HSA Contribution Limits and Deductibles for 2016

The IRS recently released the 2016 inflation adjusted amounts for health savings accounts (HSAs).

You are eligible to contribute to an HSA if you are covered under a high deductible health plan (HDHP) and meet certain other eligibility requirements.

2016 Annual HSA Contribution Limitation

The maximum contribution to a health savings account (HSA) for 2016 is:

	2016
HSA contribution limit (employer + employee)	Individual: $3,350 Family: $6,750

2016 High Deductible Health Plan

For calendar year 2016, a high deductible health plan (HDHP) is defined as a health plan with:

	2016
HDHP minimum deductible	Individual: $1,300 Family: $2,600
HDHP maximum out-of-pocket (deductibles, co-payments and other amounts, but not premiums)	Individual: $6,550 Family: $13,100

You can view the complete IRS announcement — IRS Revenue Procedure 2015-30 — here.

If you are wondering if a high deductible health plan with health savings account is right for you, give us a call at 703-707-8270.

Preventive vs. Diagnostic Medical Services Under the Affordable Care Act

The Affordable Care Act (ACA) mandates that all qualified health insurance plans (except grandfathered plans purchased prior to March 23, 2010 and still in place) include coverage for ten essential health benefits.  That does not mean these medical services are necessarily free, merely that your health insurance will cover some or all of the cost.

But certain preventive services are free.  This means your health insurance must cover 100% of the service without charging you a co-payment or co-insurance, even if you have not yet met your deductible.

NOTE: you must use an in-network provider to receive free preventive care.

Preventive Services vs. Diagnostic Services

Many people are surprised to learn a service they believed to be preventive — and therefore free — was not considered preventive by the insurance company — and therefore resulted in a medical claim.

It is important to understand the difference between a preventive service and a diagnostic service.

Preventive services are things that prevent health problems.  Preventive care happens before you feel sick.  Examples are immunizations, lab tests, physical exams, certain medications.

Diagnostic services are things that help your doctor understand the symptoms you’re having and diagnose an illness. Diagnostic care happens when you feel sick or have a known health issue.

The tricky part is sometimes the same service may be preventive — and free — under certain circumstances, yet diagnostic — and not free — under others.

How Do I Know if the Care I Receive is Preventive or Diagnostic?

Whether a service is preventive or diagnostic depends on the reason for having it.

In general, a medical service is considered diagnostic if it is done for the purpose of monitoring, diagnosing, or treating a known health issue or symptom.  For example:

If you have a known, already-diagnosed chronic disease like diabetes, and your doctor monitors your condition with certain tests, these tests are considered diagnostic.

If a preventive screening test reveals a health problem and then your doctor orders more tests to further diagnose the exact issue, these tests are considered diagnostic.

If you are having symptoms, like abdominal pain, and your doctor orders tests to figure out the cause, these tests are diagnostic.

A service is considered preventive if it is done for screening purposes, and not based on any symptoms.  Certain preventive services, when done on a recommended schedule (e.g., at a certain age or frequency), are covered at 100%.

The Same Service can be Preventive or Diagnostic, Depending on the Reason

Here are a few examples of services that can be either preventive or diagnostic, depending on the reason for the service:

• Mammogram – preventive if done as a screening based on your age or family history; diagnostic if you have symptoms like pain or have detected a lump.
• Cholesterol testing – preventive if done as a screening based on your age or family history; diagnostic if you were already diagnosed with high cholesterol and your doctor is monitoring your numbers.
• Colonoscopy – preventive if done as a screening based on your age or family history; diagnostic if you have symptoms like bleeding or irregularity.
• Colon Polyp Removal – the removal itself is preventive if done as part of a screening colonoscopy; if sent to the lab for testing, this is diagnostic.

Understand Your Policy

It is best to fully understand the provisions of your health insurance policy when seeking medical care.  You can consult your plan’s documentation for specifics on your coverage.  If we helped you enroll in coverage, you can also give us a call and we’ll be glad to help!

 

Buying Health Insurance on the Maryland Exchange

Jonathan Katz
Maryland Health Connection
Consumer Assistance ID#: 9000116389

The state of Maryland is running its own health insurance exchange — officially called Maryland Health Connection.  Maryland residents who are eligible for a subsidy MUST buy their insurance on the MD exchange in order to get the subsidy.   Other Maryland residents may wish to shop on the exchange as well.

Jonathan Katz is an authorized broker with Maryland Health Connection, and therefore, is available to assist all of our Maryland customers with their health insurance purchase decisions — on or off the exchange.

Having Jon’s assistance with your purchase means you get the benefit of his 20+ years of experience to guide you through the decision-making process, AND you get his service throughout the life of your policy.  The best part is it costs you nothing extra!

When you work with Jon to find a policy on the Maryland exchange, we will ask you to complete a consent form that we are required to keep in our files.  We also have been issued a Consumer Assistance Reference ID# that should be entered into your Maryland Health Connection account.   Jonathan Katz’s ID# = 9000116389.   Click here for instructions on how to enter the ID#.

Please give us a call if you are considering shopping for insurance on the Maryland exchange.  We are here to help!

Having the following information available will be helpful:

• Social security numbers and dates of birth for those in your household needing insurance
• Employer and income information for everyone in your family (e.g., W-2’s or wage statements)
• Information about any job-related health insurance available to your family
• Completed Maryland Health Connection Consent Form for our files (email, fax or mail to us)

Jonathan Katz Consumer Assistance Reference ID#: 9000116389

Click here for the Maryland Health Connection Consent Form

Browsing the Health Insurance Exchange

Since Open Enrollment for health insurance began this past Tuesday, all major news outlets have been reporting on the glitches and capacity overload that have prevented users from getting into the sites (see yesterday’s health care news).

When things do settle down and you are actually able to get in, what will you find?

If the consumer experience is anything like what brokers went through to register with the exchanges during the summer months, you can expect to be asked numerous, very specific, identity-verifying questions — along with your name and social security number — in order to establish an account.  Questions like: “on what street did you live in 1982?”  “with what bank did you refinance your home in 2004?” “what was your phone number in 1966?”

Of course, these questions are asked for the purpose of verifying that you truly are who you say you are.  And that is a good thing in light of the prevalence of identity theft.

But, a word of advice:   As a casual user, you will NOT be able to browse plans before establishing an account.  And, establishing an account will not be as simple as choosing a user name and password.  So, be prepared to jump through some hurdles and answer some very detailed — and often obscure — questions about yourself.

We invite you to visit our website www.vamedicalplans.com.   As carriers make their 2014 plan and rate information available, you can find it here, directly on our site.   You can browse available plans with just a few key strokes — and no obligation.

And when your browsing returns 10-15 options, leaving you unsure of the best one, give us a call or send us an email.  We’ll be glad to help!