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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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2answers
480 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
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1answer
614 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 ...
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3answers
392 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. ...
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2answers
14k 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
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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 ...
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3answers
2k 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
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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
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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
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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 ...
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2answers
468 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
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3answers
56k 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
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2answers
791 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
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1answer
114 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
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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
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1answer
75 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 ...
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1answer
2k 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
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1answer
91 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 ...
1
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1answer
261 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 ...
4
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2answers
2k 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 over some ...
5
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1answer
283 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 ...
9
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2answers
728 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 ...
4
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1answer
252 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/...
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1answer
128 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'...
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 ...
3
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1answer
569 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 ...
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2answers
163 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 ...
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1answer
122 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 ...
2
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2answers
354 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 ...
2
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1answer
1k 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 ...
5
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1answer
7k views

Doctor's office won't submit claim to insurance after 5 months

I visited a doctor in August of 2015 that was in-network. They required me to pay for the services up front (in cash, btw). I should have known that was the first red flag, but I needed a prescription ...
4
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1answer
53 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 ...
1
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1answer
54 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 ...
3
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2answers
947 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?
3
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1answer
113 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,...
3
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1answer
663 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 ...
5
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2answers
975 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 ...
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0answers
93 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
2k 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
66 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
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1answer
369 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
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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 ...
10
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2answers
4k views

What if an employer sets up and contributes to an HSA for an ineligible employee - can he withdraw the excess contributions with no penalty?

My son is 21 years old and starting his first job. He is covered under my health insurance, which is a non-HDHP PPO, until he turns 26. (Because I have other children, I wouldn't save any money by ...
2
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1answer
421 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, ...
12
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3answers
17k 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 ...
1
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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 ...
3
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1answer
231 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 ...
1
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1answer
526 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
5answers
416 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
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1answer
146 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
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0answers
63 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 ...