Friday, January 27, 2012

Can Medicare Supplement Insurance Plan Premiums Be Standardized?

Every year, approximately 10 million seniors supplement their Medicare Parts A and B with a Medigap plan. The goal is to handle all of the health care expenses left out of traditional Medicare coverage. Many of these beneficiaries don't even realize that they are paying too much for their Medigap plan, though.

One of the biggest problems faced by those who hope to buy a Medicare Supplement Insurance plan is the variability of premiums as set by insurance companies. Although the benefits of Medigap plans are standardized, insurance companies can sell a plan for whatever price they can get. It's let the buyer beware, and only educated buyers find the best value for their money.

According to a report from the independent rating agency Weiss Ratings, millions of seniors are having trouble shifting through a barrage of plans coming at them from various insurance companies. Here's why.

Even for beneficiaries of the same age and living in the same city, one specific plan, such as Medigap Plan C, can be selling for very different premiums with absolutely no difference in the benefits. Prices can vary by as much as 1,300 percent among plans sold across the nation and here's why.

State regulators allow insurers to price Medigap plans based on the insurance company's expenses and medical costs. If you get Medigap Plan F, for example, you can pay as low as $3,654 or as high as $5,419. There's no difference in coverage, but someone is getting it for almost $2,000 less a year than someone else is.

You Can Get Medigap Plans Without Becoming A Mark

One of the best ways to protect yourself and your money, is to compare prices from several leading insurers before you apply. Talking to an agent who works for every insurance company selling Medicare Supplement plans where you live could take a while, but there is a shortcut. Online websites offer free use of their quote systems. But, using the Internet is not your only option. These websites typically offer free personal assistance as well.

Another thing you want to clear about exactly what each specific type of Medigap Insurance covers. Plan A has the fewest benefits and Plan F has the most comprehensive coverage. The other plans offer a range of choices and combine benefits in various ways. Some plans reimburse for 50, 75 or 100 percent of Medicare's biggest deductible. That's the Part A deductible on hospitalization. It's up to $1,132 and Congress declares how much it will be each year.

While that's a pretty hefty deductible, it's not even an annual cost. The Part A deductible resets after you've been released from a hospital or skilled nursing facility for 60 days. If you need inpatient care again in the same year, Medicare will require you to spend enough to meet the Part A deductible again.

It's important to remember that open enrollment events mean no health questions will be asked. That's another key to keeping your premium costs low. If you shop outside of open enrollment and the insurer is concerned about your health issues, you may be asked to pay higher premiums than healthier people. When you're first eligible for Medicare, you'll have open enrollment, and some insurers offer special open enrollment periods at other times, too.

Wednesday, January 25, 2012

Have You Ever Wondered the Best Questions to Ask Concerning Prescription Plans?

Have you ever found the experience of understanding prescription benefit plans intimidating? Ever found out the hard way a prescription was not covered, or needed a prior authorization, or had quantity limitations before it could be filled? I know I have, and a basic list of questions would have relieved frustration, time wasted waiting for approvals, improved efficiency, and given me a better understanding of how my plan worked before going to the pharmacy.

A basic list of best questions to ask my Prescription Benefit Management Provider would have been ideal at the beginning of my plan year so I could have asked ahead of time and been forewarned, and forearmed before trying to fill my prescriptions. Prescription benefit plans can be independently obtained, or can be part of your employee benefits. Locating who is your Prescription Benefit Management Provider and any materials provided when your benefit year begins will give you the phone numbers to contact your benefit provider.

If you answered yes to any of the above questions, then I have good news! Now there is a list of questions you can ask your Prescription Benefit Management Provider when understanding your prescription benefit plans. This list of questions will develop a better understanding of how your benefits work, and how to make them work the best for you.

Here are just a few questions you will find:
1. Are there any refill limitations on maintenance medications for my plan?
2. Am I required to do mail order on maintenance medications, or can I continue to fill at the local retail pharmacy?
3. Is there any cost savings when filling prescriptions through mail order versus retail?

Understanding your prescription benefit plan helps you make your plan work the best for you. Knowing what limitations apply, and if further action needs to be taken with you and your doctor with prior authorizations or appeals processes can drastically reduce frustration, time, and money. No one likes to pay full price out of pocket for medication if there is any way it can be covered by your insurance. Basic questions can help cover major points to your prescription benefit plan, and while discovering this information, it may lead to more specific information provided by your Prescription Benefit Management Provider. Knowing the correct information for your Doctor's office or pharmacy to submit for prescriptions and claims can reduce time spent waiting for prescriptions.

Here are some helpful Hints:

When calling for refills, call before the weekend in case the pharmacy needs to contact your physician for additional refills. This way if you only have a few days of medication left, it will provide time if there is a problem with limitations or refills so you are not without medication, or finding yourself paying full price for it.

Also check the Internet for a manufacturers' coupon on the medication, it could help save you more money at retail if you have to pay more than you normally would.

Thursday, January 19, 2012

Health Insurance - How to Get the Benefits You Need

Why do people laugh when they hear the words Affordable Health Plan?

Is it because they believe there's no such thing?

Is there really such thing as an Affordable Health Plan or is it all smoke and mirrors? Yes there is and I am going to share with you how you can have an Affordable Health Plan!

Insurance companies are one of the top 3 richest businesses in North America. There is a reason for that. All you need to do is ask somebody who's paid hundreds of dollars a month for a health care plan what their experience was like and you'll understand why it is that insurance companies make so much money. They'll tell you how so many of their prescription costs were not covered, only certain brand medications were claimable and others were not. Or how they're only allowed 60 or 70% of the cost for some paramedical service and 80% of the user fee for others. Or, Sorry you have reached your limit. Are you confused yet? How about the common phrase, "Sorry, that's not covered." Yes that is the story of trying to claim medical and dental costs through an insurance provider.

So what's the alternative? Business owners do have an alternative in Canada. Under our income tax act a Private Health Insurance Plan is an option for Canadian business owners. This is an opportunity for a company to own and administer their own health plan. Home Based Businesses in Canada can really leverage this option.

How does this create an affordable health plan?

When you own and administer your own health plan you get to set the limits. Through the plan contract you decide the level of healthcare benefits for yourself and for your employees. Because there is no middleman there are no premiums to pay. In a Corporation you can set tears or levels of benefits. Upper management has a much higher pay level and much more responsibility, which allows you to also give them higher benefit levels. Proprietorship can create a plan and have it administered through a company like Gumboot Business Services. They also get to set their limits.

How does a private health insurance plan work?

Your medical and dental expenses become a business expense. You bring in your receipts and reimburse yourself through your company. When your employees bring in a medical expense receipts you simply reimburse them. If there are no expense receipts submitted, there are no costs. And because you set the limit in the health care plan you set exactly what each employee can expense and what your budget is going to be for the year.

A simple tracking system will allow you to keep track of exactly what each member of your family and employee has spent. This ensures that nobody goes over their limit, and keeps your numbers accurate for your year and income tax filing.

The other wonderful bonus with a private health insurance plan is medical and dental expenses paid for by a company to its employees are tax-free to the employee. No CPP, no EI for either of you and no income tax for the employee.

Can A Home Based Business Owner set up a Private Health Insurance Plan?

If you are a corporation, it's easy. The way the legislation is written, you need an employee. As a worker in your corporation, you are the employee and that is all you need. If you are a proprietorship, you need an employee. Who is working in your business with you? Is your spouse or one of your older children doing web design or something that supports your business?

What about your personal health and dental costs?

As an employee of your own company, yes you can write all of your family's health and dental costs off through your business. This is what really makes an affordable health plan. You're already paying out money for you and your family's health and dental costs, now you can move those personal costs into your business as business expenses. That makes your personal medical and dental costs 100% tax-deductible.

Are there exceptions? What are the exemptions?

There is a difference between corporations and proprietorships. The biggest reason for this is that a proprietorship cannot have a contract with themselves. A proprietorship requires a separate company to administer the private health insurance plan. Because a corporation is an entity unto itself, it has the ability to have a contract with its employees. The other difference is a corporation can set tiers for different levels of employees. A proprietorship has to match the owners benefit level to the employees.

How do I find out more about Private Health Insurance Plans?

Gumboot Business Services will walk you through what is needed. We will look at your company structure to help you see if you are eligible and how much money you can save through owning your own health plan. Come visit our site and take advantage of the free 20-minute consultation.

Medicare Choices for 2012 After Annual Enrollment

Congress is constantly changing programs funded with our tax dollars and Medicare is no exception. Last year the significant annual enrollment dates for Medicare recipients were changed to October 15th through December 7th. During that time, your government allowed you to change from one Medicare Advantage plan to another; join Original Medicare plan and a Part D plan for the first time; or, choose a Medicare Supplement Plan and a Part D plan. All of the changes were effective on January 1st.

Now that the Annual Enrollment dates are history, your health plan choices are limited, but not eliminated. From January 1st to February 14th, your government allows you to drop your Medicare Advantage Plan, if you are dissatisfied with it, and return to Original Medicare and choose a Part D plan or join a Five Star Medicare Advantage Plan if you have one in your area. Five Star Medicare Advantage plans are few and far between, but if you do have one in your area, you have until November 30, 2012 to join one.

Keep in mind that if you dis-enroll from your Medicare Advantage plan after January 1st and you are beyond your six month window, you may have to meet the medical underwriting requirements of your chosen Medicare Supplement company. The Medicare Supplement policies help pay some of the health care costs that Medicare doesn't cover. You have a six month Open Enrollment Period which starts the first month you're 65 and enrolled in Part B. You have a guaranteed right, during this block of time, to buy any Medicare Supplement policy available in your state regardless of your health condition. However, once this period begins, it can't be delayed or replaced.

If you are turning 65 and aging into Medicare, you have a seven-month (three-months before your birthday month, your birthday month, and three months after your birthday month) to enroll in Medicare Part A and Part B without leaving yourself vulnerable to a penalty. If you are disabled, you can join Medicare three months before or three months after your 25th Month of disability.

Although January 1st has passed, you still have some options, but you need to consider them very carefully with your health condition being front and center. If you are beyond the six month Open Enrollment Period and have significant health problems, it may be better to have a minimally acceptable health plan then no health plan at all. Under these conditions, you should stay in your current plan until the next Annual Enrollment Period begins. However, if you have a Five Star Plan in your area, go for it.

Monday, January 16, 2012

Advantages of Obtaining Various Life Insurance Quotes

The Life insurance is important in every single approach of life. Acquiring insurance coverage not only makes sure that your family will be looked after upon your demise, it will also procure you immeasurable reassurance at present. It is not just important to purchase life insurance policies, it is actually important to purchase a proper policy, the one that meets your preferences as well.

Most effective way of getting insurance quotes

Buying insurance is a personal affair, since we do it to meet our long term goals and to ensure the financial future for our families. Provided that every single individual has various financial wants and well being complaints, the life insurance policies too really need to gratify to these specific personal factors. The lone way you could get a policy, which is just best to you could be by obtaining numerous insurance quotes and comparing them.

Nonetheless, if this presents you psychological pictures of bustling into a lot of insurance corporations, and sizing up their gives then you may unwind. Currently, almost all the insurance firms have online presence. They provide you with hundreds of insurance quotes. Consequently due to this entirely automated approach, any of the life insurance policies could match with your demands.

Shopping about could take months for research, but with the internet, it will basically take just a few minutes and only a fraction of hard work. Internet could be the ideal way to acquire life insurance quotes.

Main advantages of finding about several insurance quotes

Obtaining many insurance quotes has several benefits. A regional agent normally offers four carriers, and taking into account the fact that a well-intentioned agent too acquires commissions for marketing policies of particular carriers, the agent is never going to market other carriers' policies to you, regardless of your requirements. Certainly, there is a tremendous factor of bias involved. Evaluating different life insurance quotes help you to discover the one that fits you the most and offers you an effective price tag. Thus, you could get more security on your rates only by evaluating various quotes.

Insurance quotes vary from corporation to corporation, depending upon their insuring strategy. There are several companies that glimpse upon elements of health and fitness extra favorably than few others. Moreover, underwriting pointers are typically adjusted, and is truly difficult to keep track of them on your own. By observing numerous quotes, which is possible with the help of internet quote suppliers having massive database.

The insurance is a competitive business and so, in an effort to remaining ahead, some companies offer totally free riders in conjunction with their life insurance quotes. Acquiring multiple quotes could keep you informed about these providers and give you the benefit of such free riders like incidental loss of the life rider, extended expression treatment rider, waiver in rates, and many others, which could enhance your coverage.

Whenever you look on the web for multiple quotes, the agency sites also offer you finish money information and comparison graphs within the businesses connected to several quotes. This enables you to make an intelligent choice. Few companies also offer cell phone or face-to-face consultations at this point, to help you decide much better.

Australians Should Compare Health Insurance Policies for Pre-Existing Condition Coverage

Understanding your health insurance options can be confusing to begin with. If you or someone you love suffers from a pre-existing condition - that is an illness or condition that began within six months of acquiring health coverage - it becomes even more complicated. Determining whether your medical treatments are covered by your existing insurer can be just as intimidating as finding yourself insurance plans in anticipation of needing medical treatment. The sense of confusion and fear is often compounded by the stress endured from the medical condition itself.

There are online websites in Australia that can help you understand your rights when it comes to health insurance coverage, so you can compare coverage options and make a decision that suits your medical needs, and your budget.

A growing number of Australians suffer from chronic health problems, including heart disease and diabetes. A deficient diet, combined with a sedentary lifestyle are primary culprits in some of today's most common health problems. In addition to the challenges and risks of living with a chronic illness, many people who do not already have health coverage face the daunting prospect of what the cost of adding private insurance to their household budget will mean.

It is important to first examine the different types of insurance coverage available so you can move forward armed with the knowledge you will need to make intelligent comparisons of different policies offered by different insurers. Private health insurance often covers most medical treatment costs. Unfortunately, fewer and fewer Australians are able to afford private coverage, and for anyone suffering from a chronic illness, the idea of having no medical insurance can be downright frightening. Medicare is an alternative for those who do not have private coverage, however it may not be enough to pay all the medical expenses necessary to treat certain conditions.

In the past, insurers could refuse coverage to people with pre-existing conditions. However, legislation passed in 2007 halted the insurance companies' ability to refuse coverage for any pre-existing condition, making private health insurance available to anyone who needs it. However, when you compare insurance premiums, you could discover that a pre-existing medical condition increases the cost of the policy, and that a waiting period before treatments are covered may be required.

For many, private health insurance is simply unaffordable once the pre-existing condition rates are factored in. Insurance companies are not making much of a profit, if any, on these policies, and prefer to work with healthy individuals who are less likely to use their health care benefits very often. When a pre-existing condition factors into your health insurance coverage, you have no choice but to compare policies carefully to determine which insurer has the best coverage for your treatment needs, and your budget. find valuable information on comparing providers, and answers questions on difficult health-related subjects, including pre-existing conditions.

There are few things in life more challenging than dealing with chronic illness. Making tough decisions should not have to include worrying about which insurer can offer the best health coverage at the best rate. Find out more about your options and your rights when it comes to comprehensive health care by visiting online insurance comparison sites and examining your options.

Saturday, January 14, 2012

What Is The Personal Information That HIPAA Protects?

The personal information of patients is protected and safeguarded by the various rules and regulations of the Health Insurance Portability and Accountability Act (HIPAA) that was enacted as a federal law in 1996. HIPAA ensures that all confidential medical information of patients is secure and safe. The patients will be able to decide on the accessibility of medical records and this gives them a great deal of control over how and when their medical records can be accessed and transmitted.

If the confidential information of patients is to be used for any other purpose other than treatment then patients or their relatives or representatives will need to give proper authorization in this regard. This permission to access medical records will not be required if it is used for treatment purposes.

Whenever a patient visits a health care provider for the first time they would be provided with a notice of privacy that needs to be signed by the patient. This form is to enable the patient become aware of the various provisions of the Health Insurance Portability and Accountability Act.

HIPAA helps in protecting any kind of patient information whether it is stored electronically or in physical form. The safeguards that need to be enforced in both cases is similar as the intention is to prevent any misuse.

What Are The Various Types Of Patient Information That Is Protected By HIPAA

The most basic patient information that needs to be safeguarded is name of the patient and their address. This information can be used to identify the patient easily.

Apart from this age, phone, fax number and email address is also provided by patients and they would also need to be protected as per the provisions of HIPAA.

There should also be adequate safeguards for medical records of past and present along with test results, X rays, scan reports and other relevant reports would also need to be protected.

Billing records and insurance claims made are to be protected as per the guidelines specified by the Health Insurance Portability and Accountability Act.

The covered entities usually authorize certain employees to access the confidential medical records of patient and no one else is allowed to access them. This is done for the purpose of preventing any misuse of such information for commercial purposes. Authorization to access the protected information of patients will not be required by federal and state agencies. Apart from this they can also be accessed without permission on the orders of the court or to solve a crime.

There are usually very stringent provisions for violating the guidelines of the Health Insurance Portability and Accountability Act. The penalties for the violation can be fine or imprisonment depending on the extent of the violation. The violations can be civil or criminal in nature.

The best way to avoid any sort of violation would be by creating awareness about the various rules and regulations of the Health Insurance Portability and Accountability Act. This can be done by organizing training programs using the online medium or through classroom sessions.

What Are The Top 6 Issues In HIPAA Security Compliance?

The Health Insurance Portability and Accountability Act (HIPAA) that was passed as a federal law in 1996 has some stringent penalties for non compliance and it is important that all covered entities are aware about them. This will ensure that all the rules and regulations of HIPAA are complied by them and this will help prevent violations.

Top 6 Issues Of HIPAA Security Compliance

As most covered entities start storing medical records electronically, it would be advisable to use passwords and encryption programs to help protect them from unauthorized access. There should also be risk assessment done by the organizations to help determine any loopholes that are there in the policies that will help safeguard the confidential information of patients.

There should be checks and counter checks in place that will help the covered entities safeguard all information of patients in the best possible way. This will help only authorized individuals access all the necessary information of patients and unauthorized access can be completely eliminated.

All employees of covered entities will need to be provided with adequate training. This will help them know all the rules and regulations of the Health Insurance Portability and Accountability Act. There are also frequent amendments and changes that are made to HIPAA and employees will need to be aware about them too. It is usually the responsibility of the employer to provide these amendments to the employee to ensure better compliance.

There are some very stringent provisions of the Health Insurance Portability and Accountability Act for non compliance of the Act. The penalties can be civil or criminal and depending on the nature and extent of the violation the penalties can be fine or imprisonment. While the civil violations attract fines starting from $100 and this can go up to a million dollars annually. The criminal violations will attract fines and imprisonment. The imprisonment period can be two to five years if the violation was intentional.

The covered entities will need to have internal audit checks to determine whether all the provisions of the Health Insurance Portability and Accountability Act are followed in an effective way. The audits should also be on a continuous basis and this will help in determining if employees who are entrusted with the responsibility of handling confidential information of patients are able to comply with all the requirements of HIPAA.

Although all protected information of patients cannot be accessed without proper authorization by the patients there are some instances when it can be accessed as per HIPAA. These exemptions are usually available to federal and state agencies. The confidential information can also be accessed if there is a court order in this regard.

Apart from the exemptions that are specified by the Health Insurance Portability and Accountability Act, protected information of patients cannot be accessed by anyone other than the physicians and nurses who form part of the treatment plan. The patient can request for a copy of their medical report and changes can also be made to it if it is found to be wrong.

Thursday, January 12, 2012

HSA Qualified Expenses - 53 Items To Maximize Your HSA Deductions

HSA Qualified Expenses - 53 Items To Maximize Your HSA Deductions

Using a HSA (Health Savings Account) with your federally qualified HDHP (High Deductible Health Plan) is a great way to provide health insurance to you and your family. Since the federal government has provided HSA's a tax advantaged status, it is important to know what expenses are allowed (and what is not allowed) so you don't get in trouble with the IRS.

Review the list below and make use of every HSA Qualified Expense you are eligible for. You may be surprised at some of the items on the list, because the government does allow for some medical expenses that are typically excluded from traditional health insurance plans.

What are HSA Qualified Expenses?

The government basically says that an expense incurred for the diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body is allowable. This includes payments for legal medical services rendered by physicians, dentists, and other medical practitioners. You can also include costs of equipment, supplies, and diagnostic devices needed for the above mentioned items. However, medical expenses must be primarily to alleviate or prevent a physical or mental defect or illness. It does not allow for expenses that are merely beneficial to general health, such as vitamins or vacations.

The following list includes items that are commonly over-looked, but are considered HSA Qualified Expenses. Note, this list does not include all possible medical expenses, just some of the ones that may not be so obvious.

HSA Qualified Expenses


Alcoholism - Inpatient treatment, including meals & lodging. Also, transportation expense to and from Alcoholics Anonymous meetings if the attendance is pursuant to medical advice.


Artificial Limbs

Artificial Teeth


Birth Control Pills - If prescribed by a doctor.

Body Scans - Electronic body scans ordered by a doctor.

Braille Books & Magazines - Just the cost difference between a regular printed version and the version for the visually impaired.

Breast Pumps and Supplies - Medical expenses incurred that assist lactation.

Breast Reconstruction Surgery - Non-cosmetic purposes only, such as reconstruction surgery following a mastectomy for cancer.

Capital Equipment (i.e. Medically Required Home Improvements) - If the equipment/improvement/modification does not increase your property value, all of the expense is a HSA qualified expense. However, if the equipment/improvement/modification increases your property value, then only the difference is allowable. For example, you put an elevator in your home that cost you $15,000, but your property value increased $20,000, the difference is $5,000 and is the amount which is allowable. Some of the more common improvements include, but are not limited to, the following items:
Constructing entrance or exit ramps for your home
Widening doorways, both exterior and interior
Installing railings, support bars, or other bathroom safety modifications
Lowering or modifying kitchen cabinets and equipment
Moving or modifying electrical outlets and fixtures
Installing porch lifts and other forms of lifts (but elevators typically add value to the property)
Modifying fire alarms, smoke detectors, and other warning systems
Modifying stairways
Adding handrails or grab bars anywhere
Modifying hardware on doors
Modifying areas in front of entrance and exit doorways
Grading the ground to provide disabled access to the home
Only reasonable costs are allowed. Costs for architectural or aesthetic reasons are not HSA qualified expenses.

Car - much like your home, the cost for equipment/improvements/modifications necessary for the use of a person with a disability are allowed. Again, if it increases the value, only the difference is allowable.


Christian Science Practitioner

Community Living for the Intellectually and Developmentally Disabled - Allows the cost of keeping a person in a special home, (not a relative) on the recommendation of a psychiatrist to help the person adjust from life in a mental hospital to community living.

Contact Lenses - Can also include saline solution, enzyme cleaner, and other items required for using contacts.

Crutches - Either the cost to buy or rent is allowable.

Dental Treatment - Preventative treatment, such as teeth cleaning, sealants, fluoride are allowable. Also, X-rays, fillings, braces, extractions, dentures, etc. are also HSA qualified expenses.

Diagnostic Devices - You can include the medical expense of devices used in diagnosing and treating illness and disease, such as a blood sugar monitor for diabetics.

Disabled Dependent Care Expenses - Some disabled dependent care expenses may qualify as either:
Medical expenses, or
Work-related expenses for purposes of taking a credit for dependent care

Drug Addiction - Inpatient treatment at a therapeutic center for drug addiction, including meals and lodging at the center.

Eyeglasses - Eye exams, lenses, frames are allowable expenses.

Eye Surgery - You can include the amount you pay for eye surgery to treat defective vision, such as laser eye surgery or radial keratotomy.

Fertility Enhancement - Procedures to help overcome the inability to have children, such as in vitro fertilization (including temporary storage of eggs or sperm) and surgery to reverse prior sterilization surgeries.

Guide Dog or Other Service Animal - Costs of buying, training, and maintaining a service animal for the visually-impaired, hearing-impaired, or a person with other physical disabilities.

Health Insurance Plan Deductibles, Co-Pays and Co-Insurance

Health Institute - Only if prescribed by a physician and the physician issues a statement that the treatment is necessary to alleviate a physical or mental defect or illness.

Hearing Aids - Cost of the exam, hearing aid, and batteries used to operate it are HSA qualified expenses.

Laboratory Fees

Lead-Based Paint Removal - Only the removal (not the repair) of surfaces in poor condition in homes with children.

Legal Fees - Legal fees necessary to authorize treatment for mental illness are allowable, but guardianship, estate fees, or other fees that are not necessary for medical care are not allowed.

Lodging - A person traveling with the person receiving medical care can allow up to $100 per night ($50 per person), for example a parent traveling with a sick child.

Medical Conferences - Admission and transportation to a medical conference if the medical conference concerns the chronic illness of yourself, your spouse, or your dependent. The majority of the time spent at the conference must be spent attending sessions on medical information.

Medicines - Prescribed medicines and drugs only. (Note: Beginning 1/1/2011 the Patient Protection and Affordable Care Act states that HSA funds can no longer be used for over-the-counter drugs without a doctor's prescription.)

Nursing Home - Medical reasons.

Osteopath - expenses paid to an Osteopath are considered HSA qualified expenses.

Oxygen - Oxygen and oxygen equipment to relieve breathing problems caused by a medical condition

Physical Exam - An annual exam and diagnostic tests are HSA qualified expenses even if you are not ill.

Pregnancy Test Kit

Psychiatric Care - Includes cost of supporting a mentally ill dependent at a specially equipped medical center.



Special Education - Medical expenses you pay on a doctor's recommendation for a child's tutoring by a teacher who is specially trained and qualified to work with children with learning disabilities caused by mental or physical impairments. You can also include the tuition, meals and lodging costs of attending a school that furnishes special education to help a child overcome learning disabilities. A doctor must recommend attendance. This includes:
Teaching Braille to the visually impaired
Teaching lip reading to the hearing impaired
Remedial language training to correct a condition caused by a birth defect


Stop Smoking Programs - Nicotine patches or gum are not covered, unless prescribed by a doctor.

Telephone - Cost of TTY & TDD, including repair and maintenance.



Transportation - Transportation expenses used primarily for, and essential to, medical care. Including, bus, taxi, train, plane, ambulance. Also includes transportation expense of a parent who must travel with a child and that of a nurse, required by a patient who is traveling to get medical care and is unable to travel alone.

Weight Loss Programs - Only if it is treatment for a specific disease diagnosed by a physician (i.e. obesity, hypertension, etc. ). You cannot include membership dues in a gym, health club, or spa, these are not considered HSA qualified expenses.

Wheelchair - Autoette or a wheelchair used mainly for the relief of sickness or disability, and not just to provide transportation to and from work.

Wig - A wig purchased upon the advice of a physician for the mental health of a patient who has lost all of his or her hair from disease.

Most people remember that hospital stays, doctors visits, and prescription drugs are HSA qualified expenses, but as you can see, the list of items that are considered HSA qualified expenses is very lengthy. Read IRS publication 502 for more details. Your HSA is intended to help you pay for medical expenses, so save your receipts to be sure that you can use those tax free funds to the fullest and maximize your tax write-offs.

However, if you use the HSA funds for something that is not considered HSA qualified expenses, you will not only receive no tax break, but also pay a 20% penalty. Make sure you also know the items that are NOT considered HSA qualified expenses.

A Quick Guide To Individual Health Insurance

There are many different types of health insurance available on the market. If you are searching for individual coverage, I have a bit of bad news. While it is readily available, it usually is not cheap. To help you figure out how to get the best deal, I've put together this guide for your edification.

You might be wondering off the bat why individual health insurance tends to be a bit pricier than group insurance. The answer has to do with risk. With a group insurance policy, the risk that the insurance company will have to pay out a large claim is spread over the people in the group. If there are 20 people in the group and one needs surgery, the cost is mostly offset by the large premiums paid by the group as a whole. If there is just one person, this is not the case and insurance companies are leery about losing their shirts on individual policies.

Once you apply for individual health policy, you are going to be subject to more onerous requirements than those who apply as a group. Your application will ask you to list all medical conditions you have. The insurance company may then ask to see certain medical records to ascertain if you are telling the truth and the extent of any problems. Again, they are trying to evaluate the risk of insuring you.

If any pre-existing conditions are found, the company may not insure you or may put an exemption for those conditions. For example, let's assume I apply for health insurance on myself. I am found to have a heart condition that could lead to a heart attack. The insurance company may reject my application because there is too much risk I will have major problems during the year. Alternatively, they may offer me a policy with very high premiums or a rider that excludes coverage for any medical costs related to my heart condition. The exact approach often depends on the state you are in due to legal requirements, but neither of these two options are very good.

When Catastrophe is Good

Okay, that subheading might be a little misleading. Catastrophe is never good, but there is a particular type of health insurance that carries the title that can be very good for individuals seeking coverage. It is called a catastrophic health plan and it is perfect for individuals who are comfortable with the risk of a higher deductible or if they have an HSA.

So, what are those pros and cons? Well, let's start with the positives. The first positive is this type of policy comes with much cheaper premiums than any other health insurance policy you will find. The second positive is that it will cover you for any health bills related to major health issues. The third positive is it is very easy to qualify for these policies. Having said all this, there is a potential big negative that you need to understand up front.

A catastrophic policy is also known as a high deductible health plan (hdhp). What this means in practical terms is the policy is only going to pay for medical bills after a high deductible has been satisfied. A typical deductible for a policy of this type might be $3,000 or more. This means that you have to pay all your medical bills during the year until they total $3,000. Only after that is done then the insurance company will take over payments. Most people only incur $3,000 in medical bills in a year if they have some major health problem, which is where the name "catastrophic" comes from.

I'm not going to mislead you, it's not easy to find the right individual coverage, make sure you shop around. If the prices are simply too high, check into the possibility of a catastrophic insurance policy. When you combine a high deductible plan with a health savings account it's really quite slick. I have one and am very happy with it.

Wednesday, January 11, 2012

Healthcare Roadmap: Healthcare Strategy in a Post-Reform Environment

The concept of Wellness has been around for 25+ years, however most programs at the workplace fall short of full impact.

We will most likely agree that over the past five years, company profits have flattened, while healthcare costs have steadily risen.

Employers will need to find more innovative solutions to not only control costs, but instill employee accountability into their employee benefit plans.

According to the 2010 Towers Watson Employer Survey on Purchasing Value in Health Care Report, employer groups identified three concerns as the top challenges in maintaining affordable benefit coverage:

1. Employees' Poor Health habits,
2. Underuse of preventative services, and
3. High cost of catastrophic cases.

All three of the concerns listed above can be addresses and identified through properly designed wellness programs and certain incentive-based models, with a primary focus on outcome-based results.

Outcome-based results being the key word, it is important to first realize that a small number of claimants drive the largest percentage of claim dollars. Some of these "high claims" cannot be controlled, due to hereditary disease and/or uncontrollable injuries and illnesses, but a very large percentage of claim dollars can be controlled and often reversed.

Obesity and tobacco use are two of the major contributors to claim costs for just about any organization. These are also two of the more controllable drivers, and the proper implementation of robust wellness programs can begin to help control and contain costs in these areas.

The ultimate goal of a wellness program is to create and sustain a culture of heath within an organization. Once this culture has been realized, only then can healthcare costs begin to flatten or in many instances, actually begin to reverse.

With a large percentage of companies already having some form of a wellness program, the larger question becomes how to utilize and create systems that will actually accomplish the goal, and see a significant return on investment, which many wellness programs currently do not realize.

Before we discuss some of the parameters of successful programs, please note that according to The Harvard Business Review (Leonard L Berry, Ann M. Morabito, and William B. Baun, 2010), the ROI on comprehensive, well-run employee wellness programs can be as high as 6-1. If your business could purchase a product that generates a 6-1 ROI, you would most likely implement this product as quickly as possible.

For simplicity purposes, I will identify four levels to specifically designed to reduce trend.

Level One: Understanding, Supporting and Demonstrating the business value of workforce health. This is the beginning stage of building a healthy, productive workforce. By combining a set of employee incentives and activity-based results, strategies in this level are designed to implement a health insurance program that operates efficiently and lays the foundation for a High Performing Health Insurance program.

Level One Employee Responsibilities:
1. Mandatory biometric screenings and
2. Mandatory health risk assessments.

Level One Employer Responsibilities:
1. Formation of a Wellness Committee,
2. Achieve plan design adherence to high-performing results,
3. Demonstrate the organization's interest in employee well-being, and
4. Support employees' in managing their health and wealth.

Level Two: Establish business-focused goals to ensure that health investments deliver a health dividend - and begin to measure the program's success in producing targeted results. This is the second stage in building a healthy, productive workforce. By engaging employees' and promoting a culture of health, strategies in this level are designed to create a sense of shared responsibility and employee accountability for health and cost management.

Level Two Employee Responsibilities:
1. Health Promotion Programs,
2. Outcome-based results (first stage via rewards programs),
3. Voluntary preventative schedule, and
4. Use of information, resources and tools to support health promotion.

Level Two Employer Responsibilities:
1. Enhancement of Wellness Committee,
2. Changes in the work environment to encourage healthier behavior and support a culture of health,
3. Promote culture of shared responsibility and accountability, and
4. Create/Provide Health Resources Website.

Level Three: Designing programs that support transparency and create meaningful incentives for healthy behavior and choices. This is the first stage in outcome-based results. By establishing business-focused goals to ensure that health investments deliver a health dividend, strategies in this level are designed to rigorously measure the success of the program in producing targeted results.

Level Three Employee Responsibilities:
1. Care/Disease Management Programs,
2. Use of High-Performing providers,
3. Outcome-based results (second stage via rewards programs),
4. Use of Evidence-Based treatments, and
5. Health Advocacy/Coaching

Level Three Employer Responsibilities:
1. Further enhancement of the Wellness Committee,
2. Encouraging employees to assess their personal health risks,
3. Senior Management involvement/support, and
4. Disciplined execution.

Level Four: Designing programs that will drive the market towards better solutions that deliver more value for both employees and organizations. This is the second and final stage in outcome-based results. Strategies in this level are designed to align health benefit programs with rewards and business strategy, allowing businesses to create, achieve and maintain a competitive advantage.

Level Four Employee Responsibilities:
1. Mandatory Preventative Schedule,
2. Use of Centers of Excellence (E.g., Specialty Treatment Networks), and
3. Outcome based results (third stage via rewards program).

Level Four Employer Responsibilities:
1. Further enhancement of the Wellness Committee,
2. Further employee encouragement,
3. Further Senior Management involvement/support, and
4. Smoke free environment.

The Patient Protection and Affordable Care Act (PPACA) will position wellness at the forefront. Legislation will force companies to evaluate their policies and procedures in healthcare by virtue of the Medical Loss Ratios (MLR's). Make sure that the MLR's have a positive impact within your organization.

Tuesday, January 10, 2012

Effective Ways To Generate High Quality Health Insurance Leads

If you want to generate high quality health insurance leads then first of all make your prospects realize how important it is for them and their family. There are several companies who wants to generate health insurance leads thereby making health insurance lead generation a difficult process but if you want to be one step ahead then don't just follow the trends generate your leads by using the same methods but in a different way. Because remember one thing, companies would buy leads from you only if you assure them that you would provide them top quality leads and not the shoddy one and the prospects are genuinely interested in buying health insurance.

In order to generate high quality health insurance leads you must keep three main factors in your mind which are as follows

Advantages of service or product offered by you
Prospects' emotional craving and needs
Efficacious communication skills that combine both the above mentioned factors

What I have been noticed is generally the those who are in system of lead generation overlook the prospects' emotional cravings and needs which ultimately bring disappointment and failure to them. When you want to generate leads for health insurance rather than explaining them first what is health insurance, make them understand and realize why they need to buy it this will help you to win their confidence. Once you have taken your prospects in your confidence explain them about health insurance. Just observe the mind of your prospects and establish a connection between their emotional cravings and benefits of health insurance. And if you are not able to do so then you are most likely to get no leads.

Why emotional cravings and needs should not be overlooked? Well to explain my this point I would give you an instance. You must have seen advertisements of companies selling electronic appliances. They don't sell their products by talking about the material they used in it manufacturing or the electronic components used in it rather they sell by combining the prospects' emotional cravings with the benefits of their products. They make their prospects feel how comfortable their life could be if they buy these products, how more time they can spend with their family after using their products and thus successfully get top qualified leads.

Similarly if you just have to make your prospects realize that life is unpredictable and anything can happen anytime so buying health insurance can help them lead a safe and healthy life and protect them from bearing huge financial loss. If your prospects don't believe that their life is in danger, they can met an accident anytime or suffer from some serious disease, you won't be able to generate leads.

Target those prospects whose emotional desires go with the benefits of the services offered by you. Develop an efficacious communication skill to convince your prospects that they really need a health insurance.

Don't just start telling them the benefits of health insurance just after having introduction as if you have crammed everything. Try to be informal while telling them its benefits. So that they can relate themselves with the benefits told by you. Just simply asks those questions or discuss those topic which indirectly prompts them to buy it or to go for it. If you want to ask such type of questions, then firstly think what your prospects actually may desire for and make a list like this:

To keep himself and his family safe from injuries, illness and any kind of harm
To be able to pay medical bills
To be ready to face any medical emergency
To provide health security to his family members
To keep himself and his family tension free regarding health related issues

No matter which method you are using to generate health insurance leads just remember to explain your prospects those things which definitely covers the above mentioned points. Like you can explain them following points after a healthy introduction:

How middle class family can best protect their members from physical sufferings and harms?
How to invest smartly and safely to lead a fit and healthy life?
How to be ready to face any kind of medical emergency?
How to get rid off tensions regarding medical bills?

Believe me if you explain such points to your prospects, then certainly you would generate top quality health insurance leads without much trouble as these points are related with your prospects' desires and concerns. Just make them realize that health insurance is the only service that can help them to fulfill those concerns and desires.

See how simple yet how effective this method is to generate highly effective health insurance leads. Try this out and stay ahead in the lead generation system.

POP Users, Nondiscrimination Testing, and the Necessities for Compliance

If you are not aware of non-discrimination testing and you have a premium only plan, you will probably want to know that the IRS requires everyone who uses premium only plans to submit to non-discrimination testing once a year. At first glance, the idea of being audited by the IRS every year may be a little intimidating, but there is good reason behind the scrutiny of the IRS when it comes to the incredible benefits that premium only plans provide their solicitors: The reason for nondiscrimination testing is to prevent highly compensated employees from taking advantage of the benefits that POP plans provide for employers and employees alike. Such advantages, as you may already know, consist of an increase in take home pay for employees ranging between 1-300 dollars and a 7.65% savings annually on employers matching FICA tax. Needless to say, these benefits are meant to compensate those who meet the necessary requirements for financial compensation.

The benefits for complying to federally mandated nondiscrimination testing, in regards to premium only plans, is simple, and, in many ways, all too obvious: complying with IRS regulations allows for favorable tax treatment in way of employer provided benefits. I might also suggest that pre-testing or testing early in the year will allow for corrections if failures do occur.

It is essential for everyone who uses premium only plans to follow through with and comply to all of the federal regulations involved with the use of POP plans. Nondiscrimination testing is a big factor in way of compliance. If employers do not adequately follow all the steps necessary for nondiscrimination testing, or they fall out of compliance with federally mandated regulations while using POP plans, all discriminatory benefits are included in the gross pay of highly compensated employees. This also means, consequently, that employers can no longer take advantage of the 7.65% tax break on their annual employer matching FICA tax. In other words, if an employer fails to comply with IRS regulations and testing procedures, any and all benefits that were received from that employer's premium only plan must be re-paid.

Overall, the greatest concern when filing nondiscrimination testing is that your company is in compliance with all regulations before you begin. As stated above, the initial reason for nondiscrimination testing is to avoid the abuse of these benefits by highly compensated employees (HCE). Although there are no clear parameters for what defines an HCE, there are at least some general guidelines that indicate whether or not an employer fits the description of an HCE:

• Highly compensated:
o Officers.
o More than 5% shareholders.
o An employee with gross annual compensation over $110,000.
o A spouse or dependent of any of the above defined employees.

• Key employee: employee who at any time during the plan year or any of the four preceding plan year is:

• An officer with gross annual compensation over $160,000.
o An owner of at least 5% of the company, or
o An owner of at least 1% of the company with gross annual compensation over $150,000.

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As these are only general guidelines, the water is still pretty mucky however. With policy changes, compliance updates, and a dictionary sized headache for paperwork, the struggle to meet these regulations can be rather daunting.

Fortunately Taxfreepremiums offers nondiscrimination testing software, handles all subscription work, provides all required documents, is 100% online, and automatically handles any and all compliance updates at a very competitive price. With the services provided by Taxfreepremiums, using premium only plans becomes free of complications, allowing you to feel comfortable while you enjoy the benefits of these plans.