The IRS Deductions Blog

Posts Tagged ‘deductible’

Question: Deductible/coinsurance and out-of-pocket maximum question?

This is so confusing to me! I have BCBS. So, here’s the deal:
my deductible is $300
my coinsurance is 20%
my out-of-pocket max is $1750

Will the most I have to pay be $2050 or can I be held accountable to pay for other charges? (For example, my pain was really bad and I asked for more medication or there was some complication and I needed a blood transfusion or whatever!)
I guess my question is if something is not medically necessary, will I have to pay for it? And are the doctors required to tell me that something is not medically necessary?
I’m having a c-section in 5 weeks with an in-network doctor at an in-network hospital. The reason I’m asking is because the last c-section I ended up paying more than my deductible and out of pocket max for some reason.

Answer: OK, assuming you are not an HMO plan…

1. You pay the first $300
2. You then pay 20%
3. When the 20% equals $1750, you are then covered at 100%

BUT (and its a big one) we are only talking about in network providers. During a delivery (vaginal or c-section) the way everyone gets hammered is because of the anestheolgist. They (along with radiologists and pathologists) are not in networks usually. So, be pro-active. You are having a scheduled c-section. Make sure that your doctor and the 2nd doctor (again, a loophole) are in the network. Tell the hospital AHEAD of time (and make sure its written down) that you are in XXX network and the anestheologist needs to be in the network. When he walks into your room to give you the epidural, its your husbands job to confirm. (Really. I threw mine out because he wasn’t in the network and they went and found me one that was).

Also, confirm that the baby is covered under your deductible and doesn’t require a seperate deductible, And that every doc who sees the baby is in the network, too.

Its not a question of what is or is not medically necessary, its a question of insuring that everyone who sees you, your child or LOOKS at your med records is in the network. That’s when you can get hit with out of network charges.

Hope that helps and congratulations!

Items on Amazon Right Now for Out Of Pocket Maximum Deductible:

Health Insurance Plans

Question: Will you donate your wedding dress to help people in need?

Your wedding dress deserves a happy life too? Right? But it sits in your closet, waiting to be eaten by bugs or fire or rejected by your daughter because the dress doesn’t have a wireless hook-up thingy to regulate body temperature (standard in yr 2025).

Making Memories is a non-profit organization founded for the express purpose of granting memory-making events and last wishes to women and men who suffer from metastatic breast cancer. Making Memories is able to grant these wishes by selling wedding gowns that have been donated by manufacturers, bridal shops and individuals at our events called “Brides Against Breast Cancer” across the nation.

Please visit www.makingmemories.org and see the wishes we grant with the proceeds of our wedding gown sales.

Your donation and shipping costs are tax deductible. We’ll love an appreciate your dress and you’ll have more room for shoes.

Answer: No way! I spent 5,000 on my dress! And I am not donating it! It is for my daughter if I ever have one!

Items on Amazon Right Now for Deductible Selling Costs:

Selling Used Cars : How to Purchase an Extended Vehicle Warranty

Question: What does your employer call your High-Deductible/HSA plan?

If your employer offers a high deductible plan tied to a health savings plan (HDHP/HSA) (commonly known as a consumer-driven health plan, what do they call it? Is there a special name for the plan, or do they just call it the “high deductible plan”?
I’m just interested in how different plans are marketed to employees. I’m planning to rename our plan, and am looking for ideas!

Answer: The proper name is “High Deductible Health Plan“, which is the origin of the acronym HDHP. (The savings plan, properly known as a “health savings account”, is the HSA.)

Items on Amazon Right Now for Deductible Plan:

Understanding Your Deductible Plan

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Question: Is my employer responsible for paying my deductible for auto repairs?

I have to use my car a good deal for work to travel to meet with clients. Someone damaged my car in a parking lot and then drove off while I was in a meeting and on work time. My deductible is $1000 and the repair will cost about $500. Looked at my employee handbook and regarding use of car it says ” …the employee’s own individual auto liability policy would be primary in the event of an accident. The Company’s auto liability policy would serve only as excess over primary coverage.” Does this mean they will or wont pay any of that $500 Deductible for which I am responsible?

Answer: Pat’s answer was pretty good. But I think an exact translation of the insurance statement is that the Company’s liability is only of excess. Which means that if the existing employees insurance is limited to let’s say 2,000 dollars and the repairs are 3000 dollars, then the company’s liability is for the 1,000 difference. Not the deductible.

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Personal deductible contributions: it’s all in the timing

Retirement planning: Rachel Leong explains how the retirement date, withdrawals and the timing of Section 290-170 notices can have a great impact on the amount of deductions that can be claimed for clients with deductible contributions as part of their financial plan.

Car Insurance : Types of Car Insurance Liability