The IRS Deductions Blog

Posts Tagged ‘healthinsurance’

Question: Maximum HSA contribution for 8 months of coverage in 2010 ?

I paid monthly premiums on a high deductible HSA insurance plan until August of this year. Normally my maximum contribution would be $6150 for the entire year. Should I simply prorate the maximum amount I can contribute for 2010 based on 8 months of coverage ?

Answer: HSA contribution limits aren’t subject to pro-rating. Even if you establish an HSA for a partial year, you can still make up to the maximum contribution for the tax year. The 2010 annual contribution limits are $6,150 for family coverage. A catch-up contribution is available for taxpayers 55 and older of $1,000.

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Question: I need some help understanding health insurance “out of pocket” and “in network” and “out of network”?

This is a plan from Aetna. I’m an single male wanting to get on this plan. I don’t understand a few things. First “out of pocket” being $7,500 for individual, what exactly does out of pocket mean? If the deductible is 0.. I just don’t get it. And what is “in network” and “out of network”. Thanks!

*In Network*
deductible – $0 individual / $0 family
co-insurance – 30% (0% once out-of-pocket max is satisfied)
out-of-pocket maximum – $7,500 Individual / $15,000 Family
*Out of Network*
deductible – $5,000 individual / $10,000 family
co-insurance – 50% (0% once out-of-pocket max is satisfied)
out-of-pocket maximum – $12,500 Individual / $25,000 Family

Answer: What are hte cost os these plans? They look decent.

In Network – doctors in your area that have signed up to be part of Aetna’s network. You get a discount because they are “in network”
Out of Network – all the doctors in the United States who didn’t sign up to be in Aetna’s network.

Deductible – amount of money you must spend before your plan starts paying for medical care. In you go in network you don’t have a deductible (it pays the first dollar). If you go “out of network” you have to pay the first $5000.

Out of pocket maximum – If you go to an “in network” doctor your plan will pay on the very first doctyour plan will start paying at the first dollar you spend. But until you met the maximum out of pocket you will have to pay a portion (either 30-cent for each dollar or 50-cents for each dollar).
- What this means on the out of network is that you pay all of the first $5000; for the next $15000 you will pay 50% (= $12500 = $5000 + 15500/50%)

Hope this makes sense.
Also, networks vary by geographic area. Aetna has a very good network in my area. I think every doctor I have tried to go to (I haven’t tried to go to that many) has been a member of the network.
Aetna also has a really good website that you can find the doctors in your area.

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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!

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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!

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McDonald Hopkins Files Federal Lawsuit Challenging Constitutionality of Illinois Statute: Hospital-Based Physicians …

CHICAGO, July 12, 2011 /PRNewswire/ — Hospital-based pathology groups and physicians in Illinois filed a federal lawsuit on June 24, 2011, seeking to invalidate, on constitutional grounds, Illinois legislation designed to shift the burden of absorbing certain patient-related costs from insurers to practitioners of only a few specifically-enumerated medical specialties. The Statute: Illinois …

EXPOSED: ☢☣Obama lied about his own dead mother in the 08 campaign