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| Health Insurance |
INTRODUCTION
In the United States, the term "health insurance" is commonly used for all programs that contribute to the payment of medical expenses, climate insurance, private insurance, or government-funded uninsured social security programs. Synonyms for this use are "health insurance," "health insurance," "sickness benefit," and "health insurance." Technically, the term is used to describe any form of insurance that protects against injury or illness.
In the United States, health insurance has multiplied in recent decades. In the 1970s, most health insurance had compensation insurance. Compensation insurance is often referred to as a service fee. This is traditional health insurance where the service provider (usually a doctor or hospital) receives a fee for each service provided to the patient to whom the policy applies. Consumer-directed medical care (CDHC) is an essential category in the context of compensation plans. Consumer-oriented health plans enable individuals and families to control better their medical care, including when and how they have access to care, the types of care they receive, and how much they spend on health services.
However, these plans involve higher deductibles that the insured must pay out of pocket before claiming insurance. Consumer health plans include health reimbursement plans (HRAs), flexible spending accounts (FSAs), big franchise health plans (HDHps), and medical savings accounts (Archer Medical Savings Accounts, MSA). ) and Health Accounts (HSA). Of these, the health savings accounts are the youngest and have increased in the last decade.
WHAT IS A HEALTH ACCOUNT?
A Health Savings Account (HSA) is a medical savings account that offers US taxpayers tax benefits. Credit balances on the account are not subject to federal income tax at the time of deposit. These can be used at any time to pay eligible medical expenses without any obligation to pay federal tax.
Another feature is that the funds in the health account are transferred and accumulated year after year if they are not spent. These can be recalled tax-free by employees at the time of retirement. Payments for eligible expenditure and interest are also not subject to federal income tax. According to the US Treasury. UU. A sickness benefit account is an alternative to traditional health insurance; It is a savings product that offers consumers another way to pay for their medical care.
HSAs allow you to pay for ongoing healthcare costs and save on qualified tax-exempt retirees for future medical expenses. As a result, the Health Savings Account seeks to increase the efficiency of the US healthcare system and encourage people to be more responsible and responsive to their health needs. It falls into the category of consumer-centered health care plans.
Origin of the health account
The health account was established following the US Congress passed the Medicare Prescription Drug Improvement and Modernization Act. UU. Signed in June 2003 by the Senate on July 2003 and on December 8, 2003, by President Bush.
Eligibility -
The following persons are authorized to open a health account:
- Persons covered by a high-deductible health insurance plan (HDHP).
- Persons who are not covered by other health insurance.
- Those who are not enrolled in Medicare4.
Also, there is no income restriction for individuals who can contribute to a HAS, and there is no need to have earned income to add to a HAS. However, anyone who relies on someone else's tax return can not tell HAS. Also, children can not independently set up HSA.
What is a high deductible health plan (HDHP)?
Registration with a high deductible health plan (HDHP) is a necessary condition for opening a health insurance account. The HDHP has been boosted by the Medicare Modernization Act that introduced the HSA. A high deductible health plan is a health plan with a specific deductible. This limit must be exceeded before the insured person can claim the insurance money. It does not cover the medical costs of the first dollar. Therefore, a person must pay the initial costs, which are referred to as pocket costs.
In several HDPS, the cost of vaccination and preventive care is excluded from the franchise, which means that the person receives a refund for these expenses. HDHP can be consumed by both individuals (self-employed and workers) and employers. In 2008, insurance companies in the US offered the HDHP program with deductibles ranging from at least $ 1,100 to personal and family insurance. The maximum payout limit for HDHP is $ 5,600 for self-employed and $ 11,200 for individuals and families. These deductible limits are called IRS limits set by the Internal Revenue Service (IRS). For HDHP, the ratio between deductibles and the premium paid by the insured is inversely proportional, ie, a higher deductible, a lower premium, and vice versa. The key benefits of HDHP are a) Reduce health care costs by raising patient cost awareness. b) they will make insurance premiums more affordable for persons without insurance. The logic is that patients who are fully insured (ie, have low-deductible health insurance plans) tend to be less health-conscious and also less-expensive if they are assured they are being treated.
Open a health account.
A person can register with HSA at banks, credit unions, insurance companies, and other licensed companies. However, not all insurance companies offer health insurance approved by the HSA. It is, therefore, essential to hire an insurance company that provides this type of insurance. The employer can also draw up a plan for the employees. The account remains the property of the individual. Online HSA-approved health insurance registration is available in all states except Hawaii, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, Vermont, and Washington.
Contributions to the health account
Contributions to HSAs may be made by an account holder, an employer, or another person. The gift is not included in the income of the employee at the instigation of the employer. If done by an employee, this is considered tax-free. For 2008, the maximum amount that can be added (and deducted) to an HSA from all sources is:
2,900 USD (individual insurance)
5,800 USD (Family Insurance)
These limits are set by law in the US Congress and are linked annually to inflation. For people over 55, there is a special provision that allows them to pay an additional $ 800 for 2008 and $ 900 for 2009. The actual maximum amount a person can pay also depends on the number of months covered. For an HDHP (pro-rata) from the first day of the month. For example, if you no longer receive HDHP coverage from January 1 through June 30, 2008, you will receive an HSA contribution of $ 6 / $ 12 to $ 5,800, or $ 2,900 for the year 2008. If you book from January 1, 2008, through to You may have a HSA contribution of 6/12 x $ 5,800 plus 6 if you have an HDHP Family Insurance from June 30, 2008, and independent HDHP insurance from July 1, 2008, to December 31, 2008, On the first day she can contribute to the HSA on the first day of the month. However, if he opens an account on a day other than the beginning, you can make a contribution to HSA from next month. Submissions can be submitted by April 15 of the following year. The individual or subject must collect donations to the HSA that exceed the contribution thresholds to an individual tax. The person has to pay the excess income tax.
employer contributions
The employer can do this under a salary reduction plan called § 125. This plan is also referred to as a cafeteria plan. Contributions within the Mensaplan are made before taxes; that is, they are excluded from the employee's income. The employer must pay the participation similarly. Comparable contributions are employer contributions to all HSAs equal to 1) the same amount or 2) the same percentage of the annual deductible. However, part-time workers working less than 30 hours per week can be treated separately. The employer can also classify workers into two categories: those who choose to cover their insurance and those who want to protect themselves. The employer may automatically pay contributions to the HSAs on behalf of the employee unless the employee expressly decides not to receive such gifts from the employer.
HSA withdrawals
The HSA belongs to the employee, and he can make qualified expenditure as needed. He/she will also decide on the amount of his or her contribution, the amount of its eligible cost, the company that will hold the account, and the type of investment required to grow the account. Another feature is that the funds remain in the report and work from year to year. There are no rules for use or loss. HSA participants do not need to obtain the prior approval of their administrator or health insurer to withdraw money. Funds are not subject to income tax when used for "eligible medical expenses." Eligible medical expenses include the cost of services and items covered by the health insurance plan but subject to shared expenses such as deductibles and co-insurance, as well as many other costs not covered by medical procedures, such as: For example, dental expenses. , ophthalmic, and others. Chiropractors pay attention to durable medical devices such as glasses and hearing aids. And transport costs associated with medical care. Over-the-counter medicines are also approved. However, eligible medical expenses must be incurred from the establishment of the HSA.
Free HSA distributions may be used to cover the medical expenses of the person insured by HDHP, the spouse (even if uninsured) of the person and other dependent persons (even if this is not the case) 12) The HSA account may also be used for payment eligible expenditure from the previous year, provided that such cost was incurred after the establishment of the HSA. The person must keep receipts for expenses covered by the HSA as it may be required to prove that withdrawals have been made by the HSA for eligible medical expenses and have not been otherwise used. Also, the person may be required to provide receipts to the insurance company to prove that the retention limit has been reached. If a withdrawal is due to certain medical expenses, the withdrawn amount is considered as taxable (plus the income of the person) and is subject to an additional 10% excellent. Usually, health insurance premiums can not be paid with money. Under certain circumstances, however, exceptions are allowed.
These are -
1) to cover the health insurance plan, while the federal or state governments provide unemployment benefit.
2) Continuation of post-employment COBRA protection at a health insurance company.
3) Qualified long-term care insurance.
4) Medicare premiums and reimbursable costs, including deductibles, back payments and co-insurances for Part A (Hospital and Hospital Services), Part B (Medical and Outpatient Services), Part C (Medicare HMO Plans) and PPO) and Part D (prescription drugs).
If a person dies or is disabled or reaches the age of 65, withdrawals from the sickness benefit account are considered as income-tax-exempt and regardless of the amount as an additional 10% fine the purpose for which these withdrawals are made. There are several ways to differentiate from HSAs. Some HSA accounts provide account holders with debit cards, other checks, and other options for a reimbursement process similar to health insurance.
Growth of HSA
Since the establishment of health savings accounts in January 2004, their numbers have grown phenomenally. From around 1 million members in March 2005, the number increased to 6.1 million in January 2008.14 This represents an increase of 1.6 million since January 2007, 2.9 million This growth was visible in all segments, but that of large and small groups was much higher than that of the individual category. According to the projections of the US Treasury Department. In the US, the number of HSA subscribers will increase to 14 million in 2010. These 14 million contracts will cover 25 to 30 million US citizens.
HSA / HDHP, which was purchased in January 2008, covered 1.5 million people in the single market. Depending on the number of covered lives, 27% of the recently concluded individual contracts (defined as the contracts concluded last month or last quarter) are included in HSA / HDHP coverage. In the small group market, the number of registrations in January 2008 was 1.8 million. In this group, 31% of all new listings belonged to the HSA / HDHP category. The largest group category registered the most registrations in January 2008 with 2.8 million members. In this category, 6% of all new listings belonged to the class HSA / HDHP.
HSA benefits
Lawyers at HSA offer several benefits. First, it is assumed that the insured person is more concerned about his or her health due to the high deductible threshold. You will also be more aware of the costs. A high deductible encourages people to pay more attention to their health and medical expenses, to do good business and to be more vigilant against the excesses of the health sector. This should reduce the rising costs of medical care and increase the efficiency of the US healthcare system. Eligible HSA plans generally provide tools for decision-making by affiliates, some of which include information about health care costs and the quality of healthcare providers. Experts suggest that reliable information about the value of some healthcare services and the quality of some healthcare providers would help members to be more active in health care purchasing decisions. Health insurance companies may provide these tools to all members of health plans, but they are likely to be more relevant to members of HSA eligible plans which are more financially motivated to make informed health insurance plan decisions. health. Quality and cost of service providers and health services.
Lower premiums associated with HSA / HDHP are expected to allow more people to take out health insurance. This means that low-income groups that do not have access to Medicare can open the HSA. There is no doubt that higher deductibles are associated with HDHP, which are eligible for HSA, but it is estimated that the tax savings achieved by HSA and the lower premiums make them cheaper than other insurance plans. Amounts paid into the HSA can be transferred from one year to the next. There are no rules for use or loss. This leads to an increase in the savings of the account holder. At the owner's request, funds may be collected tax-free for future medical expenses. Also, the savings made in the HSA can be increased through investment.
The insured decides on the nature of these investments. Interest income in the HSA is also income tax exempt. The holder may deduct his savings after the age of 65 from the HSA without paying any fees or fines. The Account Holder has full control of his account. He/she is the owner of the report since its inception. If necessary, a person can withdraw money without the carrier. Also, the owner decides how much money should be paid into his account, how much money should be spent and how much money should be saved for the future. HSAs are inherently portable. This means that the owner can keep the account if he changes his job, becomes unemployed, or moves out.
If the account holder so wishes, he may also transfer his sickness benefit account from one administrative organization to another. Therefore, portability is an advantage of HSAs. Another advantage is that most HSA plans provide primary coverage for the provision. This applies to virtually all HSA plans offered by large employers and more than 95% of the plans offered by small employers. This was also the case for more than half (59%) of plans purchased by individuals.
All plans that provide primary preventive care included annual medical examinations, vaccinations, healthy baby and childcare, mammograms, and Pap tests. 90% included screening for prostate cancer and 80% screening for colorectal cancer. Some analysts believe that HSAs are more beneficial for young people and healthy people because they do not have to pay recurring fees. On the other hand, they have to pay lower premiums for HDHPs to help them cope with unexpected events.
Health accounts are also suitable for employers. The benefits of choosing a sick leave account instead of a traditional health plan can directly affect the outcome of an employer's benefit budget. For example, health care accounts rely on high deductible, which lowers the employee's premiums. Also, all contributions to the hospital balance are pre-tax, which reduces the gross salary and the taxes payable by the employer.
Criticism of the HSA
Opponents of sick pay accounts claim to do more harm than good to US health insurance. Others believe that HSAs remove healthy people from the insurance group and increase premiums for those who stay. HSAs encourage people to be more self-aware and less risk-averse. Another problem is that the money people save for HSA is not enough. Some people think that HSAs do not save enough to cover the costs. Even the person who contributes the most and never collects money would not be able to cover the cost of retired healthcare if inflation in the health sector persists.
Opponents of the HSA also include figures such as the insurance commissioner John Garamendi, who has described them as a "dangerous prescription" that destabilizes the health insurance market and worsens the situation of people without insurance. Those who earn more can receive higher tax exemptions than those who earn less. Critics point out that higher deductibles and insurance premiums will take up much of the benefits of low-income groups. Also, low-income groups do not benefit from substantial tax exemptions because they already pay little or no tax. On the other hand, tax exemptions for HSA savings and the additional revenues generated by these savings in the HSA cost billions of dollars in cash taxes.
The Treasury estimated that HSAs would cost the government $ 156 billion for a decade. Critics say this could increase dramatically. Several surveys on the effectiveness of HSAs have revealed that account holders are not particularly satisfied with the HSA system and many are unaware of how HSAs work. A 2007 survey of recruitment firm Towers Perrin among US staff found that satisfaction with account-based health plans is low. People were generally unhappy with people with more traditional medical care. Respondents said they were not familiar with the risk and did not understand how it worked.
According to the Commonwealth Fund, initial experience with qualified, high-quality health care plans eligible for HAS is low satisfaction, high direct costs, and cost-related access issues. Another survey, conducted with the Employee Benefits Research Institute, found that people enrolled in HSA eligible, highly deductible health insurance were much less satisfied with many aspects of their health care than adults in more comprehensive health insurance. The beneficiaries of these plans receive significant income for their health care, especially for those with poorer health or lower income. The survey also found that adults in high-deductible health plans are much more likely to delay or avoid necessary care or omission of medication because of the cost. The problems are particularly pronounced in people with poor health or low income.
The political leaders have also criticized the HSA. Congressman John Conyers Jr. made the following statement criticizing the HSA: "The president's health insurance plan should not cover the uninsured, make the health insurance affordable, or even reduce the cost of medical care, ease work, Relieving workers from health insurance, granting tax exemptions to the rich and increasing profits for banks and financial agents. Interest-based promotions Promotions do not help the average American in many ways - in many cases, they can make medical care even more inaccessible. "Indeed, a report from the Accountability Authority of the U.S. government. UU., Published on April 1, 2008, states that the SAH school-leaving rate is higher for high-income individuals than for low-income individuals.
a) HSA-eligible health insurance premiums may be lower than traditional insurance premiums, but these plans translate more of the financial risks into higher deductibles on individuals and families.
b) Health insurance premiums and expenses assessed by the HSA would occupy a significant portion of the budget of a low-income family.
c) The majority of low-income individuals and families are not faced with a sufficiently high tax liability to benefit significantly from tax deductions related to HSAs.
d) People with chronic illnesses, disabilities, and other high-need medical needs can be faced with even higher additional costs through HSA-qualified health insurance.
(e) Cost-sharing reduces the use of healthcare, mainly primary and preventive services, and low-income and ill people are particularly vulnerable to greater cost-sharing.
f) Healthcare accounts and high deductible plans are unlikely to increase health insurance coverage for uninsured persons significantly.
Choose a health plan.
Despite the benefits HSA offers, it may not be suitable for everyone. When choosing an insurance plan, a person should consider the following factors:
1. To pay premiums.
2. Cover/benefits are available under the program.
3. Various exclusions and limitations.
4. Portability.
5. Personal expenses such as coinsurance, copays, and franchises.
6. Access to doctors, hospitals, and other providers.
7. How much and sometimes how you pay for the care.
8. Existing health problems or physical disabilities.
9. Type of available tax savings.
The plan you choose must meet your needs and your financial capacity.
LITERATURE
1 / Health Insurance Questions and Answers: A Consumer Guide published jointly by the Agency for Health Research and Health Quality (AHRQ) and the United States Health Insurance Plans (AHIP)
2/2002 AHIP overview of health insurances
3 / "How high is it? Impact of health plans with high deductibles" Davis, Karen; Michelle Doty and Alice Ho. Commonwealth Fund, April 2005
4 / CENSO HSA / HDHP 2008 by Hannah Yoo, Center for Policy and Research, US Health Insurance Plans
6 / Thomas Wilder and Hannah Yoo, "Health Insurance Plans (HSA) Survey, July 2007", US Health Insurance Plans, November 2007.
7 / Gladwell, Malcolm, "The Myth of Moral Danger," The New Yorker (29.08.2005)
8/2008 Basic survey on the HAS Bank
9/2007 Annual study on health care benefits, Kaiser Family Foundation
10 / Health Accounts and High Deductible Health Insurance: Are They an Option for Low-Income Families? Catherine Hoffman and Jennifer Tolbert for the Kaiser Family Foundation, October 2006
11 / Medicare Prescription, Improvement and Modernization Act, 2003
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