Showing posts with label Health Plan. Show all posts
Showing posts with label Health Plan. Show all posts

Tuesday, October 6, 2015

High Deductible Health Plans


If you are among the growing number of individuals and families with a high deductible health plan (HDHP), managing your healthcare expenses may be a top priority. Increasingly common, HDHPs are characterized by lower premiums and higher deductibles. A deductible is a fixed dollar amount specified by the plan that insured individuals must pay out-of-pocket. Once the deductible has been reached, eligible healthcare expenses will be covered by the plan. In most cases, the deductible must be met each plan year, which is not necessarily the same as a “calendar” year.

If you are covered by a plan with a high deductible, in return for a lower premium, you will be responsible for most healthcare costs until you meet your deductible. While this may seem overwhelming, especially if you have many healthcare needs, there are options for managing and controlling your out-of-pocket healthcare costs under an HDHP.

How do you know if you have an HDHP? 

An HDHP features a lower insurance premium and a higher deductible than those of traditional health plans. Though HDHPs are usually a type of Preferred Provider Organization (PPO) plan, they also could be a Health Maintenance Organization (HMO) or a Point of Service (POS) plan. If you are unsure of the type of plan you have, and/or the deductible amount for which you are responsible before coverage kicks in, consult your plan documents, or ask your employer or health plan representative. See Alphabet Soup of Plans for more information on different types of health plans.

Your Out-of-Pocket Responsibilities Under A High Deductible Health Plan


An HDHP typically does not cover services and prescription drugs until the deductible has been met. However, some high deductible plans may cover preventive services and programs, such as prenatal care, cancer screenings, and smoking cessation programs. In these cases, the deductible applies to services that are not considered preventive. After you meet your deductible, the plan coverage provisions determine how much you will be reimbursed. Remember, you may still be required to pay co-pays and/or co-insurance for medical services and prescription drugs covered by the plan. It is a good idea to ask your plan about which services may be covered, and what your out-of-pocket responsibilities will be – before and after you meet the deductible.

Managing Expenses Under A High Deductible Health Plan


Health Savings Accounts and Health Reimbursement Arrangements

To offset HDHPs’ higher deductibles, most individuals enrolled in HDHPs are eligible to set up a tax-advantaged health savings account (HSA).  An HSA enables you to pay for eligible health expenses, including expenses before the deductible has been met, with tax-free dollars. Increasingly referred to as a consumer-driven health plan (CDHP), an HDHP coupled with an HSA can help you take control of your healthcare expenses and save for the future.

Individuals may contribute pre-tax earnings each year to their HSAs. Some employers help employees contribute to their HSAs on a regular basis through payroll deductions, and some may also elect to make contributions to employee HSAs to help them pay for healthcare expenses before they meet their deductibles.  Though contribution limits apply, individuals can save significant amounts to be used for healthcare costs through HSAs. Unlike flexible spending arrangements, individuals keep their HSAs even when they switch employers. And, any unused amounts in the account at the end of the year continue to accumulate on a tax-free basis to be used for future healthcare costs.

As an alternative to an HSA, some employers contribute to a health reimbursement arrangement (HRA), which employees can use to pay for healthcare expenses that are not reimbursed by the plan. Employees do not contribute to HRAs; any unused funds are forfeited at the end of the year. And under these arrangements, if you change jobs, you no longer have access to the HRA.

HDHPs coupled with an HSA or HRA are an effective way to manage healthcare costs. You can use tax-advantaged dollars to get the care you need, but any unused funds continue to grow tax-free until you need them. Then, once you satisfy your plan’s deductible, your insurance company will reimburse all or a portion of your healthcare costs based on the provisions of your plan.

How Does Your Plan Know When You Have Met Your Deductible?

While you are responsible for paying for services before you reach your deductible (and your HSA or HRA may provide a debit card for this purpose) under an HDHP, you or your provider will submit claims as usual and they will be tracked towards your deductible. When you receive your explanation of benefits (EOB) from your plan, it will show that the expenses will not be reimbursed because you have not yet met your deductible. Once you have satisfied the deductible, the EOB will reflect reimbursement for covered expenses according to the terms of your plan.

Know Before You Go

Under an HDHP, you are responsible for out-of-pocket healthcare costs until the deductible is met, so knowing the cost of a service or procedure in advance can help you better plan your healthcare expenses. Look up your anticipated out-of-pocket costs on the FH® Medical Cost Lookup; before you meet your deductible, the “estimated charge” amount is what will be most relevant to you.

Talk To Your Provider

In some cases, providers may be willing to negotiate their fees, or develop a payment schedule to enable you to pay for the service in installments over time. Ask your provider whether s/he would be willing to consider these options.

You also may want to ask your provider if there are less expensive alternatives to prescribed medications, such as a generic option, or a pill/injection that could be taken at home instead of in your physician’s office.

Prevention

Taking steps to prevent illness and disease is always a good idea and may also be helpful in managing — and possibly avoiding — higher costs of care. As recommended by your provider, go for preventive screenings and annual checkups, and adopt health-promoting behaviors, such as consuming a healthy diet and exercising. Preventive measures, as recommended by your provider, may help you avoid the need for costlier treatments in the future. Remember, some HDHPs cover preventive services and programs before you meet your deductible, so check with your plan to find out how these services are covered.


Your Action Plan For Managing Costs In High Deductible Health Plans


If you are enrolled in an HDHP, following these tips may help you manage your healthcare costs:

Read your plan documents carefully. Contact your employer or plan with any questions you may have about your coverage.
If you do not already have one, ask your employer about enrolling in a health savings account (HSA), or a health reimbursement arrangement (HRA).  If you are eligible, but your employer doesn’t offer an HSA, you can open an account with a local bank (or online). See A New Look at Flexible Spending Accounts, which also includes information on HSAs.
If you have funds remaining in your HSA after meeting your deductible, you may continue to use the account for co-pays, co-insurance and other qualifying healthcare expenses. An HSA cannot be used to pay for insurance premiums. The IRS publishes a list of qualifying healthcare expenses under an HSA.
Always keep a record and copy of your healthcare receipts; this will help you keep track of your healthcare expenses, so that you know when you have met your deductible.
Know before you go: Find cost estimates for services and procedures you may need on the FH Medical Cost Lookup. Knowing how much you may be responsible for paying can help you plan your healthcare expenses accordingly.
Talk to your providers. They may be willing to negotiate fees, accept payments in installments, or prescribe less expensive medication or treatment options.
Go for your clinically-recommended screenings and annual checkups, and talk to your provider about ways in which you could improve your overall health through preventive measures. Remember, some HDHPs cover preventive services and programs before the deductible is met, so ask your plan representative about which of these may be covered.


And most importantly – remember that you are your own best advocate. Speaking up and asking questions up front will help you get the care you need and avoid confusion about your out-of-pocket healthcare costs.

Health plan


Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific health care goals within a society." According to the World Health Organization, an explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people.

There are many categories of health policies, including personal health care policy, pharmaceutical policy, and policies related to public health such as vaccination policy, tobacco control policy or breastfeeding promotion policy. They may cover topics of financing and delivery of health care, access to care, quality of care, and health equity.

Background


Health-related policy and its implementation is complex. Conceptual models can help show the flow from health-related policy development to health-related policy and program implementation and to health systems and health outcomes. Policy should be understood as more than a national law or health policy that supports a program or intervention. Operational policies are the rules, regulations, guidelines, and administrative norms that governments use to translate national laws and policies into programs and services. The policy process encompasses decisions made at a national or decentralized level (including funding decisions) that affect whether and how services are delivered. Thus, attention must be paid to policies at multiple levels of the health system and over time to ensure sustainable scale-up. A supportive policy environment will facilitate the scale-up of health interventions.

There are many topics in the politics and evidence that can influence the decision of a government, private sector business or other group to adopt a specific policy. Evidence-based policy relies on the use of science and rigorous studies such as randomized controlled trials to identify programs and practices capable of improving policy relevant outcomes. Most political debates surround personal health care policies, especially those that seek to reform health care delivery, and can typically be categorized as either philosophical or economic. Philosophical debates center around questions about individual rights, ethics and government authority, while economic topics include how to maximize the efficiency of health care delivery and minimize costs.

The modern concept of health care involves access to medical professionals from various fields as well as medical technology, such as medications and surgical equipment. It also involves access to the latest information and evidence from research, including medical research and health services research.

In many countries it is left to the individual to gain access to health care goods and services by paying for them directly as out-of-pocket expenses, and to private sector players in the medical and pharmaceutical industries to develop research. Planning and production of health human resources is distributed among labour market participants.

Other countries have an explicit policy to ensure and support access for all of its citizens, to fund health research, and to plan for adequate numbers, distribution and quality of health workers to meet health care goals. Many governments around the world have established universal health care, which takes the burden of health care expenses off of private businesses or individuals through pooling of financial risk. There are a variety of arguments for and against universal health care and related health policies. Health care is an important part of health systems and therefore it often accounts for one of the largest areas of spending for both governments and individuals all over the world.


Philosophy: right to health


Many countries and jurisdictions integrate a human rights philosophy in directing their health care policies. The World Health Organization reports that every country in the world is party to at least one human rights treaty that addresses health-related rights, including the right to health as well as other rights that relate to conditions necessary for good health. The United Nations' Universal Declaration of Human Rights (UDHR) asserts that medical care is a right of all people:

UDHR Article 25: "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, illness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control."
In some jurisdictions and among different faith-based organizations, health policies are influenced by the perceived obligation shaped by religious beliefs to care for those in less favorable circumstances, including the sick. Other jurisdictions and non-governmental organizations draw on the principles of humanism in defining their health policies, asserting the same perceived obligation and enshrined right to health. In recent years, the worldwide human rights organization Amnesty International has focused on health as a human right, addressing inadequate access to HIV drugs and women's sexual and reproductive rights including wide disparities in maternal mortality within and across countries. Such increasing attention to health as a basic human right has been welcomed by the leading medical journal The Lancet.

There remains considerable controversy regarding policies on who would be paying the costs of medical care for all people and under what circumstances. For example, government spending on health care is sometimes used as a global indicator of a government's commitment to the health of its people. On the other hand, one school of thought emerging from the United States rejects the notion of health care financing through taxpayer funding as incompatible with the (considered no less important) right of the physician's professional judgment, and the related concerns that government involvement in overseeing the health of its citizens could erode the right to privacy between doctors and patients. The argument furthers that universal health insurance denies the right of individual patients to dispose of their own income as per their own will.

Another issue in the rights debate is governments' use of legislation to control competition among private medical insurance providers against national social insurance systems, such as the case in Canada's national health insurance program. Laissez-faire supporters argue that this erodes the cost-effectiveness of the health system, as even those who can afford to pay for private health care services drain resources from the public system. The issue here is whether investor-owned medical insurance companies or health maintenance organizations are in a better position to act in the best interests of their customers compared to government regulation and oversight. Another claim in the United States perceives government over-regulation of the health care and insurance industries as the effective end of charitable home visits from doctors among the poor and elderly.

Economics: health care financing


Many types of health policies exist focusing on the financing of health care services to spread the economic risks of ill health. These include publicly funded health care (through taxation or insurance, also known as single-payer systems), mandatory or voluntary private health insurance, and complete capitalization of personal health care services through private companies, among others. The debate is ongoing on which type of health financing policy results in better or worse quality of health care services provided, and how to ensure allocated funds are used effectively, efficiently and equitably.

There are many arguments on both sides of the issue of public versus private health financing policies:

Claims that publicly funded health care improves the quality and efficiency of personal health care delivery:

Government spending on health is essential for the accessibility and sustainability of health care services and programmes.
For those people who would otherwise go without care due to lack of financial means, any quality care is an improvement.
Since people perceive universal health care as free (if there is no insurance premium or co-payment), they are more likely to seek preventive care which may reduce the disease burden and overall health care costs in the long run.
Single-payer systems reduce wastefulness by removing the middle man, i.e. private insurance companies, thus reducing the amount of bureaucracy. In particular, reducing the amount of paperwork that medical professionals have to deal with for insurance claims processing allows them to concentrate more on treating patients.
Claims that privately funded health care leads to greater quality and efficiencies in personal health care:

Perceptions that publicly funded health care is free can lead to overuse of medical services, and hence raise overall costs compared to private health financing.
Privately funded medicine leads to greater quality and efficiencies through increased access to and reduced waiting times for specialized health care services and technologies.
Limiting the allocation of public funds for personal health care does not curtail the ability of uninsured citizens to pay for their health care as out-of-pocket expenses. Public funds can be better rationalized to provide emergency care services regardless of insured status or ability to pay, such as with the Emergency Medical Treatment and Active Labor Act in the United States.[citation needed]
Privately funded and operated health care reduces the requirement for governments to increase taxes to cover health care costs, which may be compounded by the inefficiencies among government agencies due to their greater bureaucracy.

Medical research policy


Medical research can be both the basis for defining evidence-based health policy, and the subject of health policy itself, particularly in terms of its sources of funding. Those in favor of government policies for publicly funded medical research posit that removing profit as a motive will increase the rate of medical innovation. Those opposed argue that it will do the opposite, because removing the incentive of profit removes incentives to innovate and inhibits new technologies from being developed and utilized.

The existence of sound medical research does not necessarily lead to evidence-based policymaking. For example, in South Africa, whose population sets the record for HIV infections, previous government policy limiting funding and access for AIDS treatments met with strong controversy given its basis on a refusal to accept scientific evidence on the means of transmission. A change of government eventually led to a change in policy, with new policies implemented for widespread access to HIV services. Another issue relates to intellectual property, as illustrated by the case of Brazil, where debates have arisen over government policy authorizing the domestic manufacture of antiretroviral drugs used in the treatment of HIV/AIDS in violation of drug patents.

Health workforce policy

Some countries and jurisdictions have an explicit policy or strategy to plan for adequate numbers, distribution and quality of health workers to meet health care goals, such as to address physician and nursing shortages. Elsewhere, health workforce planning is distributed among labour market participants as a laissez-faire approach to health policy. Evidence-based policies for health workforce development are typically based on findings from health services research.

Health in foreign policy

Many governments and agencies include a health dimension in their foreign policy in order to achieve global health goals. Promoting health in lower income countries has been seen as instrumental to achieve other goals on the global agenda, including:

Promoting global security – linked to fears of global pandemics, the intentional spread of pathogens, and a potential increase in humanitarian conflicts, natural disasters, and emergencies;
Promoting economic development – including addressing the economic effect of poor health on development, of pandemic outbreaks on the global market place, and also the gain from the growing global market in health goods and services;
Promoting social justice – reinforcing health as a social value and human right, including supporting the United Nations' Millennium Development Goals.

Global health policy

Global health policy encompasses the global governance structures that create the policies underlying public health throughout the world. In addressing global health, global health policy "implies consideration of the health needs of the people of the whole planet above the concerns of particular nations." Distinguished from both international health policy (agreements among sovereign states) and comparative health policy (analysis of health policy across states), global health policy institutions consist of the actors and norms that frame the global health response.
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