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.

Meeting the Dec 15 Deadline to be Covered by January 1, 2015

While we are closing in on the DECEMBER 15 DEADLINE to purchase  JANUARY 1 COVERAGE —

Please use our QUICK GUIDE to get started on enrollment right away.

We are available by phone to help (703-707-8270 or 1-888-396-2341).  Our email boxes are overflowing, so please — do not use email!

Follow the steps in the guide to determine first if you will be eligible for a subsidy.

 

From there, explore your options, again, following the steps in the Guide.

Once you have found an option that meets your needs, you can go ahead and apply —  following the instructions in the Guide — either online or on paper.  If you are completing a paper application, simply fax it in to us, using the instruction sheet included with the application.

Brochures for all products, as well as paper applications, can be found on our Resources page.

We have hired an experienced agent, Brandon Boushell, and our team will be working until midnight every night to handle this unprecedented volume. Please call and if we are on the other line, leave a message.  Either Jon or Brandon will get back to you.

Again, please do not email us at this time as our email boxes are full!

Keep in mind also that the most important thing is to get you enrolled by Dec 15.  If we need to make adjustments to your coverage later, we can do that (just remember in some cases, a change could cause your deductibles to reset.)

IMPORTANT REMINDER:  We are unable to properly respond to emails during this busy time. 

If you need assistance, please CALL OUR OFFICE at 703-707-8270 or 1-888-396-2341.

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!

 

Anthem Blue Cross Blue Shield Early Renewal Option

Click on the Anthem logo to browse 2014 plans.

If you are currently covered by an individual Anthem Blue Cross Blue Shield health insurance policy (vs. one you get through your employer) we have some critical information for you.

Anthem policyholders either already have received or will receive soon a letter from Anthem explaining the options for complying with the new health care law — the Affordable Care Act (also known as “Obamacare”).

Here is a summary:

If you have a Non-Grandfathered Plan

(A non-grandfathered health plan is one that was purchased on or after March 23, 2010.  Learn more.)

Option 1 – Transition to a New Anthem ACA-Compliant Plan Depending on your policy anniversary date, Anthem may offer to transition you to a new ACA-compliant, off-exchange plan on your next renewal date.  Anthem will offer you a new plan that is as close to your current plan as possible.  To accept this offer, you must sign and return the Acceptance of Health Plan form included with your mailing. Note: if you are eligible for a subsidy under ACA, Virginia Medical Plans can help you purchase your insurance on your state’s exchange so you can receive the subsidy.

Option 2 – Renew Early For policyholders with an anniversary date between February – November, 2014, you have the option to renew your current plan early.  Your new policy effective date will be December 1, 2013. Renewing early allows you to keep your current coverage, at December 2013 rates, through November 30, 2014.  At that time, you will need to choose an ACA-compliant plan.  Early renewal simply delays the requirement to comply with the law.  Click here to learn why early renewal may be a good choice. You should have received a New Policy/Contract Offer Acceptance Form with your Anthem mailing that must be completed and sent back to Anthem by November 15, November 30 December 16, 2013* if you choose to renew early. *Date extended twice.  Update as of 11/27/13: you have until December 16 to renew early.

Option 3 – Apply for a new ACA-Compliant Plan From October 1, 2013 – March 31, 2014, Virginia Medical Plans can help you  enroll in any on- or off- exchange plan that will be effective in 2014.  Click here for a free quote on a new Anthem plan. Note:  You will have the opportunity to indicate whether or not you believe you are eligible for a subsidy.  If you are eligible, we can help you purchase insurance through your state’s exchange so you can receive the subsidy.

If you have a Grandfathered Plan

(A grandfathered health plan is one that was purchased before March 23, 2010 and has been continuously in effect since then.  Learn more.)

Option 1 – Remain on Your Current Plan But first do a little research to be sure that both the coverage and current pricing still make sense for you.  Give us a call or email us to discuss. Note:  If you are eligible for a subsidy under ACA, we can help you purchase a new plan on your state’s exchange so you can receive the subsidy.

Option 2 – Choose a New ACA-Compliant Plan We recommend you research whether or not a new plan would be a better fit for you.  But remember, once you terminate a grandfathered plan, your grandfathered status is pierced and you can not go back to that plan. Note:  If you are eligible for a subsidy under ACA, we can help you purchase a new plan on your state’s exchange so you can receive the subsidy. Click here to browse 2014 Anthem plans.

Whatever your situation, Virginia Medical Plans can help you make the decision that makes the most sense for you.  But it’s tricky, so give us a call or send us an email.

Quick Link:  Anthem online