This holiday season can be a hectic time of the year. It's not unusual to lose track of time and have to scramble to avoid missing a deadline. Don't let this happen with your Medicare benefits.
Medicare open enrollment ends in less than a week. You have until December 7, this Saturday, to make your benefit elections for 2014. If you haven't already done this, head over to Medicare.Gov and take care of it today.
If you're new to Medicare or don't understand how open enrollment works, check out "Medicare Open Enrollment--What to Do and How To Do It."
Balance billing can surprise insured people with medical bills costing hundreds, thousands, or even tens of thousands of dollars more than expected. It usually happens when people with health insurance get care from an out-of-network provider, or when people with Medicare get care from a doctor or hospital that doesn't accept Medicare assignment.
If your doctor or hospital is billing you for the amount remaining after your insurance company has paid, and after you've paid your deductible and coinsurance, you're being balance billed. Sometimes balance billing is legal, and sometimes it isn't.
Learn what balance billing is, how it works, when it's legal and when it's not in "Balance Billing--What It Is & How It Works."
Even if you're being balance billed legally, you have several options for how to handle it. Find out what to do about both legal and illegal balance billing in "Balance Billing--How To Handle It, What To Do."
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Whether you're shopping on the Obamacare health insurance exchanges, going through Medicare open enrollment, or picking a health plan from your employer's open enrollment choices, you'll almost certainly have a PPO among your health plan choices.
Because PPOs can be more expensive than other types of health insurance plans, you really need to understand exactly what they are, how they work, and whether a PPO will be a good fit for you. Learn more in "What Is a PPO & How Does It Work?"
If you're choosing a health plan or new to health insurance, you might be surprised to learn that you're required by many health plans to have a primary care physician. In fact, in some health plans your PCP is so important that if you don't choose a one from the plan's provider network, your health insurance company will assign you a PCP.
If you're not sure what, exactly, a primary care physician is, what he or she does, who can be one, or why your health insurer would force you to have one, find out in "What Is a Primary Care Physician?"
If you have a flexible spending account, you're running out of time to use all of the money in it. FSAs for 2013 are use-it-or-lose-it accounts. If you don't use the money, you'll lose it; it won't roll over to offset next year's medical expenses.
Now is the time to see the dentist, refill your prescriptions, get your eyes checked, get a spare pair of glasses or stock up on hearing aid batteries and Band-Aids. But, don't forget, over-the-counter drugs like non-prescription cold medicine, Tylenol, and Motrin aren't qualified expenses anymore without an MD prescription. If you're not sure what your FSA money can be used for, IRS publication 502 will give you a list of qualifying expenses.
Most FSA accounts allow a couple of months after the end of the year for you to file any straggling claims for 2013 expenses. But, you only have until December 31 to incur the expense.
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The rules are changing for the better for flexible spending accounts in 2014. Starting next year, instead of losing any unspent money left in your FSA at the end of the year, you'll be able to rollover up to $500 of unspent FSA funds into the next year's FSA. You'll still lose any unspent funds in excess of $500, but at least $500 is protected.
Here's how it will work. Let's say you contribute $2,500 to your FSA in 2014. But, perhaps you only have $1900 in qualified medical expenses. At the end of the year, you have $600 left in your account. Rather than losing the entire $600, you'll be allowed to rollover $500 into your 2015 FSA. You'll still forfeit $100.
In the above example, if you contribute the maximum $2,500 to your 2015 FSA, you'll actually have $3,000 available to spend in 2015 since you'll add $500 of left-0ver 2014 funds to your 2015 contribution.
A couple of caveats: employers don't have to allow the rollover of a full $500; they can make the rollover limit smaller if they choose. Check with your benefits department if you're unsure how much of your 2014 FSA money you can rollover to 2015. Also, the provision doesn't cover money left in your FSA at the end of this year. You still need to use it by December 31, 2013 or lose it.
For more details, you can read the entire IRS announcement.
Trying to decide if you want to buy health insurance on your state's health insurance exchange or remain uninsured? Don't forget to figure the Affordable Care Act's shared responsibility payment into your decision-making process.
You'll have to pay this tax penalty for being uninsured if you don't get health insurance or a health insurance exemption. Learn more in "9 Things to Know About the Health Insurance Penalty."
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A few days ago, in response to criticism about the handling of the President's promise, "If you like your plan, you can keep it," the White House changed the rules for individual health insurance. The administration now says that insurers can renew individual policies they'd been forced to cancel because they didn't meet the Affordable Care Act's 2014 rules.
The Obama administration hopes that allowing insurers to renew these plans will placate angry consumers who've received cancellation notices despite the president's promise. However, it's probably not that simple.
Since insurance is regulated by each state, even if the President says something that used to be against the rules is now permitted, that doesn't magically mean your individual health insurance policy will be renewed. Insurers still have to follow their state's rules. Many insurers will need their state Department of Insurance or Insurance Commissioner's cooperation to facilitate these unexpected renewals. Even if your state's Insurance Commissioner agrees to work with insurers to facilitate renewal of your policy, your insurer might choose not to renew it.
Why? Because unscrambling scrambled eggs is a complicated proposition. The time and effort required to renew your cancelled policy might not make financial sense to an insurer that has to make a profit. Your insurer might take the easier path of directing you to choose one of its new, ACA-compliant individual plans.
So, is this a fix, or isn't it?
Well, it might be a one-year fix for some of the people who received cancellation notices, but it's not a fix for all of them. Even if you're now able to renew a policy that had been destined for cancellation, the renewal is only good through 2014. You'll be dealing with the same situation next year. However, it does give the Obama administration the ability to say in this fact sheet, "It will no longer be implementation of the law that is forcing [consumers] to buy a new plan."
You can make a last-minute revision by adding hard-boiled eggs to a restaurant's breakfast menu. But, if the cook has already scrambled all of the eggs in the restaurant's kitchen, you're not likely to get a hard-boiled egg no matter what the menu says.
Recently, there's been a lot of discussion about the Obama administration's promise, "If you like your plan, you can keep it." Many feel the promise was misleading. If you're not sure what all the fuss is about, here's a recap.
People with individual health insurance plans have been getting cancellation notices. This only affects individual health insurance plans, not job-based plans or government insurance like Medicare or Medicaid. These individual policies are being canceled because they don't comply with the new health insurance rules established by the Affordable Care Act. For example, the plans might not cover all of the essential health benefits the ACA requires like maternity and mental health care.
The only health plans allowed to continue after January 1, 2014 are plans that comply with the ACA and grandfathered plans. Grandfathered plans, plans that were around before the Affordable Care Act became law in March 2010, are exempt from many of the ACA's rules as long as they don't significantly change things like deductibles, coinsurance, or benefits. If they change any of those significantly, they lose their grandfathered status and have to comply with all of the ACA's rules.
While there are still lots of grandfathered job-based health insurance plans, there aren't very many grandfathered individual health insurance plans left. Health insurers generally re-evaluate individual health insurance plans each year, adjusting cost-sharing, premiums, and benefits based on current risk profiles. The yearly tweaking of individual plans has caused most of them to lose their grandfathered status by now. Insurers can't continue selling those plans if they don't comply with the ACA's rules.
Why are people getting these notices now? Because January 1, 2014 is when the bulk of the ACA's rules go into effect. Since plans have to give a 90-day cancellation notice, people began receiving these notices three months before the new rules take effect. It didn't matter last year because the ACA wasn't fully implemented yet.
So, was the promise misleading?
I think a better promise would have been, "If you like your plan, you can keep it if it's still around." Otherwise, it's kind of like telling a 5-year-old that he can save his Popsicle for later if he wants to, but not letting him put the Popsicle in the freezer. The Popsicle will inevitably melt. Just as inevitably, all grandfathered plans, even job-based grandfathered plans, will die off through attrition as, plan by plan, they're forced to raise rates, deductibles, or coinsurance and thus lose their grandfathered status.
Does this mean the people getting cancellation notices are out of luck and will be uninsured? No. They can buy health insurance through their state's health insurance exchange. They can also buy an ACA-compliant health insurance policy through the same insurer they've always used if that insurer is offering one.
The caveat is that some of these plans may cost more than the plan being cancelled. Read More...
As we get closer to January 1, 2014, the date all United States residents are supposed to have health insurance, more of the uninsured are wondering if they can afford to get health insurance. If they can't, they're asking how to avoid the tax penalty for being uninsured.
There are only 3 ways to avoid the penalty:
- Get health insurance.
- Get a health insurance exemption.
- Belong to a group of people the government views as having health insurance coverage even if you're uninsured.
Although most of the uninsured can now get health insurance through their state's health insurance exchange (when the website is working), not everyone feels that coverage is something they can afford. If you find yourself in this situation, you can learn more about health insurance subsidies in "Can I Get Help Paying for Health Insurance?"
If you'll remain uninsured after January 1, you'll need an exemption or you'll owe a tax penalty for being uninsured. You can learn more about exemptions, as well as who the government views as having coverage even when they don't, by reading "Can You Get a Health Insurance Exemption?"
The type of health insurance exemption most likely to generate interest is the hardship exemption. It's aimed at helping folks who aren't able to get insurance due to a financial or situational hardship like a natural disaster, death in the family, or foreclosure. Learn who's eligible for this exemption in "How To Get a Hardship Exemption From Health Insurance."
Think you're exempt from health insurance? How you apply for the exemption is determined by what type of situation is making you exempt. Find out more in "How To Apply for a Health Insurance Exemption." If the exemption you're seeking requires you to apply through a health insurance exchange, you may have to deal with some delays as the exchanges get up to speed on exemption applications.