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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".

4
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1answer
2k views

Former Employer lied on 2016 1095-C form

I was laid off work on March 5th 2015 and was provided insurance up until March 20th 2015 and then offered Cobra. My husband had a new job and his insurance started as of June 1st and we had no issues ...
0
votes
1answer
114 views

Should a Low Income College Student Buy Insurance Through the Obamacare Marketplace?

I am an American college student. For 2016, I've made around $8,000 working. My parents, who are not American, and thus live and work overseas have been paying my rent which when I add the money they'...
1
vote
1answer
1k views

FSA Limits after switching employer, employer has non-calendar benefits year

I have recently left a job in mid January where I had signed up for an FSA in the previous election period. At the end of January I also enrolled in an FSA. I found out that at my new company, the ...
3
votes
2answers
153 views

How can I make sure that I don't pay a copay that is more expensive than over-the-counter when buying drugs in the United States?

I read this comment written by Dilip Sarwate: It sometimes depends on the circumstances. If your doctor tells you to take one 81mg tablet of aspirin as a countermeasure against future heart ...
3
votes
1answer
68 views

Affordable Care Act subsidy effect on taxes after Income Gains

Suppose an individual signed up with an insurance plan from the ACA between January to August of 2016 with an estimated income level of $23K annually that qualified this person for a subsidy. In ...
13
votes
3answers
5k views

Do health insurances never cover over-the-counter drugs in the United States?

My insurance told me that: As the [drug name] is available over the counter, it is not covered by your health insurance. This would be an out of pocket expense for you. Do health insurances never ...
3
votes
2answers
338 views

Is the co-pay the same regardless of where the drug is purchased in the United States?

In the United States, with a given US-based health insurance and for a given prescription drug, is the co-pay the same regardless of where the drug is purchased? In other words, I have insurance X ...
3
votes
1answer
842 views

Does a CDHP plan count as an HDHP plan?

I have a CDHP health insurance plan that comes with an Health Savings Account. As I'm filing my taxes, Turbotax has informed me that my HSA is being additionally taxed because I do not have HDHP ...
1
vote
0answers
114 views

Is there a public formula or algorithm for out-of-pocket healthcare cost?

Essentially, what I'm looking for is a simulation of out-of-pocket cost as a function of a health insurance plan and an arbitrary sequence of medical events -- in other words, a computational model of ...
8
votes
1answer
198 views

Switch from HSA/Limited FSA to FSA only

In 2016 I had a High Deductible Health Plan/HSA and a Limited FSA through my employer. For 2017 during our open enrollment I decided to not use a HDHP, and chose a PPO Plan. In addition, I selected a ...
4
votes
1answer
47 views

Getting medications before Covered California coverage begins?

I have a friend who takes several medications for mental health. She lost her health insurance coverage in December but signed up for a healthcare plan through Covered California during open ...
3
votes
2answers
762 views

Is it too late to file a health insurance claim (for last year)?

My primary insurance was with Aetna and that ended Dec 31, 2016. I have bills from Dec 15,2016 That were not filed...it is too late to file them?
1
vote
2answers
398 views

How does the Affordable Care Act (ACA, aka Obamacare) work?

For people purchasing insurance over the exchanges are the savings factored into the cost that they'd be paying already or are they tax credits? ie. if you have a $1,000 USD plan and was going to ...
3
votes
1answer
102 views

Personal health insurance vs. Employees group insurance

I am having a dilemma on what action I should take with regards to my insurance plans. I am working for a company which provides employee group insurance (group plan) as my employee's benefit. However,...
5
votes
2answers
953 views

What does it mean to “get health insurance to avoid a tax penalty”?

I am in NYC. I received an advertising mail from Healthfirst. On its envelope, it says: Urgent: Get health insurance for 2017 now to avoid a tax penalty. What does it mean, and why? In 2016, I ...
1
vote
0answers
87 views

When to take inherited IRA to save taxes given low income year with Marketplace premium tax credit?

Summary: Taking a $12k distribution from an (inherited) IRA this year has a nice 10% income tax rate, but effectively additional 14% "tax" due to Healthcare Marketplace (not advanced) premium tax ...
1
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2answers
1k views

Why do healthcare providers charge patients much more than the amount covered by the insurance in the United States? [closed]

Why do healthcare providers charge patients much more than the amount covered by the insurance? If the amount covered by the insurance takes into account the amount of money healthcare providers ...
1
vote
1answer
63 views

Can I buy dependents their own health care plans?

I'm shopping for health care plans in the US. I'm young and don't have any history of illness. I would be fine with a "bronze" plan. I would want my wife and child to be on a "gold" plan, however. ...
1
vote
1answer
269 views

What's the difference between Aetna payflex and a regular health savings account

I'm currently enrolled in payflex has which doesn't roll over and constantly asks me for eobs to prove that my expenses are tax deductible. My mom told me that you can open up a HSA with your bank. ...
6
votes
1answer
2k views

How does the Spousal Surcharge generally work?

We are on my wife's health insurance policy. I have access to the insurance policy from my employer; however, for the past few years wife's policy was much better. This year wife's policy introduced a ...
3
votes
1answer
241 views

How should beneficiaries be chosen for accidental death & dismemberment insurance, given that I may or may not be alive when it is paid out?

I am signing up for accidental death & dismemberment insurance through my employer, but I'm a bit confused as to how to handle the beneficiaries for this. I have to choose the same beneficiaries, ...
1
vote
1answer
1k views

HSA contribution max for unmarried dual family coverage under HDHPs

Suppose two unmarried individuals each have independent family coverage HDHPs that provide coverage for both individuals. Irrelevant, but for simplicity, assume this family coverage is free of charge ...
4
votes
1answer
228 views

Do expenditures covered by copay assistance still count towards out-of-pocket maximums?

If I am on an expensive drug (say a biological specialty drug for Rheumatoid Arthritis or Multiple Sclerosis) and the maker of the drug gives me a copay card, does the cost of the copay for the drug ...
4
votes
1answer
529 views

HSA Employer Excess Contribution: W2 vs Other Income?

Form 8889 instructions state that excess employer contributions should be included in income on Form W-2. (Box 1 I assume?) If this is not done, instructions state that excess employer contributions ...
1
vote
1answer
366 views

Is a “personal health visit” a trap? [closed]

My health insurance company has sent me a letter telling me that they will give me a Visa gift card to go to a "personal health visit" at a pharmacy. They will: review your health history and ...
4
votes
1answer
453 views

How is employer HSA excess contribution taxed?

My previous employer made an excess contribution to my HSA account. They are not particularly interested in assisting me, so it looks like I will have to correct this myself if anyhow possible. If I ...
5
votes
5answers
379 views

Why is company provided health insurance tax free, but individual health insurance is not?

Why is company provided health insurance tax free, but individual health insurance is not? I do not understand the rationale for making health care contributions by companies non-taxable, but if an ...
0
votes
1answer
105 views

Why is HMO's requirement for a referral considered a draw back?

A major difference between HMO and PPO plan is that HMO requires a primary physician's referral before one goes to see a specialist. In practice, how big of a drawback is this? It does take one extra ...
1
vote
0answers
61 views

options for Healthcare and benefits for recently graduated PhD who is short-term unemployed?

I recently (2015) graduated from a PhD program in a very employable science/engineering major from a top three university in the United States. Due to some health and motivational issues (ones that ...
5
votes
3answers
307 views

Does the rise in ACA premiums affect employer-provided health insurance premiums?

So I hear a lot about rising premiums and that the ACA is the leading cause. Recently I heard that the majority of people still get their health insurance through their employer. Is there merit that ...
3
votes
2answers
159 views

Can doctors be selective in submitting claims to insurance company?

I was charged a fee for a service upfront stating insurance do not cover this service, but turns out it was not true, insurance company covers it. I called the doctor's office asking them to submit ...
4
votes
1answer
1k views

Made big mistake with my health insurance plan; can it be changed?

Recently, my company changed its health insurance providers or something like that. Basically, the company that we would be receiving our health insurance through changed. At this point as I sit ...
9
votes
2answers
711 views

Are there any benefits of FMLA beyond preserving your job?

I'm not positive this is the right forum for this, but it regards personal finance and company benefits, so it seems to fit, if not, please recommend another SO site that's more appropriate. I'm ...
1
vote
1answer
90 views

Is there any limit for Employer contributions in the Health Care Plan?

the contributions of the employer for the Health care plan is 100% or it is combination of both the employee and employer. what is the percentage? and the contributions of the employee is taxable or ...
2
votes
3answers
118 views

Affordable Care Act claim limits by plan tier [closed]

How often can an individual covered under each of the Bronze, Silver, Gold, and Platinum tier plans claim coverage benefits, and what are the coverage limits?
4
votes
1answer
199 views

Do high premium health plans make sense for those self-employed AND subject to the AMT?

As you may have guessed, I am self-employed and subject to the AMT. When evaluating health insurance plans for my family, I chose a high premium/low deductible plan so that I could take advantage of ...
2
votes
2answers
636 views

Am I formally insured during the COBRA election period if I ultimately choose not to elect coverage?

I have recently quit my job to freelance and I am now in a position where my old health insurance ends on 8/31, but my new health insurance can only begin as soon as 10/01. However, until 10/31, I can ...
2
votes
2answers
68 views

USA Health Insurance for Senior

I am US Citizen. A valid greencard holder lives with me. She immigrated to USA. I work and cover my family, not her (my mother in law). She is sweet lady and senior citizen, in relatively good health....
3
votes
3answers
272 views

Was this bill forgotten by a medical provider, and do notices need to be sent before collections?

6+ months ago I attended this physical therapy place for 4, 1 hour visits that were billed at 600$ each. I realized they were out-of-network and switched places. Checking my records I realized I paid ...
1
vote
1answer
50 views

Secondary medical insurance for aliens

I am an alien in the US and recently I had a change of employer. The medical insurance provided by my current employer is not so great. I want to cover off the expenses and the deductibles not ...
0
votes
1answer
73 views

Do Affordable Care Act business requirements apply to “control groups?”

The Affordable Care Act (a/k/a Obamacare) imposes certain requirements, restrictions and obligations on business entities. For example, businesses that employ over 50 full time workers must ... etc. ...
7
votes
3answers
1k views

Why do HSA qualifying plans have a max deductible?

In order to be eligible to make tax deductible contributions to an HSA account, you must have a qualifying HDHP (High deductible health plan). Among the requirements, is a deductible and max OOP ...
3
votes
1answer
76 views

Can I apply for a subsidized health insurance plan when I lose my job?

Up till now I've been paying for my own insurance as my employer did not offer it. I was paying $500 / Month which was not ideal but manageable while I was working ( my employer did not cover me ). I ...
3
votes
2answers
214 views

Canadian moved to US - Hospital charges for ER / ICU visit

Pretty new to US - came down from Canada recently. So, not used to the medical/insurance system here since everything is free up in Canada! My daughter had to go to ER a few weeks ago (in ambulance), ...
3
votes
1answer
503 views

Can an employer refuse to remove a spouse who recently acquired their own health insurance coverage?

My spouse recently took a new position with benefits. Where I have been providing benefits through my employer I contacted them and ask to remove my spouse. At first, they said not a qualifying ...
1
vote
1answer
243 views

Pre tax and and after tax on dental and eye vision insurance

If anyone can help me I would really appreciate it. In my Pay stubs I realize i get tax pre tax and post tax on both my dental and vision insurance? why is that? why do they take it out twice?
3
votes
2answers
67 views

Question regarding insurance in US

I was an international student and my insurance was covered by my university. I only need to pay the copay to see a doctor and everything will be covered. I am now working. My company is a big ...
3
votes
2answers
6k views

If I voluntarily change employers, can I keep my health insurance through COBRA?

I just accepted a new position at a different company. Awesome! But, I just had surgery (nothing too major) and hit the deductible on my HDHP. I'd like to keep my health insurance right now, since I ...
1
vote
1answer
61 views

Correcting HSA contribution due to transfer of children's HDHP

I contributed the max ($6,750 for family in 2016). Now a court has ordered that my ex-wife take over health insurance for the kids, so my HDHP will cover only me, making my contribution max $3,350 for ...
1
vote
1answer
86 views

Auto insurance medical expense payments

My auto insurance offers an option for 'Medical Expense Payments' which says it: Pays medical expenses such as surgery, x-rays, ambulance, and physicians, regardless of who was at fault. I ...