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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".

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3
votes
1answer
1k views

Can COBRA-premiums be paid for pre-tax?

I have the option to remain on the previous employer's COBRA for the foreseable future. Their plan is much nicer than what my new employer is offering while being only a little more expensive. ...
8
votes
3answers
1k views

What is the purpose of putting funds into an HSA when the interest rate is so low?

I have an HSA through my employer, of which I put a certain percentage of my salary towards. The "goal" of the HSA (as I understand it) is to have a lifetime plan to support your healthcare. Looking ...
147
votes
15answers
32k 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
2k views

Paid every two weeks but health insurance premium is listed as monthly

My husband gets paid every 2 weeks. I would like to know do they divide his health insurance payment between the 2 checks. It says per month on his paper work.
0
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2answers
115 views

Product Pricing & fractional pennies

So I have a product where the price is is determined by multiplying a base price by a factor that increases by age. So depending on how old someone is when they buy the product the price is different. ...
21
votes
3answers
8k views

Is it mandatory to have health insurance?

Is it mandatory to have health insurance? Assuming that I contribute $200 monthly, which for 12 months is costing me around $2400, and don't use the insurance, then having only FSA with a fixed ...
3
votes
4answers
462 views

Why it is recommended to have High Deductible Health Insurance and to have HSA - Max out the pocket?

Why it is recommended to have High Deductible Health Insurance and to have HSA - Max out the pocket? I am not able to understand the benefit of having High Deductible Health Insurance and HSA.
7
votes
1answer
243 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 ...
8
votes
1answer
120 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 ...
4
votes
1answer
139 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 (...
3
votes
0answers
108 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 ...
0
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1answer
243 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 ...
3
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0answers
26 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? (...
2
votes
2answers
344 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)...
6
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4answers
14k views

“$100 Copay before deductible/40% Coinsurance after deductible”

I'm shopping for health insurance. (U.S., federal exchange, I'll be losing COBRA which is a qualifying life event.) One of the plans describes its emergency room costs as: $100 Copay before ...
2
votes
1answer
118 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 ...
15
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2answers
5k 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 ...
3
votes
1answer
100 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....
1
vote
1answer
102 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
126 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 ...
7
votes
1answer
2k 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
102 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
1k 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'...
4
votes
1answer
172 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 ...
2
votes
0answers
44 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 ...
5
votes
1answer
1k 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
109 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
898 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 ...
8
votes
2answers
4k 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 ...
4
votes
1answer
128 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
3k 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
107 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
5k 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?
1
vote
2answers
578 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
97 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
349 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 ...
2
votes
2answers
313 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
449 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
577 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 ...
2
votes
3answers
381 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. ...
17
votes
2answers
13k 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
1answer
93 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 ...
8
votes
3answers
1k 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 ...
5
votes
4answers
298 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
242 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 ...
0
votes
1answer
122 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 ...
1
vote
2answers
467 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 ...
16
votes
3answers
55k views

Can I use an HSA to pay off medical debts incurred before the HSA was funded?

Let's say that in year A I had a medical insurance plan without an associated health savings account, and incurred some medical expenses (co-pays, deductibles). I didn't pay them that year; they may ...
0
votes
2answers
713 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 ...