Health Insurance Articles

One unique as well as interesting feature of an HSA is that the money in the HSA account can be  invested in similar ways to how money in an IRA account can be invested.  The same kinds of rules and restrictions apply to HSAs in regards to investing money as well as deferring taxes on earnings.

• All earnings on investments in an HSA account are non-taxable for as long as the money stays in the account or is withdrawn for the purpose of paying medical expenses.
• If earnings are withdrawn for non-medical purposes, and the owner is under the age of 65, then taxes will have to be paid on the withdrawals.
• Because contributions to an HSA are made with pre-tax dollars, it gives you the ability to reduce your income taxes.

Combining an HSA with a HDHP also gives the account owner the ability to use funds in the HSA account to pay for their annual health insurance deductible and to pay for medical expenses that their policy doesn’t cover.

There are limits to the amounts to the amounts you can contribute to HSAs in one year.  The limit for individuals is $2,850 and for a family it is $5,650.

An HSA has more extensive coverage for medical expenses than most conventional health care plans.  The coverage may include the following:

• Preventative health care visits
• Physical therapy, including chiropractor visits
• Mental therapy, including psychiatry, psychotherapy and psychology
• Dental treatment
• Maternity expenses
• Prescription and nonprescription drugs
• Alternative health care for procedures like acupuncture and homeopathy
• Travel and accommodation expenses that relate to health care

HSAs are potentially a great option for individuals and families who want to have a high degree of flexibility in their health care that they can manage on their own without being required to visit network health care providers or complete lots of paperwork.

The ability for owners over the age of 65 to use the funds in the account for both medical as well as non-medical purposes means that an HSA, unlike many other types of health insurance plans, can benefit practically anyone, including individuals that have medical expenses on a continual basis as well as healthy individuals that do not have a lot of ongoing costs.

HMOs, or Health Maintenance Organizations, are entities that provide insurance for a large group of people.  Employer groups are the most common group and most people who have HMO health insurance obtained it from their employer.  HMOs usually offer the most commonly used and most well known of the managed care plans that are available in the US.

HMO plans, like many other forms of health insurance, are prepaid.  Policy holders pay a monthly fee, which covers all their medical expenses.  However this is with the provision that the user’s visits for health care are made to health care providers and specialists that are part of the HMO’s preferred providers (or network) list.  The HMO insurance does not pay for visits to non-network providers.

Most HMO plans require users to choose a primary care doctor from the network’s list of doctors.  The primary care doctor is basically equivalent to a family doctor.  You have the ability to see your primary doctor whenever you need to at no charge.  If you are in need of a specialist, you will need a referral from your primary care doctor to a specialist that is part of your HMO network.

It is important that you understand that the costs of any visits to a doctor or specialist that does not participate in your HMO network will not be covered by your HMO insurance.  In addition, if you see a specialist without getting a referral first from your primary doctor, then your specialist visits will probably not be covered by your HMO insurance either.

Typically, HMO plans cover either all or some of the following.  Not all HMO plans include prescription and emergency services.

• Primary care doctor visits
• Specialist visits, provided your primary care doctor gives you a referral ahead of time.
• Diagnostic laboratory services that have been referred by your primary care doctor
• Prescriptions
• Hospital service
• Emergency services (some HMO plans will cover network and non-network providers for emergency services)

Most HMO plans do not cover what are considered alternative treatments like acupuncture, homeopathy and aromatherapy.  Routine dental work and elective cosmetic surgery are generally not covered either.  However, coverage varies with HMO plans, so it is important that you understand what your HMO plan covers and what it does not.

HMOs generally only offer insurance to employer groups and not to families and individuals.  The biggest advantage of HMO plans is their low cost.  HMO plans are usually the least expensive form of health insurance available.  This is due to the fact that HMOs deal with a large volume of health care professionals and customers.

An HMO insurance plan may be a viable option for a family or individual who doesn’t have a lot of specialized medical needs.  If someone in your family needs to visit non-network specialists on a frequent basis, then an HMO plan would not be a good type of health insurance for your family to obtain.

All health insurance providers have underwriting criteria, whether it is a for profit organization or not.

One of the major factors effecting your health insurance is your age.  In general, the older you are the better the chances are that you will get sick or will need some form of medical treatment.  Because of this, the older you are the more expensive your insurance premiums will be.

Many people with concerns about health insurance are not just worried about themselves but their family as well.  Some insurance companies rate their premiums based on family size.  Other insurance companies have a basic family rate they charge no matter what the size of the family is.

In terms of life insurance, women tend to  pay lower rates than men do.  For health insurance, women’s premiums are generally higher.  This is due to the fact that health insurance statistics indicate that females have a tendency to need more medical care than males.

Your health history also plays a significant role in determining the cost of your health insurance premium.  Insurance operates on the basis of many statistical probabilities.  If your health has been poor in the past that means that you are more likely statistically to have higher health insurance expenses into the future, which results in either having to pay higher insurance premiums or not being able to obtain insurance at all.

Your occupation is also an important factor when it comes to health insurance.  The higher the probability is that you will suffer a work related illness or injury, the more likely you will be charged a higher premium to cover these risks.

Your health insurance application will also ask you questions regarding personal habits such as drinking and smoking.  If you are a heavy smoker or drinker, your premiums are going to be higher than someone who isn’t.

You need to be aware of certain provisions in insurance contracts.  Insurance policy exclusions remove certain procedures and other types of health care from coverage.  It is critical that you understand all the exclusions contained in your policy.

One common exclusion is preexisting conditions.  These are often defined as symptoms that a prudent person would seek diagnosis, care or treatment for in a five year period, or a condition where a physician either gave a recommendation or provided care for.

Many health insurance policies exclude coverage or injuries or illnesses that are caused by narcotic or other types of controlled substance abuse that was not prescribed by a doctor.

Some policies have an exclusion of benefits for emotional and mental illnesses that do not have a bodily cause.  Other policies may provide some limited benefits for certain items sch as psychotherapy.  It is important that you understand all the details of your health insurance policy, particularly if there is a possibility that you or a member of your family may need the services of a psychologist, psychiatrist or other form of mental health professional.

If your illness or injury qualifies for workers  compensation benefits, your own insurance will most likely exclude paying any of these medical bills.