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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".

3
votes
0answers
32 views

Health Insurance Deduction - Better to Buy Through S-Corp or Buy Individually?

I have a S-Corp that I can buy myself insurance through. If my monthly coverage costs $380, is it more advantageous for me to purchase this insurance through my S-Corp and then use it as an employee ...
4
votes
1answer
118 views

What can I do with a HSA after I leave a HDHP

I have a HSA which I opened with a previous employer who offered a HDHP. My new employer does not have a HDHP plan. Because I'm no longer an employee with my previous employer, my HSA custodian (...
1
vote
1answer
151 views

Opened HSA that I am not eligle for… How do I get rid of it without getting in trouble?

In order to keep my insurance coverage through my husband's employer I was forced to sign up for my employer's High Deductible Health Plan. My employer knew I was keeping my other coverage but told ...
3
votes
0answers
83 views

Health Insurance: Why use the iterative calculation method?

Context Self-employed Bought health insurance through a health insurance marketplace All premiums for the entire year were "specified" (nothing "unspecified") Need to calculate the the amount of ...
8
votes
1answer
118 views

Should I purchase health insurance directly, or through my LLC?

I am currently in the market for health insurance and have an LLC with myself as the sole employee. I would like to know the advantages vs the disadvantages to purchasing through my business. Also how ...
0
votes
1answer
193 views

Taxes and health insurance: Find SLCSP (second lowest cost silver plan) before 1095As are issued

To do 2017 end-of-year tax planning, I need to know the second lowest cost silver plan (SLCP) for my Colorado zip code. I've tried searching my health insurer's site, the state marketplace site, and ...
2
votes
0answers
20 views

If I am eligible for employer sponsored insurance which doesn't offer coverage in my state, can I still get an APTC on the exchange?

Normally if an employer offers "affordable" coverage that meets minimum standards, employees eligible to participate no longer qualify for an Advance Premium Tax Credit, even if they want to turn down ...
1
vote
2answers
89 views

Do I need an HSA in order to purchase an HSA health plan?

I live in New Jersey and am buying insurance through the healthcare.gov marketplace. Some of the plans are marked 'HSA'. Can I purchase these plans even if I don't have a health savings account? (...
3
votes
2answers
285 views

Why would anyone choose this PPO over PPO HSA?

The health insurance plan below has the following fees for an employee only coverage (excluding spouse + children plans to keep it simple): PPO 250: $605/mo ($7260/yr) PPO 2250 HSA: $351/mo ($4212/yr)...
2
votes
1answer
113 views

If I have a high-deductible health plan, is there any reason not to take HRA?

From Wikipedia entry for HRA: "a type of US employer-funded health benefit plan that reimburses employees for out-of-pocket medical expenses" (bold is mine). It sounds too good to be true, but does ...
3
votes
1answer
87 views

For the purposes of Obamacare, what really counts as income?

So, I need to raise my income slightly to hit the minimum income for the Obamacare premium tax credit. Do any of these count for income? I sell broken cell phones I bought off eBay (fixed, of course....
15
votes
2answers
4k views

Do birth defects in children count as pre-existing conditions?

My family is shopping for new insurance at the moment. We reside in the United States, Georgia specifically. We have had insurance continuously since she was born. My daughter, born in 2011, was born ...
1
vote
1answer
95 views

Transferred money to HSA but need it back

I transferred money from my checking to my HSA and now I realize I need it back but not for medical expenses. I usually do direct deposits but I needed some of that money for medical because my ...
1
vote
2answers
124 views

Can I deduct the cost of an out-of-pocket medical visit on my taxes?

Say I visit a specialist -- like an orthodontist -- without any insurance. I pay for everything out-of-pocket -- no insurance/deductibles/payment sharing plans/etc. I pay several thousands for the ...
4
votes
1answer
938 views

Is accident insurance worth it for my kids who play sports

I'm evaluating options at my job for insurance and an optional insurance offering is accident insurance. I'm looking at this for my kids who play sports in school and on club teams. It's $170 a year....
1
vote
0answers
94 views

Are group health insurance premiums cheaper than individual health insurance premiums?

I am self-employed and have one employee. I am a health 35 year old, with healthy wife, and 1 child. My employee is a 30 year old, also healthy. Would group health insurance rates premiums be ...
3
votes
2answers
861 views

Can I keep my HSA if I get on husband's insurance?

My husband and I recently got married and are wondering what to do about health insurance. I am currently with a company that offers a plan with the option to put funds in an HSA or FSA. My husband'...
2
votes
0answers
43 views

Why do HDHPs have a maximum out of pocket? [duplicate]

I understand minimum deductibles (to ensure HSAs are only used with cheaper plans) but why the maximum out of pocket? It is worth noting it is different form the general maximum out of pocket of ...
3
votes
1answer
120 views

Should I pick a company paid premium or company paid deductible health insurance plan?

I am switching companies in a month. Here is my current health insurance and here are my two options for when I switch (Note that I have a wife and infant child): Current: Shared premiums at $310 ...
5
votes
1answer
958 views

HSA/FSA, changing health plans mid year, concurrent coverage

My family is on the HDHP offered by my employer which has both an HSA and an LPFSA. The plan is on a calendar year (Jan 1 - Dec 31). We want to move to the plan offered by my wife's employer which not ...
3
votes
2answers
108 views

HSA - do I have to contribute to my account?

I am on my employer provided HDHP with an HSA and have been for 4 years. I have only contributed to my HSA account for a few months last year. I never go to doctors. Our new H/R person is now ...
5
votes
1answer
763 views

How to Dispute a Medical Bill that Went to Collections

I had a 2-hour ER visit for a biking accident at an out-of-network location in 2014, and provided the insurance information at check-in. Four months later the hospital and the doctors (charging ...
4
votes
1answer
126 views

Health insurance at 18

I turned 18 a few weeks ago and live in Florida. I live with my mother, and I've been waiting for years for her to get insurance, but never does. As it is, we are a low-income family. I've had ...
2
votes
1answer
2k views

EOB says I owe $4500 but provider says I do not

So I have this weird situation where I went to the dentist for a root canal and they filed a claim for my insurance. Now, on the EOB they've charged an excessive amount of money ($1500 for xrays) and ...
2
votes
1answer
101 views

Health insurance premium tax deduction if I'm a W2 with an employer who offers no insurance?

I'm currently self-employed as an LLC (USA) with a sole proprietor tax structure. I have private health insurance and I enjoy the tax deduction for my premiums. However, I have an opportunity come ...
0
votes
2answers
3k views

Do I still have to pay a copay after the out-of-pocket maximum is met? [duplicate]

Once the out-of-pocket maximum is met, do I still have to pay for co-pays for regular doctor appointments?
24
votes
3answers
4k views

Health insurance coverage canceled due to mistake. Can it be corrected?

My medical insurance coverage through my spouse's employer was terminated because my spouse mistakenly checked the wrong box during the annual open enrollment. I've been on my husband's insurance ...
1
vote
2answers
497 views

Opening an HSA mid-year: how much can I contribute to it?

I opened an HSA account in the United States during the year: what's my maximum contribution? Is it the annual maximum (i.e., 3400 USD in 2017), or should I prorate (e.g., if I started at the ...
0
votes
1answer
79 views

Marketplace insurance won't process claims for terminated policy

I seeking help for issues I have with a health care policy I subscribed thru the New York State Marketplace. I lost my job on April 15 (job policy end date was April 30) so I started looking for a ...
1
vote
1answer
340 views

compromise between 100% insurance and no insurance? (long term view)

Assume you can get private health insurance for different premiums, and they cover any directly health related costs (hospital stay, needed medicines, physiotherapy etc.) up to a maximum amount. It is ...
7
votes
1answer
235 views

Health insurance for homeless woman?

I'm trying to help a homeless woman in Saint Louis, Missouri get health insurance but do not know where to start? She has no income and no money at all but needs health insurance. This woman has not ...
2
votes
2answers
256 views

Is there a difference between “Coinsurance” and “Coinsurance after deductible”?

I'm looking at plans on the coveredCA site, and I see both terms used. However, my understanding is that coinsurance only kicks in after the deductible has been paid anyways, so "coinsurance after ...
1
vote
2answers
197 views

Who is supposed to do the preauthorization for an MRI in the USA?

Who is supposed to do the preauthorization for an MRI in the USA? Is it the responsibility of: the physician who prescribed the MRI the medical center where the MRI is performed the patient, who ...
2
votes
1answer
365 views

HSA penalty with Medicare part A

I just retired from my job at age 65 effective 3/31/17. I was contributing to an HSA up until 3/31/17. SSA says I will be penalized if I start taking my Social Security benefits now because SSA will ...
17
votes
2answers
11k views

Should there be a copay after “out-of-pocket maximum”

I have individual health insurance and have met my out-of-pocket maximum due to a surgery earlier this year. I saw my (in-network) PCP this week and was still charged the regular $30 copay. Should ...
3
votes
3answers
327 views

When should both spouses get benefits from their jobs?

My wife and I get medical, dental, and vision benefits through her job. Generally we've been pretty satisfied with them. Now for the first time, my job is offering health, dental, and vision as well. ...
6
votes
4answers
283 views

Does this very cheap traveller insurance make any sense?

A local railway company partners with an insurance company and offers insurance policies as paid addition to railway tickets. A random monthly salary in this region is an equivalent of seven hundred ...
2
votes
0answers
49 views

Can I enroll in health insurance out of enrollment period (USA) if I didn't realize I had become a US resident for tax purposes?

Context: US non-residents don’t have to have health insurance, and are not fined. I became a US resident alien for tax purposes in Jan 2017 (automatically triggered based on the time I’d spent in the ...
0
votes
1answer
82 views

How likely is it for my Medicaid plan to approve a Prior Authorization?

I just enrolled in Medicaid, specifically the UnitedHealthCare Community Plan in New Jersey. Now most of the medications I'm currently taking are included in the Preferred Drug List, but there are a ...
0
votes
2answers
404 views

Does my Medicaid plan cover medicines and tests prescribed by out-of-network doctors?

I just enrolled in Medicaid, specifically the UnitedHealthCare Community Plan in New Jersey. Now most of my existing doctors are part of the network of this plan, but there's one doctor who I really ...
3
votes
1answer
95 views

Do providers usually negotiate fees with insurance companies to incentivize the use of insurance?

My question is specifically about dental insurance, and I believe this is the right place to ask about it. If not, I would apologize. I'm a student of an university whose dental clinic I frequent. I ...
8
votes
2answers
2k views

Can I take the self employment healthcare deduction if I get my insurance through my employer?

Historically when I had insurance through ACA, I deducted the premiums on the special self employment premiums deduction. Now, I get insurance through my employer but still pay a ton for it. Is that ...
2
votes
1answer
70 views

Can I use foreign health insurance for US taxes?

I am a US citizen living abroad, and I have government-provided health insurance (that is, provided by the government of the country I live in). Does this qualify as health insurance for the purposes ...
3
votes
1answer
91 views

Health insurance for months not in the US?

I was in the US from 2010 - July, 2016, and had health insurance all the time. In August, 2016, I moved back to my home country for good - but technically I still count as a resident alien for 2016 in ...
4
votes
1answer
87 views

Health insurance deductible for self-employed equal to employer tax deduction?

As I understand it, premiums for employer heath plans are taken out of costs so they are inherently tax free. In other words they are not consider "income" for the employee. For a self-employed ...
140
votes
15answers
29k views

For very high-net worth individuals, does it make sense to not have insurance?

Various types of insurance (health, car, life) protect you from relatively low probability but very expensive events in life (cancer, serious car accident, etc.) For the average person, it makes sense ...
1
vote
1answer
210 views

could having two dental plans increase my annual limit?

I have one dental insurance policy with an annual limit of $2,000. Unfortunately, I'm looking ~$4,000 of dental expenses coming up (due to a bunch of years of neglect on my teeth), which would leave ...
6
votes
1answer
270 views

I spend more on healthcare than my HSA can cover right now. How to handle reimbursements?

My partner just changed jobs to an employer that only offers a high deductible health plan. This is not an ideal situation for our finances as we both have chronic health conditions, his being high ...
5
votes
1answer
208 views

US - paying medical insurance premiums from HSA? (while on disability leave)

My wife has been carrying our health insurance for about two years. She is on disability leave for the foreseeable future. Her employer continues to pay the employer portion of the medical/dental/...
3
votes
0answers
194 views

How does Medicaid compare with private insurance on Healthcare.gov?

How Obamacare works is that if your income is sufficiently low, then you can get Medicaid. And if your income is too high to be eligible for Medicaid, then you'll get a Premium Tax Credit (aka the ...