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Showing posts with label medical expenses. Show all posts
Showing posts with label medical expenses. Show all posts

Wednesday, December 12, 2012

Medicare Part D: Plans and price comparison

By Alston J. Balkcom


There are several steps you should take before choosing a Medicare Part D policy. A Medicare beneficiary is likely to be faced with a myriad of choices, so the first step is to eliminate some of those options from consideration. You will only want to consider policies that serve your local area. You will want a plan that has a low overall cost. You will want to make sure you understand your policy before you enroll.

 

A great free tool you should use


Medicare.gov has made selecting a Medicare Part D policy a lot easier! This government website is full of resources that will make your quest for the best prescription drug plan a lot easier.

 

Rules you must know


It is important to note that you cannot have two prescription drug plans. It is also important to note that enrolling in a prescription drug plan, can in many instances, automatically disenrolls you from your Medicare health plan. This is not the case if you have a Medicare Supplement or Medigap plan. Be sure you understand these rules before you join a plan.

 

Medicare advantage policies and prescription benefits


(If you choose to have your medical services covered by a Medicare Advantage policy, you should investigate the programs that provide prescription benefits to their members. For many, this is a better way to get prescription drug coverage.)

Understanding your coverage in some detail is important, however there is no point in reviewing details of policies that are unlikely to work well for you. This is where Medicare.gov's and its plan finder comes in.

This tool is free and easy to use. After telling the website where you live and giving it the names and dosages of your medications, you will receive an estimate of the costs you are likely to pay for any given policy.

Determining the premiums you might pay for a plan is fairly easy. However there is more you will need to know. You will want to know if a given policy covers the medications you use and if the insurance will include a local pharmacy in their network.

The Medicare plan finder can do all this for you. In addition, it will give you an estimate of your costs for the following year. Since you will be paying for both the policy's premium and the copayments and deductibles, the estimate includes all of the above in the calculation.                                                                                                      

This tool is widely used by insurance agents as well as Medicare beneficiaries. (It will also help you compare Medicare Advantage policies.)

 

Other steps to take


After you have gotten your short list of policies that are likely to work well for you a logical next step to take is to start learning more about each policy. You are likely to have a monthly premium. You may have a deductible. You are likely to have copayments and coinsurance for your prescriptions also.

You can get information about each plan from the company. You should be able to view or print the information from the company's website. Whether or not you choose to enlist the aid of an agent to help with enrollment, knowing the benefits each policy will provide before signing a contract is crucial.

 

Summary


You are likely to find several plans offered to you from several private insurance companies that seem to meet your needs. By using Medicare.gov's Medicare Plan Finder before you make a change, you will be able to see which plans provide coverage for your state and town.

You will see which are likely to have a low cost when the monthly premium, deductible and copayments are all considered. By contacting the various company's websites or agents you can learn what is required of you in regards to using their network. Following these steps should make it easier for you to select the right prescription drug plan for you needs.

About the author: Alston J. Balkcom is a veteran insurance agent.  He is the head of a family-owned insurance agency.  He helps clients find Medicare health plans in Connecticut.

* Image licenses: US-PDGov 

Thursday, December 6, 2012

Cheating insurance companies deny patients proper care

By Aaron Gormley

We all know that there are many areas where health insurance is suffering in this country. One of the most frustrating examples of this is in the area of so-called experimental treatments. Insurers are routinely denying patients important healthcare because they have labeled certain treatments as investigational or experimental.

Another frustrating part of our struggling healthcare system is insurers who don’t cover preventative treatments that can actually prevent a more serious disease from forming. An example of this is that an overweight person who does not bring his or her weight down may develop diabetes.

TMJ Surgery

A good example of the ridiculous concept of experimental treatment is that of reconstructive surgery for TMJ. An alloplastic hemiarthroplasty of TMJ has been proven to be successful for fifty years. Insurance companies have labeled this surgery as experimental. To further confuse the issue, they will cover multiple autologous grafts that have a 69-90 percent failure rate.

Does this make even the slightest sense? Deny a patient surgery that is proven to work, but approve a surgery that is known to fail. It’s ludicrous. The health of Americans will never improve if insurance companies continually make these decisions.

Gastric bypass surgery

Gastric bypass surgery is a surgery reserved for those persons who are morbidly obese. They must be at least one hundred pounds overweight and tried other weight loss methods before being medically eligible for gastric bypass. However, just because a patient qualifies for the surgery does not mean the insurance company will cover it.

Although some insurance policies are beginning to cover this procedure, there are many that still won’t. Yet if these obese patients do not get help, they are at risk for diabetes, heart failure and other health problems. One study proved that very few states ensured coverage of obesity, even though it is seen as one of the most challenging health problems Americans face.

Not covering preventive care

Most people think of preventive care as a complete physical exam once a year, but it is much more than that. For instance, an overweight person can develop diabetes or sleep apnea if they do not get their weight under control. The insurance company will cover treatment for diabetes, but will not cover weight loss treatments that could prevent diabetes in the first place.

The same concept applies to conditions like sleep apnea. Sleep apnea can affect anyone, but overweight people are at a higher risk. If the insurance companies would step in and help overweight patients lose weight, they would not have to later cover conditions that were brought on by the obesity.

What the insurance companies say

Insurance companies try to insist that they will conduct reviews of new treatments to determine if they should be covered under their plan. Reading their handbook will lead a patient to believe that they are doing everything they can to research these treatments and eventually provide coverage. This is far from the truth, as this article shows.

If insurance companies will not cover a TMJ procedure that has been proven to work for fifty years, it is highly unlikely they will cover something that has been on the market for only five years.

The sad part is, while the insurance companies are dragging their feet about covering certain treatments, people continue to die. It’s a shame and the healthcare in this country will never be healthy until insurance companies are prevented from making these types of exclusions.

About the author: Aaron Gormley writes on all financial topics, from insurance scams to how to find CDs that yield high rates.

Wednesday, February 16, 2011

Claiming medical bills on taxes

Medical costs can be claimed as adjustments and/or deductions to one's taxable income. That is to say, there are two opportunities tax filers have to lower their taxes and consequently, lower their annual medical costs through tax savings.

Those two ways include tax deductions for  medical expenses within the itemized section of a tax return, i.e. Form 1040, schedule A or as an adjustment through a health savings plan on the adjustments section of form 1040. This article will illustrate how these reductions to taxable income occur and provide tips on using medical expenses in tax filings.


Deducting medical expenses on Form 1040 Schedule A

Medical and dental bills can be claimed on form 1040, Schedule A if the cost of the expenses are in excess of 7.5% of the tax filings adjusted gross income. For example, if the adjusted gross income after adjustments is $38,000.00, medical expenses in excess of $2850.00 are deductible on a schedule A. A household would have to have significant annual medical expenses to benefit from this percentage deduction.

For people with high annual medical expenses, this deduction favors can be beneficial to tax filers with high medical bills and/or income tax brackets. For example, a tax filer who is in the 25% tax bracket can save approximately $250.00 in taxes per $1000 of income in over $30,650 if medical expenses over 7.5% of adjusted gross income. On income levels below the 25% tax bracket, deduction to income as a result of medical expenses will save 10%-15% in tax or lower depending on the income amount.

The range of medical expenses that are deductible on an IRS form 1040, Schedule A is outlined in the IRS instructions of the Schedule A. The allowable medical expenses are quite broad and include but are not limited to, the following expenses, as outlined by the IRS schedule A instruction booklet.

• Supplemental Medicare costs and Medicare pare D premiums
• Medical and Dental Health Insurance premiums
• Self employment health insurance premiums
• Medical examinations
• Hospital care
• Surgery
• Ambulance services
• Medical equipment

Adjusting income through health savings plans

Contributions to health savings plans can also lower taxes because those contributions may lower adjusted gross income. In other words, medical expenses that take the form of contributions to health savings plans may be beneficial to a tax payer as a way of hedging insurance fees with tax savings. To adjust for income contributed to a health savings plan, a form 8889 is required. Instructions and eligibility requirements for a health savings plan adjustment are available through the Internal Revenue Service website.

According to the Internal Revenue Service form 8889 instructions, the contribution limit for a health savings plan's of persons under 55 years of age is currently $2,850.00 for individuals and $5,650.00 for families and the contributions must be made to a "high deductible health plan" or HDHP. The potential savings one can achieve through a Health savings plan adjustment are $427.5 at a flat tax rate of 15% for individuals, and $847.50 for families. The advantages of such adjustable medical expenses may be beneficial in lowering overall medical costs through a tax hedge.

Health coverage tax credits

Health coverage tax credits are available to qualifying individuals and families. Generally, this tax credit is only available to a specific demographic as proscribed the Internal Revenue Service and the potentially eligible groups include 1) persons over 55 and receive pension form the Pension Benefit Guaranty Corporation, 2) the tax filers state of residence provides supplemental income and considers the tax filer to be part of a trade readjustment program and 3) the tax filer is 50 years old or higher and participates in an alternative trade adjustment assistance program.

The above tax credits are specific to age groups and those affected by job losses caused by free trade outsourcing. Participating in such programs is a factor, but not necessarily a sole determinant of eligibility for the health coverage tax credit. The Internal Revenue Service has specific links for the health care tax credit program, one of which is cited at the bottom of this article.

Tips to consider for deducting medical expenses

When making use of medical expenses to lower taxable income there are several techniques that may prove helpful in maximizing the benefits and making full use of the allowable tax deductions. A few tips tax filers may wish to consider when making use of medical expenses are the following:

• Consider Switching Health Plans: A High Deductible Health Plan takes a percentage of monthly premiums and contributes that amount to the Health Savings Account. That balance is used for medical bills and is tax deductible.

• Ask for Co-pay, and deductible receipts: Doctor co-pays and deductible can add up over the course of a year. Keeping track of every co-payment and deductible will help ensure the maximum deduction is made on the tax filing.

• Weigh the benefits: It may be more advantageous to use a different health plan than a high deductible health savings plan. To figure out which plan is better 1) subtract the tax savings from HDHP from annual medical costs using the HDHP, then 2) compare that amount to the premium and annual medical expenses minus any potential tax savings using another health insurance plan.

• Research: Understand how preventative medicine can sometimes lower costs across the board and study which insurance plans are best and have the lowest co-pays and deductibles for the lowest costs. The more cost effective solution will either cost less in terms of annual expenses or yield greater tax savings than the savings achieved through the most cost effective health savings plan.

• Consult: Contacting the IRS at 1-866-829-1040 may be of assistance when one has questions regarding allowable expenses and how those expenses should be adjusted for, deducted or credited. If the information provided by the IRS is not sufficient a tax preparation service may be of use, but of additional cost.

Summary

Tax deductions exist because the creators of tax code determined certain living expenses should not over burden consumers. One such tax "break" is medical expense deductions in excess of 7.5% of one's adjusted gross income and tax adjustments from contributions to a high deductible health savings plan.

In some instances, tax filers participating in specific pension plans administered by the pension benefit guaranty corporation and/or participating in trade readjustment program may qualify for a tax credit.
Benefiting from the tax benefits of medical expenses involves a little analysis of the pros and cons of medical treatments, various health insurance programs, and courses of action pertaining to one's or one's family's health.

Studying the options and the potential tax benefits and weighing those tax benefits against more cost effective insurance plans and health programs can be helpful in achieving the most optimal financial benefit.

The tips in this article provide some guidance but should not be considered more than that as tax filer's health and tax situations tend to be different. However, being aware of the tax benefits and information provided herein, can potentially yield tax savings.

Sources:

1. http://www.irs.gov/pub/irs-pdf/i1040sa.pdf
2. http://www.irs.gov/pub/irs-pdf/i8889.pdf
3. http://www.opm.gov/hsa/HSA_NetAmounts.pdf
4. http://www.irs.gov/individuals/article/0,id=109945,00.html