It is open enrollment time for healthcare participants, which means it is an occasion to evaluate how well a person’s medical coverage worked for him or her last year.
It is also a chance to make adjustments to an individual’s healthcare plan as is necessary for the upcoming calendar year.
Evaluating coverage and medical expenses is a priority. It is also a good idea to make sure that often referenced healthcare words or terms are adequately understood and being applied correctly in order to garner the best care for a person’s health.
HSA and HDHP
Two commonly heard acronyms during the period of open enrollment for healthcare insurance are: HSA (health savings account) and HDHP (High Deductible Health Plan). These two acronyms go together because in order to have a health savings account, a policyholder must be enrolled in a high deductible health plan.
A HDHP requires that a person’s medical expenses meet a pre-established, high deductible before health insurance starts taking over any medical bill payments. This type of plan has an out-of-pocket maximum and a lower premium payment. HSA (Health Savings Account) is a bank account that can be acquired if a person is enrolled in a HDHP (High Deductible Health Plan). It is designed to hold funds on a pre-tax basis. These funds can be used to pay for medical treatments, dental procedures, vision screenings, co-pays, prescription medicines, and more. An individual’s friend, boss, coworker, family member, or roommate can contribute to his or her HSA because there are no restrictions on who can give money to a person’s HSA. Tax deductions are even available for the people, except for employers, who contribute funds to an HSA. According to the Internal Revenue Service (IRS) there are other tax perks to having a HSA, such as: “The contributions remain in your account until you use them. The interest or other earnings on the assets in the account are tax free. An HSA is “portable.” It stays with you if you change employers or leave the work force.“
Supplemental vs. Primary Healthcare Plans
During open enrollment time periods there is a lot of information made available about a person’s primary insurance coverage. Supplemental insurance is a policy that is provided in addition to the main healthcare coverage already in place. Supplemental insurance can provide additional protection and security should a person becoming very sick or severely injured. This type of insurance is helpful, but cannot be secured instead of a primary coverage plan.
During the open enrollment period it is smart to take notice of supplemental health insurance plans as they pertain to accidents or critical illness. These types of plans will provide monetary assistance, for an affordable price, should a policyholder receive a critical diagnosis or become injured in an unforeseen accident. Oftentimes medical and non-medical expenses will be covered under a supplemental health plan depending on the terms of the written policy.
Out-of-Network, In-Network, Deductible, Co-Pays, Dependent, and More
There are a lot of insurance terms that can get lost within complicated wording, however they are important for every policyholder to know and understand.
Network is a simple word with a big meaning when it comes to healthcare. Doctors or medical providers that are in-network are covered more fully by a person’s insurance, than a doctor or medical professional that is out-of-network. It is very common for out-of-network providers to not be covered at all.
Deductible is the established limit of money that one must pay before the healthcare insurance company begins picking up their share of the payments. Co-pays are similar to deductibles in that they are a set amount, however co-pays get paid per medical appointment or visit and do not have a pre-determined limit.
Dependents are people with direct ties to an individual that qualifies them for the same medical insurance coverage. Dependents are usually spouses or children. A person can gain coverage for their dependents by signing up for a family plan.