Do you want to use your Insurance & Flexible spending benefits before it is too late?
At this holiday season, there is no more appropriate time for us
to say Thank You for allowing us to play a role in your health and
to express to you and yours every happiness for the joys of this
beautiful season and health throughout the coming year!
Most Deductibles reset at the end of the year .
Most Flexible Spending Accounts (FSA) do not carry over to the next year.
The saying is, "use it or lose it".
health, diagnostic tests, or get any health related equipment/supplies
needed before 2009.
Everyone's Health Insurance, Flexible Spending Accounts, Health Savings accounts, and HRA's work differently.
**Please consult your individual health plan or human resources dept for more details on your specific situation.
See below for more detailed information on:
-Flexible Spending Account (FSA)
-Health Savings Account (HSA)
-Health Reimbursement Account (HRA)
If you have follow up questions or suggestions e-mail us at
Please feel free to forward this to family or friends.
yours in health,
Dr. Weisz, D.C.
Chiropractical Solutions & Massage
Click here: www.drweisz.com
E-mail: firstname.lastname@example.org with any questions or comments
**The best way to maintain health is to eat well, exercise, get regular Chiropractic adjustments to maintain alignment and a healthy nervous system as well as Massages for a healthy muscular system.
Detailed information on:
-Flexible Spending Account (FSA)
-Health Savings Account (HSA)
-Health Reimbursement Account (HRA)
*source information included from Wikipedia
Go to http://en.wikipedia.org/wiki/Health_insurance for more details
The term health insurance is generally used to describe a form of insurance that pays for medical expenses.
It is sometimes used more broadly to include insurance covering disability or long-term nursing or custodial care needs.
It may be provided through a government-sponsored social insurance program, or from private insurance companies.
It may be purchased on a group basis (e.g., by a firm to cover its employees) or purchased by individual consumers.
In each case, the covered groups or individuals pay premiums or taxes to help protect themselves from high or unexpected healthcare expenses.
Similar benefits paying for medical expenses may also be provided through social welfare programs funded by the government.
By estimating the overall risk of healthcare expenses and developing a routine finance structure (such as a monthly premium or annual tax)
that will ensure that money is available to pay for the healthcare benefits specified in the insurance agreement.
The benefit is administered by a central organization, most often either a government agency or a private or not-for-profit entity operating a health plan.
A health insurance policy is a contract between an insurance company and an individual. The contract can be renewable annually or monthly. The type and amount of health care costs that will be covered by the health plan are specified in advance, in the member contract or Evidence of Coverage booklet. The individual policy-holder's payment obligations may take several forms:
- Premium: The amount the policy-holder pays to the health plan each month to purchase health coverage.
- Deductible: The amount that the policy-holder must pay out-of-pocket before the health plan pays its share. For example, a policy-holder might have to pay a $500 deductible per year, before any of their health care is covered by the health plan. It may take several doctor's visits or prescription refills before the policy-holder reaches the deductible and the health plan starts to pay for care.
- Copayment: The amount that the policy-holder must pay out of pocket before the health plan pays for a particular visit or service. For example, a policy-holder might pay a $45 copayment for a doctor's visit, or to obtain a prescription. A copayment must be paid each time a particular service is obtained.
- Coinsurance: Instead of paying a fixed amount up front (a copayment), the policy-holder must pay a percentage of the total cost. For example, the member might have to pay 20% of the cost of a surgery, while the health plan pays the other 80%. Because there is no upper limit on coinsurance, the policy-holder can end up owing very little, or a significant amount, depending on the actual costs of the services they obtain.
- Exclusions: Not all services are covered. The policy-holder is generally expected to pay the full cost of non-covered services out of their own pocket.
- Coverage limits: Some health plans only pay for health care up to a certain dollar amount. The policy-holder may be expected to pay any charges in excess of the health plan's maximum payment for a specific service. In addition, some plans have annual or lifetime coverage maximums. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs.
- Out-of-pocket maximums: Similar to coverage limits, except that in this case, the member's payment obligation ends when they reach the out-of-pocket maximum, and the health plan pays all further covered costs. Out-of-pocket maximums can be limited to a specific benefit category (such as prescription drugs) or can apply to all coverage provided during a specific benefit year.
- Capitation: An amount paid by an insurer to a health care provider, for which the provider agrees to treat all members of the insurer.
- In-Network Provider: A health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or copayments, or additional benefits, to a plan member to see an in-network provider. Generally, providers in network are providers who have a contract with the insurer to accept rates further discounted from the "usual and customary" charges the insurer pays to out-of-network providers.
Prescription drug plans are a form of insurance offered through some employer benefit plans in the US, where the patient pays a copayment and the prescription drug insurance part or all of the balance for drugs covered in the formulary of the plan.
Some, if not most, health care providers in the United States will agree to bill the insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company doesn't pay. The insurance company pays out of network providers according to "reasonable and customary" charges, which may be less than the provider's usual fee. The provider may also have a separate contract with the insurer to accept what amounts to a discounted rate or capitation to the provider's standard charges. It generally costs the patient less to use an in-network provider.
Flexible spending account
A flexible spending arrangement (FSA), or Flexible Spending Account, as they are commonly called, is one of a number of tax-advantaged financial accounts that can be set up through a cafeteria plan of an employer in the United States. An FSA allows an employee to set aside a portion of his or her earnings to pay for qualified expenses as established in the cafeteria plan, most commonly for medical expenses but often for dependent care or other expenses. Money deducted from an employee's pay into an FSA is not subject to payroll taxes, resulting in a substantial payroll tax savings.
The most common FSA, the medical expense FSA (also medical FSA or health FSA), is similar to a health savings account (HSA) or a health reimbursement account (HRA). However, while HSAs and HRAs are almost exclusively used as components of a consumer driven health care plan, medical FSAs are commonly offered with more traditional health plans as well. An FSA may be utilized by paper claims or an FSA debit card also known as a Flexcard.
An FSA allows money to be deducted from an employee's paycheck pre-tax and then spent on qualified expenses.
Use it or lose it
Any money that is left unspent at the end of the coverage period is forfeited back to the company; this is commonly known as the "use it or lose it" rule.
Health savings account
From Wikipedia, the free encyclopedia
A Health Savings Account (HSA) is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a High Deductible Health Plan (HDHP). The funds contributed to the account are not subject to federal income tax at the time of deposit. Unlike a Flexible spending account (FSA), funds roll over and accumulate year over year if not spent. HSAs are owned by the individual, which differentiates them from the company-owned Health Reimbursement Arrangement (HRA) that is an alternate tax-deductible source of funds paired with HDHPs. Funds may be used to pay for qualified medical expenses at any time without federal tax liability. Withdrawals for non-medical expenses are treated very similarly to those in an IRA account in that they may provide tax advantages if taken after retirement age, and they incur penalties if taken earlier. These accounts are a component of consumer driven health care.
Proponents of HSAs believe that they are an important reform that will help reduce the growth of health care costs and increase the efficiency of the health care system. According to proponents, HSAs encourage saving for future health care expenses, allow the patient to receive needed care without a gate keeper to determine what benefits are allowed and make consumers more responsible for their own health care choices through the required High-Deductible Health Plan.
Opponents of HSAs say they worsen, rather than improve, the U.S. health system's problems because people who are healthy will leave insurance plans while people who have health problems will avoid HSAs. This however is just a rehashing of the criticism of current health insurance coverage where the young and healthy are forced to pay higher premiums to subsidize the old and sick. There is also debate about consumer satisfaction with these plans.
Health Reimbursement Account
HRAs are initiated by the employer and serviced by a third-party administrator or plan service provider. The employer may provide in the HRA plan document that credit balances in an employee's HRA account can be rolled over from year to year like a savings account. The employer decides if the funds are rolled from year to year and how much rolls over (which can be either a flat amount or a percentage).
According to the IRS, "employees are reimbursed tax free for qualified medical expenses up to a maximum dollar amount for a coverage period". HRAs reimburse only those items (copays, coinsurance, deductibles and services) agreed to by the employer which are not covered by the company's selected standard insurance plan (any health insurance plan, not only high-deductible plans). These arrangements are described in IRS Section 105.
Qualified claims must be described in the HRA plan document at inception, i.e., before reimbursing employees for those medical expenses. Arrangements (medical services, dental services, co-pays, coinsurance, deductibles, participation) may vary from plan to plan, and an employer may have multiple plans in place, allowing much flexibility.
The employer is not required to prepay into a fund for reimbursements, instead, the employer reimburses employee claims as they occur.
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