Health Insurance
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Dental Insurance
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Medicare & Medicaid
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Frequently Asked Questions
What if my doctor doesn’t accept Medicare?
You can cover the costs out of pocket, but this is usually unaffordable for most people. Instead, try asking your doctor for a referral to another healthcare provider that does accept Medicare, do your own research, or visit an urgent care facility. Most urgent care offices accept Medicare.
Is there a way to appeal an insurance denial?
Yes, you may appeal an insurers' denial of your claim. Typically, your insurer will expect you to work with your physician's office to provide justification for the need for the treatment, drug, or device, and it still may not be approved. You may appeal beyond your health insurance company with the state insurance commissioner.
Learn MoreWhat Does Health Insurance Not Cover?
How do I avoid the late enrollment penalty for Medicare Part D?
Try to sign up during the enrollment period: three months before you turn 65 through the three months after your birthday. Next, if you lose other drug coverage, make sure to sign up for Part D within 63 days. Last, make sure you have proof of credible drug coverage in your records so you can prove you do not deserve a penalty.
Learn MoreAvoid the Part D Premium Penalty
Can you use FSA funds to pay for a gym membership or exercise classes?
The Internal Revenue Service (IRS) typically does not allow FSA funds to pay for health club or gym membership dues. However, the IRS allows FSA funds to be used to pay separate fees charged at health clinics or physical therapy centers for specific activities when prescribed by a doctor.
Are any medical costs tax-deductible?
Yes. Tax-deductible medical costs include payments to doctors, dentists, surgeons, inpatient hospital care, acupuncture treatments, participation in weight-loss programs, and more. The Internal Revenue Service has a list of examples of deductible medical expenses on its website.
What do vision care plans cover?
Most vision care plans provide discounts on laser eye-correction surgery. Vision care plans have different offerings—some offer minimal services; others may help cover treatments for eye surgery.
Key Terms
Health Insurance Deductible
A health insurance deductible is a set amount of money that an insured person must pay out of pocket every year for eligible healthcare services before the insurance plan begins to pay any benefits. The amount of the deductible varies depending on the health insurance plan you choose.
PPO
A preferred provider organization (PPO) is ahealth insuranceplan for individuals and families that involves networks made up of contracted medical professionals and health insurance companies. Health care facilities and practitioners, known as preferred providers, offer services to policyholders at reduced rates.
Health Savings Account (HSA)
A health savings account (HSA) is a tax-advantaged account to help people save for medical expenses that are not reimbursed by high-deductible health plans. No tax is levied on contributions to an HSA, on the HSA’s earnings, or on distributions used to pay for qualified medical expenses.
Preexisting Condition
A preexisting condition is a health condition such as diabetes, cancer, or heart disease, that existed prior to applying for health or life insurance. Under the Affordable Care Act (ACA), health insurance companies can’t refuse coverage or charge more for preexisting conditions.
Medicaid
The term Medicaid refers to a publichealth insuranceprogram that provides health care coverage to low-income families and individuals in the United States. The program is jointly funded by the federal government and individual states. It is operated at the state level which means that coverage and administration vary greatly from state to state.
Medicaid Waiver
A Medicaid waiver can help a person live in the community in the least restrictive setting, rather than live in a nursing home or institution. Services may include case management, personal care or adult daycare, financial management, job coaching, assistive technology, personal support services, nursing care, and more.
Medicare
Medicare is a U.S. government health insurance program covering primarily people age 65 or older. Medicare coverage is for particular aspects of health care, and some come at a cost for the insured. While this allows the program to offer participants more choices regarding costs and coverage, it also introduces complexity for those seeking to sign up.
HMO
An individual who needs to secure health insurance may find a variety of insurance providers with unique features. One type of insurance provider that is popular on theHealth Insurance Marketplaceis a health maintenance organization (HMO), an insurance structure that provides coverage through a network of physicians.
Coinsurance
Coinsurance is the amount, generally expressed as a fixed percentage, an insured must pay toward a covered claim after the deductible is satisfied. It is common in health insurance. Some property insurance policies also contain coinsurance provisions. In this case, coinsurance is the amount of coverage that the property owner must purchase for a structure.
FSA
A flexible spending account (FSA) is a type of savings account that allows you to contribute a portion of your regular earnings before tax. Employers establish FSAs and can also contribute to employees’ accounts. Distributions from the account must be used to reimburse the employee for qualified expenses related to medical and dental services. An FSA is sometimes called a “flexible spending arrangement."
COBRA
TheConsolidated Omnibus Budget Reconciliation Act(COBRA) is a health insurance program that allows eligible employees and their dependents the continued benefits ofhealth insurancecoverage when an employee loses their job or experiences a reduction of work hours.
High-Deductible Health Plan
The term high-deductible health plan (HDHP) refers to ahealth insurance plan with a sizabledeductiblefor medical expenses. An HDHP usually has a larger annual deductible (usually four figures, varying year to year) than a typical health plan but charges lower monthlypremiums. Plans fully cover routine preventive care, which means that individuals aren't responsible for copays or coinsurance.
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Explore Health Insurance
AllDefinitions A - MDefinitions N - ZBest Health Insurance Companies
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