Health Insurance

Why Health Insurance is Important.

September 7, 2015 by Frank West

If you’re a relatively healthy individual, you may find yourself occasionally asking, “Do I even need to have health insurance?” Don’t be foolish though—having health insurance is incredibly important, not to mention it’s the law!

A health emergency can be expensive. A hospital stay in Washington state can costs as much as $3,000 a day!1 Aside from unplanned emergencies, health insurance provides you with a wealth of preventive services that will help you maintain your health and well-being long-term.

Apart from the health aspect, there are also financial implications if you don’t have a health plan.

PENALTIES

Under the Affordable Care Art, most people are now required by law to have health insurance either through their employer, Medicare, Medicaid, or by purchasing their own coverage.

Don’t have any of the above? You could be subjecting yourself to an annual penalty that could cost you nearly as much as buying insurance.

Penalties were relatively low in 2014, but are increasing in 2015 and will continue to go up each year, thereafter.

Penalties are assessed in one of two ways and you will pay whichever is greater of the two amounts:

• 2% of your yearly household income. For example, if you make $50,000 and don’t have a health plan, you would be subject to paying a $794 penalty for 2015 according to a calculator from the Tax Policy Center. The maximum penalty is the national average premium for a bronze plan. In addition to the penalty, you will also be responsible for 100% of your medical bills during the year.

• $325 per adult and $162.50 per child under 18 years of age, with a maximum penalty of $975 per family for the year.

Note: In 2016, it will be 2.5% of your household income or $695 per person with a maximum of $2,085 per family.

If you do end up having to pay a penalty for not having health insurance, you will be required to pay it when you file your federal income tax return. If you’re uninsured for just part of the year, 1/12 of the yearly penalty applies to each month you are uninsured. If you’re uninsured for less than three months, however, you won’t have to pay a penalty.

10 secrets every health insurance company knows.

August 25, 2015 by Frank West

http://www.freep.com/story/life/wellness/2015/08/21/dealing-insurance-companies/32149661/

Filed Under: Health Insurance Tagged With: Health Insurance Exchange

Tardy tax filers at risk of losing health insurance subsidies.

August 25, 2015 by Frank West

http://www.jsonline.com/business/tardy-tax-filers-at-risk-of-losing-health-insurance-subsidies-b99563280z1-322743301.html

Filed Under: Affordable Care Act, Health Care Reform Tagged With: Affordable Care Act, individual mandate

Covered California Has a One-Star Rating on Yelp.

August 4, 2015 by Frank West

Covered California, the Obamacare insurance marketplace in the Golden State, has a one-star review on Yelp, the ratings site which allows individuals to post reviews of local businesses.

The Yelp page for Covered California currently has 208 reviews, 191 of which give it one out of a possible five stars. Only six reviews give the exchange a very positive review of four or five stars. Some of the negative reviews seem to come from people with a generalized opposition to Obamacare. However, many are personal stories by people who have tried to buy insurance and found it difficult.

Laura N. from San Diego writes:

Nightmare!!!!! I have been dealing with trying to straighten out this situation for months. I call once a week, go through long wait times to then be put on hold. I have been cancelled but still have to pay for payments on insurance I don’t even have even after I update information and each phone call they tell me it’s all taken care of. … Each time I talk to someone after waiting forever and on hold they tell me it’s all taken care of and then it’s never done and they have no records of my last calls only that I called for general information. I’m so frustrated and now I owe thousands of dollars and I’ve never seen one doctor.

Kris A. from Encinitas calls Covered CA a “chaotic wasteful mess”:

I have never in my life, so far, experienced this degree of disorganization, ineptitude, and inefficiency. …The fact that we cannot discuss this issue with anyone that can actually fix it is infuriating. All we can do is send letters. It is so ridiculous how much time, energy and money has been wasted in this system. … I hope this new system is changed quickly or gotten rid of completely. Sadly I supported health care reform but reforming something into a chaotic wasteful mess of bureaucracy is not a solution.

Brandon B. from Huntington Beach lost his insurance and says Covered CA is worse than the DMV:

We have spent at least 16 hours on the phone and on hold with reps and supervisors promising they would fix the issue and the billing, but they don’t and they never call back when they say they will. … This is 100 times worse than the DMV, I feel like I’m going insane, we have a baby in the NICU and this has caused my wife untold stress and time and we aren’t even to finish line yet, we may now not even have coverage.

Meesh B. from San Diego was unable to cancel her insurance and said, “I received another bill in November and again in December. After endless hours of hold times I was told that they had ‘no record of my requests to cancel coverage.’ What a surprise. … Shame on you Covered CA!”

Cal Berkeley grad Knot S. had a message for President Obama: “Good idea that has gone HORRIBLY, HORRIBLY, HORRIBLY wrong. … Obama you are alienating those who supported you. Come on I/we deserve better than this.”

Vi C in Huntington Beach has a long story about trying (and failing) to cancel her insurance. She writes in part:

I filed an appeal with covered california- kept a list of notes and reference numbers, dates and exact times i spoke with everyone since Nov. (thank god) i got an email from someone named Matt Forster stating he was handling my appeal and that it had been cancelled. No phone call, no number on his email signature… I called blue shield with a reference number he gave me only to be told the reference number did not exist or go to anything and the never received cancellation. They DID however receive a renewal for a f*****g new policy!!! … 4 months later and i now have 2 insurance policies with blue shield, been sent to collections, received no phone call from covered ca, have non existing appeals rep, and somehow a simple task is taking over my life.

Krista N. from Oakland is so frustrated she has become somewhat sarcastic:

It seems that even the most mundane of tasks is too difficult for the Covered California rep with whom I’m still on hold. He simply cannot find any way to resolve the issue of moving my health insurance start date from October 1, 2014 to November 1, 2014 — a request that was made initially 6 months ago (and repeatedly throughout the intervening months). … It occurs to me, however, as I listen to this synthesized on-hold music on loop for the 73rd time today, that I was foolish to expect a solution to such a complex request. How could anyone expect their normal, human-sized brains to conquer a task of this magnitude? Oh, it is a problem for Einstein or Socrates or Schopenhauer, not for the likes of Covered California!

Jorge from Long Beach is frustrated with the call center:

Negative five stars. Just today I got hung up on twice, with a grand total of 90 minutes waiting time. I wish they would at least hang up on me right away instead of having me wait. Seriously, how long does it take to simply hang up on everyone without even saying anything?

Kelly W. in Brentwood writes:

They have changed the plan that I signed up for, and now it is essentially the same cost but we have $6,000.00 deductibles for each person before the insurance that I am paying $1122.00 a month for pays a dime. … When I first saw it, I thought the deductibles were for catastrophic events. … If one of us ended up needed surgery or cancer treatments or something horrible. … Nope. Man, would I love to be on a commercial talking about how effing horrible this insurance is.

Typhone in Woodland Hills is upset enough to want to see a Republican in the White House, stating, “EVERYTHING ABOUT COVERED CALIFORNIA IS THE WORST!!!!!! … I am a Democrat … and I never thought I would say this. But I hope a Republican takes office and does away with this.”

V W from Palm Springs writes:

I am all in support of the Affordable Care Act. Covered CA is a nice idea but the infrastructure needed to actually provide services to everyone that needs it was not well planned out. Covered CA is INCOMPETENT. Nice and caring people on the phone if you can stand the hour hold times. … Then they can’t help you. …. SUCKS.

Dozens and dozens more stories like these exist. Many of the reviewers say they only wish they could give zero stars instead of one. And the problems with the website and the call center have been ongoing for over a year now. Breitbart News reported last September that nearly two-thirds of callers to the Covered CA call center were simply hanging up. Add to this that Covered CA enrollment, which was praised in 2014, seems to have stalled in 2015, and you have a system that does not seem to be living up to many people’s expectations.

Breitbard June 3, 2105

Filed Under: Health Insurance, Obamacare Tagged With: Obamacare

Can I Change My Health Insurance Plan Outside of Open Enrollment?

August 4, 2015 by Frank West

Question:

When my employer offered open enrollment last year, I enrolled in a high-deductible health plan. I see now that this wasn’t the best plan for my situation and would like to switch to a policy with a lower deductible and higher premium. How can I change plans mid-year?

Answer:

Choosing health insurance is a difficult and often confusing task, so for many people, open enrollment is a time of hand-wringing and guesswork. Unfortunately, you may be stuck with your current plan until the next open enrollment period. But in some cases, you might qualify for what’s known as a “special enrollment period.”

You may qualify for a mid-year policy change.

Your eligibility for special enrollment depends on whether one of the following “qualifying events” have occurred in your life:

Loss of coverage due to:

Divorce or separation
Job loss or reduced hours
Death of spouse who maintained your coverage on their policy
Loss of dependent status
Marriage
Birth or adoption of a child

Some insurance carriers allow for additional qualifying events, such as gaining citizenship. Contact your human resources representative or insurance company to find out if there are additional qualifying events under your policy.

If you experience a qualifying event, you’ll generally have a minimum of 30 days to choose another plan. If you purchased a plan on the ACA or state marketplaces, you’ll have 60 days.

If you don’t qualify, there are other ways to save.

Since qualifying events are uncommon, it may be more helpful to cut down on health care costs to lessen the burden of your deductible. Here are a few ways to save:

Make full use of your HSA.

Because you have a high deductible health plan (HDHP), you qualify for a Health Savings Account (HSA). These are typically offered through your employer and allow you to set aside tax-free money to help cover medical costs — such as that deductible. If your employer doesn’t offer an HSA, you can sign up for one before the next open enrollment period through a bank or investment firm. Most HSA administrators allow you to contribute to the account throughout the year.

You mentioned that you’re willing to pay a higher monthly premium when you get a new plan. Consider setting aside the additional money you’re willing to put toward higher premiums into your HSA until you can switch plans.

Always review your medical bills for errors.

Experts estimate that 80% of medical bills contain errors. If you’re paying out-of-pocket to cover your deductible, these errors could be costing you. Look for errors such as duplicate charges, charges for services you didn’t receive, or charges that are too high for the services you did receive.

Filed Under: Health Care Reform, Health Insurance, HSA Tagged With: Health Savings Account, insurance broker

Medical Insurance Humor.

July 28, 2015 by Frank West

Image result for health insurance jokes cartoons

Filed Under: Health Insurance Tagged With: independent insurance agent

More Insurance Jokes.

July 28, 2015 by Frank West

Image result for health insurance jokes cartoons

Filed Under: Health Insurance Tagged With: Health Insurance Self Employed

Are Health Insurance Premiums Tax-Deductible?

July 22, 2015 by Frank West

You know you can deduct some medical expenses from your federal income taxes, but don’t know the specifics. Here’s a look at what is and isn’t allowed.

Getting sick can be a real pain in the neck, but at least Uncle Sam gives Americans a little bit of relief in the form of federal income-tax deductions for medical expenses.

“Medical bills can be a huge expense, so the Internal Revenue Service gives people a break so they can recoup some of that money,” says Lisa Greene-Lewis, a certified public accountant with TurboTax.

Some 10.2 million U.S. households collectively deducted $85.3 billion of medical expenses on their 2012 federal tax returns, according to the latest available Internal Revenue Service statistics. Many Americans can make similar write-offs from their state income taxes as well.

But who can deduct what is pretty complicated, and experts say few taxpayers really understand the rules.

“I think the biggest misconception is that people think that all medical expenses are deductible from dollar one. But for my clients, I’d say that well under 10 percent actually qualify to deduct anything,” says Rob Seltzer, a Los Angeles certified public accountant and chairman of the California Society of CPAs’ Financial Literary Committee.

Here’s a look at the basics of deducting medical expenses from your federal income taxes. Consult your tax advisor for specifics regarding your personal situation.

Who qualifies for medical-expense deductions?
The Internal Revenue Code includes two big rules that can severely limit who truly qualifies for relief from medical expenses:

You must generally itemize deductions on Form 1040 Schedule A rather than take the “standard deduction” if you want a break on medical expenses. If what you plan to deduct for everything (from medical bills to mortgage interest) adds up to less than the standard deduction ($6,400 for singles and $12,600 for married joint filers in 2015), there’s no point in itemizing.
Most taxpayers can only deduct allowable medical expenses that exceed 10 percent of “adjusted gross income” (AGI). That’s the amount you earn in a given year from wages, investments and other sources minus what you paid for alimony, student-loan interest and a few other things. So, if a married couple has $100,000 AGI and $10,500 of qualified medical expenses, they can deduct only $500 — $10,500 minus $10,000 (10 percent of their $100,000 AGI). Note: In 2015 and 2016, seniors age 65 or older can deduct any medical expenses above 7.5 percent of AGI.

Seltzer says the only taxpayers who pass both tests are typically those with unusually high medical expenses relative to income. That’s often just the elderly, the unemployed, low-income people or those with big medical bills due to serious illness, in-vitro fertilization or a child’s birth.

Are health insurance premiums deductible?
Yes, in certain circumstances, you can deduct your health insurance premiums as part of your overall medical expenses.

But you can deduct only premiums that you pay with after-tax money from your own pocket. For example:

If your health insurance premiums are paid entirely by your employer or the government, you cannot deduct the cost.
If you have health insurance through your employer and your share of the premium is deducted from your paycheck pre-tax, you cannot deduct the cost because the premiums were tax-free already. If you don’t know whether you pay pre-tax or after-tax, ask your human resources department.
If you buy health insurance through the state- or federally run health insurance marketplaces, you can deduct only the portion of the premium you pay out of your own pocket. You cannot deduct the amount of any subsidy.
If you buy an individual or family health insurance plan, either on the open market or through a marketplace, and you pay all of the cost out of pocket, then the whole amount is deductible.

Your total medical expenses, including premiums, must surpass 10 percent of your adjusted gross income to be deductible.

What else is deductible?
Assuming you pass the above tests, the IRS lets you write off pretty much every out-of-pocket medical expense that’s ordered by a doctor or other health care professional. (See IRS Publication 502 for a list.)

Common items you can deduct from taxes include medical appointments, tests, prescription drugs and durable items like wheelchairs and prescription glasses. In fact, you can even write off unusual expenses as long as they’re medically necessary. For instance, one of Seltzer’s clients deducted a home lap pool because a serious injury meant the man could only swim for exercise but couldn’t risk colliding with others in a public pool.

You can also deduct transportation expenses for going to the doctor — parking, tolls, mileage, cab or bus fares — and even air fare and certain lodging costs for out-of-town treatments.

But remember, you can only write off out-of-pocket expenses — copays, deductibles, etc. — not bills that your insurance covers.

What’s not deductible?
There’s a wide list of things you can’t deduct, from medical marijuana to over-the-counter vitamins and drugs (except insulin). Hair transplants and cosmetic surgery are also out, unless procedures correct underlying medical problems (like breast-reconstruction surgery following mastectomies).

As noted above, you also can’t deduct expenses that your insurance covers, nor things you paid for with money from a flexible spending account or health savings account. If you get insurance through work, you typically can’t write off your share of the premiums because your employer won’t normally withhold taxes on the money in the first place.

Writing off health insurance for the self-employed
One big exception to the above rules involves health insurance premiums paid by self-employed people. You can write those off as adjustments to income even if you don’t itemize your deductions. The adjustment to income cannot exceed what you earned, though.

Self-employed people can deduct health insurance premiums directly on Form 1040 (Line 29 on returns for the 2014 tax year). You deduct all other qualified medical expenses on Schedule A, Line 1.

How to maximize your health care deductions
You obviously can’t control when you get sick, but TurboTax’s Greene-Lewis says Americans who are close to meeting the annual AGI threshold should “bunch up” procedures to maximize any deductibility.

For instance, if one family member has a major illness in a given year and rings up big hospital bills, everyone else in the family should get any needed dental work, prescription eyeglasses, etc., during the same year in order to boost the available tax break.

“You should look at anything you were putting off and bump it up [to the current tax year] if that’s going to put you over the AGI threshold,” she says.

You don’t need to attach receipts to your 1040, but it’s a good idea to keep them for three years after filing your return just in case the IRS audits you.

This article original appeared on Insurance.com

Filed Under: Health Insurance, Health Savings Account Tagged With: insurance broker, IRS Tax Penalty

What Types of Insurance Do I Need?

July 9, 2015 by Frank West

When you find a new job and sit down to look at the benefits you may be surprised at the options that are available to you. It may seem overwhelming to consider all of the insurance that you can purchase. Do you really need all of the insurance or can you pass on some of the policies? Is it possible to be over insured? It is also important to check on your insurance to see if you qualify for better rates. Some insurance like home insurance or car insurance is a given> Learn about the other insurance options.

health-insurance-need.jpg - PhotoAlto/Federic Cirou/PhotoAlto Agency RF Collections/Getty Images

1. Do I Need Health Insurance?

Health insurance is something your should have. You run the risk of financial ruin without it. Even if you are relatively healthy, if you are involved in a serious accident or suddenly develop appendicitis, you may end up owing tens of thousands of dollars in medical bills before you are done. If your employer covers you, you should take advantage of that plan, if you are self-employed you may want to consider high deductible health insurance as a money saving option. More »

2. Do I Need Life Insurance?

Life insurance is another benefit that is offered by many employers. Generally employers will offer a basic life insurance policy equal to one year’s salary at no cost to you. You may have the option of purchasing more insurance through your benefits package. If you are single and do not have children, you may be fine relying on just the insurance provided by your employer. However, if you have responsibilities towards a spouse or children you should insure yourself to help them in the event of your death.

3. Do I Need Disability Insurance?

Disability insurance will help to cover you in the event that you are no longer able to work. This insurance will help you to pay your bills and make ends meet while you are coping with an illness or injury. This is generally good insurance to have. Short-term disability will help to cover maternity leaves and fill in the waiting period before disability insurance kicks in.

4. Do I Need Dental Insurance?

Dental insurance can help to pay for your dental checkups and other work that you need done. You need to carefully look over your policy to make sure that your dental benefits are more than the premiums you are paying. If the plan will not save you money, you may want to shop around for a dentist and look for a dental discount card to save on the cost.

5. Do I Need Long Term-Care Insurance?

Long term care insurance will help to pay the cost of care if you end up needing to be in a nursing home or an assisted living facility. Since you are young and in your twenties you may opt to wait on this insurance. A good time to get this insurance is in your late thirties, after that the rates begin to rise rapidly. If you have a condition that makes you think you will need this sooner, you should get it. If you have a family history of certain conditions such as Alzheimer’s you may consider purchasing it earlier to lock in lower premiums.

6. Types of Insurance: Do I Need Cancer Insurance?

Cancer insurance may also be available to you. Unless you have a strong family history of cancer, this is one insurance that you are pretty safe not having. You should make it a priority to save money to cover the extra medical bills that may arise from this or any other serious health problem.

Definition:

Cancer insurance is a benefit that will pay you money if and when you are diagnosed with cancer. The policies vary widely, so it is important to carefully read the policy before you purchase. Some policies will be pay a designated amount once you are diagnosed with cancer. This is to help defray costs such as missed work and out of pocket expenses. Other cancer insurance is supposed to cover the amount that your insurance would not cover.

Many cancer policies are risky because they have so many exclusions and limitations. Additionally your traditional health insurance may decrease the amount it covers as a result of the cancer insurance. You should carefully examine every limitation and benefit before you sign up.

Filed Under: employee benefits, Group Health Benefits, Health Insurance Tagged With: Group Health, insurance broker

Covered California, the Obamacare insurance marketplace in the Golden State, has a one-star review on Yelp, the ratings site which allows individuals to post reviews of local businesses.

Quick Links