPI as in-network, does this mean that any physician with the same NPI is also in-network?

If a health insurance plan in the United States considers a physician with a given National Provider Identifier (NPI) in-network, does this mean that any physician billing via the same NPI is also ...
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1answer
65 views

Must Israeli citizens who do not reside in Israel pay for the nationwide Israeli healthcare system?

businessinsider.com claims that: Healthcare in Israel is universal and, by law, all citizens and permanent residents must participate in it. I find this surprising, as typically citizens who do not ...
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1answer
98 views

Can I use my Health Savings Account to pay for medical bills before insurance reimbursement?

This answer establishes that Health Savings Accounts (HSA) can be used to pay for co-payments and deductibles. Suppose that instead footing a co-payment bill with my HSA debit card, I use my HSA to ...
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2answers
39 views

Mass Connector Health Plans and new employment

I'm currently self-employed and I have insurance through Massachusetts Health Connector, which is what the Affordable Care Act is called in Massachusetts. I have a good income level so I don't ...
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1answer
41 views

ACA health insurance: What will happen if my income ends up being way higher than I have on record?

I have a state subsidized health plan through Covered CA (California, US). My income fluctuates quite a bit from year to year, but I always do my best to guess what it will average out to be, and if I'...
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0answers
28 views

What are the options for a French citizen, US-resident to get French medical insurance only applicable to France?

I am French citizen, US-resident and interested to know the option to get French medical insurance only applicable to France. https://www.crystal-finance.com/page/prevoyance-sante-expatrie says: Pour ...
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2answers
47 views

Use HSA to pay for previous medical expenses? [duplicate]

I'll be starting an HSA for the first time on Feb. 1. I have significant medical bills for treatment in December. Can I deposit money into the HSA on Feb. 1 and then use the HSA to pay the bills for ...
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0answers
30 views

Why is the second lowest cost silver plan (SLCSP) premium reported as $0 when no advance premium tax credit (APTC) was taken?

In the instructions for Form 8962 (Premium Tax Credit), it says: If no APTC was paid for your coverage, Form 1095-A, Part III, column B, may be wrong or blank or may report your applicable SLCSP ...
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1answer
45 views

Employee health insurance before vs after tax deduction

The employee insurance I am being offered gives a choice deduction being taken out before or after tax. Which of these choices would result in overall more money saved? Cost of insurance is ~ $60 a ...
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1answer
23 views

Claiming tax deduction on Family Health Insurance covering parents in India

I am going to buy a health insurance policy in India. I am single, salaried and 24 years old. And I want to include my parents(both 50 yrs) too in the health insurance. I have the following queries: ...
6
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1answer
125 views

If you are hospitalized on December 31st and released a few days into the following year, how is the deductible applied?

I was hospitalized on December 31st after a surgery that was done that same day. Now it is looking like I'll be staying in the hospital at least another day or two for recovery into the new year. I'm ...
4
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2answers
127 views

Employer Paid COBRA asking for reimbursement

Due to COVID I loss work. I requested COBRA paperwork filled them out and returned them to my former employer I never received any bill or any request for payment. I never paid anything toward my ...
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1answer
73 views

Insurance product for retirement

I am new in finance. If I want to propose an insurance product for retired people, and I am supposed to take on financial risks in the hope of profit. Can someone give me some informative tips of what ...
3
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2answers
553 views

Who pays after deductible? Coinsurance not listed

Our company switched health care providers and I'm a little confused because the provider doesn't call out "coinsurance". So for example, on this base plan, if I were to meet the $3000 ...
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2answers
255 views

What kind of health insurance does the American public have and how do they benefit from it? [closed]

My question What kind of health insurance does the American public have and how do they benefit from it? I was surprised to read articles about the American health care system; this seems to be ...
2
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1answer
43 views

Owed taxes for discounted health care after pension cash out

Last year in 2019 my Mom signed up for "Obamacare". At the time she signed up, she was under 400% of the poverty limit, which for 1 person was 12,490 x 4 = 49960. Being under this limit ...
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1answer
45 views

Where can I find a definitive list of FSA/HSA qualifying expenses?

I was recently informed that the Coronavirus Aid, Relief, and Economic Security (CARES) Act expanded the list of eligible HSA/FSA expenses to include things such as feminine hygiene products and over ...
4
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2answers
98 views

I started a new job, want to switch my wife to my new insurance. Can I open an HSA if she had an FSA on her previous plan?

I've been searching for a clear-cut answer to this for a while, to no avail. My employer benefits advisor's guidance was unsatisfactory, and my CPA hasn't gotten back to me about it. And so...once ...
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2answers
1k views

Add someone else to employer-sponsored health insurance?

My brother recently started working at the Internal Revenue Service (IRS). He tells me that he can add anyone to the health insurance that covers him. Can he add me to his health insurance? I'm an ...
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4answers
124 views

Does the benefit of a HDHP with an HSA disappear if the premium is the same as a PPO plan

I'm comparing a couple of different health insurance plans as part of open enrollment at work. Based on answers to some other questions as well as my own analysis, high-deductible plans with an HSA ...
12
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3answers
4k views

Can I afford to take this job's high-deductible health care plan?

I don't have the job offer yet, but one of the jobs I'm looking at would offer me only a high-deductible health insurance plan with an HSA (I don't knw what the deductible is exactly yet). However, ...
4
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1answer
173 views

Am I HSA qualified if I am covered on two health plans, one of which is not high deductible?

I am trying to figure out whether I am legally permitted to open an HSA account. Here is the background: I am the primary account holder on a high deductible health care plan which comes with an HSA ...
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2answers
148 views

how to protect from high medical emergency

I see a news item where a Patients is billed $50K+ for air ambulance. Suppose one day a person who does not have future earning potential and gets a heart attack or some other medical emergency and he ...
4
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1answer
280 views

Why would my health insurance provider call me to spontaneously offer a lower rate?

Asking anonymously for privacy. I have had both basic and extended health insurance at company "A", which is now a sub-brand of company "B". Today, I was called by someone ...
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3answers
164 views

Question About Medical Bill Defense

So, I've been researching for a quite a bit and haven't been able to find a case or ruling that relates close to my situation. I went to a sleep specialty physician about four years ago who was ...
5
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2answers
162 views

Does my new insurance plan have to pay for my pre-scheduled surgery (it normally covers this surgery)?

I am 25 and on my parent's plan until I turn 26 on December 25, 2020. It has pre-authorized me for a surgery which is currently scheduled for November 17. However I want to reschedule it to after I ...
5
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1answer
80 views

Wrong Cancellation of Medical Insurance

I enrolled in medical, dental and vision during open enrollment. I saved the summary after I submitted. The summary shows all my elections. Insurance was supposed to start on September 1st. I received ...
4
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1answer
310 views

For medical charges, how much does insurance company pay?

I had a doctor visit with a specialist recently, and my insurance company gave the following explanation of the claim: Service charges: $522 Health Plan Allowed Amount: $157.64 Deductible: $157.64 ...
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2answers
715 views

If you change to a new employer, does dental lifetime maximum reset?

Suppose that you have a lifetime maximum with Provider A at Employer A. You use your $1500 lifetime maximum for major work. Then you get a new job. Then you want to do more major work. You get an ...
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2answers
41 views

COBRA eligibility and plan transfer

United States (NYS specifically) here. I am in somewhat of a unique position. I have a W2 (salaried) job that has full health, dental and vision benefits, and I have lined up another W2 job (full time,...
2
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1answer
50 views

When Would My Medicare Part B Coverage Begin?

I am over 65 and currently have Medicare Part A coverage, and am under my husband's GHP. He is leaving his job on 9/11/2020, at which time I will no longer be insured. If I sign up for Medicare Part B ...
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2answers
70 views

Do doctors get paid by insurance if the patient received services but didn't pay their deductible, co-insurance, etc?

Don't think there is a need for any additional information. Spirit of the question is to understand some details of what doctors have to go through in order for their services to get settled by the ...
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1answer
167 views

After a Divorce, may I use my HSA to Pay Spouse's Medical Bill that Occurred Prior to Divorce

I am recently divorced (in Iowa). My spouse got a large bill in the mail covered by insurance for an emergency room visit. She still owes money even after insurance paid a portion of the bill. I'm not ...
3
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2answers
61 views

Does insurance gap affect pre-existing condition coverage?

I might be unemployed for a few weeks and will lose health insurance during then. I'm trying to figure out what the implications are, in particular, whether I'd have troubles getting pre-existing ...
2
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0answers
74 views

Is it wise to have two health insurance plans?

I have not come across many articles discussing this topic, but I am guessing if it wise to have multiple health insurance plans. For example if there are two top health insurance plans. If I wanted ...
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0answers
15 views

Can I open an HSA if on parents health plan but not a tax dependent?

I plan to remain on my parent's health plan until I am 26. The plan is a HDHP and therefore they are able to contribute to an HSA. I know that while I was still a tax dependent I was unable to open my ...
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0answers
63 views

How do I get my insurance to treat an ambulance charge for a 5150 transfer as “in network”?

My daughter became suicidal and after taking her to our local emergency room she was placed on a 5150 and was subsequently transferred to the nearest inpatient mental health faculty. Our local ...
3
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1answer
81 views

Contributing to medical insurance

We are hiring a nanny and we would like to contribute to her medical insurance, as our understanding is it would be not be taxable (we are in California). Do we need to purchase the whole insurance or ...
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2answers
101 views

Where can I find a highly detailed model for how a normal US health insurance companies sets premiums?

I found this, and it was a great starting point for research but I would like to learn about the nitty-gritty details. For example, obesity is not considered a "pre-existing condition" and is often ...
2
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2answers
39 views

Indian health insurance incurred claims ratio

I was trying to calculate the incurred claims ratio for the New Assurance Assurance Co. (an Indian insurance company) for health insurance from the company's public disclosure information. This seems ...
3
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1answer
40 views

Can ACA subsidy repayment be deducted as medical expenses?

I used ACA in 2018 and received a subsidy based on incorrect information received via phone call with the Health Marketplace regarding what qualified as income. This resulted in me having to payback ...
2
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1answer
63 views

HSA/FSA eligibility and Last Month Rule

Spouse has had an HSA eligible plan but because I had an non-limited FSA throught my employer we had not been able to contribute to the HSA. Last year we decided to get rid of the FSA, the FSA ...
1
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1answer
136 views

Retirement benefits vs. better salary/health insurance

I'm a research scientist and postdoctoral fellow in a US government lab. Currently, my position is funded through a DOE-run organization as an educational/training position. The salary is good for my ...
3
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1answer
67 views

Understanding Indian insurance claim statistics

I'm in India, and I'm currently trying to understand the accounting (i.e. simple arithmetic) of the Public Disclosure information of Indian insurance companies. The context is that I'm trying to ...

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