|
1. What
is a deductible?
|
|
2. How
does my deductible affect my monthly premium?
|
|
3. How
should I decide what deductible amount is right for me?
|
|
4. What
is co-insurance?
|
|
5. What
is a co-pay?
|
|
6. Why
would I choose an HMO health plan?
|
|
7. Why
would I choose a PPO health plan?
|
|
8. What
is the advantage of participating in a Group Association plan?
|
|
9.
Which
carriers are available in the Chamber of Commerce group plans?
|
|
10.
What is a
short-term medical plan?
|
|
11. What is a
Health Savings Account (HSA)?
|
|
12. What are the
primary advantages of an HSA?
|
|
13. What is a
"Fee-for-Service" plan?
|
|
14. What is a
catastrophic health plan?
|
|
15. Will a
catastrophic health plan cover my office visits?
|
|
16.
What is a
Health Savings Account (HSA)?
|
|
17.
What are the
primary advantages of an HSA?
|
|
*********************************
|
|
1.
What is a deductible? (click to return to question)
A
deductible is the amount which you are required to pay each calendar year before the plan begins to provide benefits for covered services.
|
|
2. How does my deductible affect my monthly premium? (click
to return to question)
Within
any particular plan and provider, the higher your deductible, the lower the premium, and vice versa.
|
|
3. How should I decide what deductible amount is right for me? (click
to return to question)
Consider
how often you (and your family) visit the doctor or hospital, and how much financial risk you are willing to assume up front.
|
|
4.
What is co-insurance? (click
to return to question)
Coinsurance
is the level of coverage (usually a percentage) provided by the plan after the calendar-year deductible has been satisfied. For example, in an 80/20 plan, the
insurance provider pays 80% of such charges while the insured pays the remaining 20%.
|
|
5. What is a co-pay? (click
to return to question)
The
copay is your share of the cost for a specified service (usually a flat dollar amount). This is most often applicable for office visits and prescription drugs.
|
|
6. Why would I choose an HMO health plan? (click
to return to question)
Generally,
an
HMO plan has no deductible. What distinguishes an HMO plan is that you must select a Primary Care Physician to handle or refer all of your medical needs.
|
|
7. Why would I choose a PPO health plan? (click
to return to question)
A
PPO plan allows you a choice of physicians and hospitals within a given network of providers. One of the largest and most common network in Illinois is PHCS
(Private HealthCare Systems).
|
|
8.
What
is the advantage of participating in a Group Association plan?
(click
to return to question)
The
self-employed and small businesses are eligible to participate in a group plan, and take advantage of group benefits that would not otherwise be available to them.
|
|
9.
Which
carriers are available in the Chamber of Commerce group plans?
(click
to return to question)
The
current Chamber of Commerce group plans available are a Unicare HMO,
an Aetna HMO, and an Aetna QPOS plan.
|
|
10.
What is a
short-term medical plan?
(click
to return to question)
A
short-term medical plan is a temporary health plan available to
those who are changing jobs, graduating from college, waiting for
group coverage, anticipating being laid off, or other similar times
of transition. Oftentimes a short-term medical policy can be
used as a cost-effective alternative to COBRA or to serve as a
"bridge" between health plans.
|
|
11.
What is a
Health Savings Account (HSA)?
(click
to return to question)
A
Health Savings Account plan is a combination of a qualified
high-deductible health insurance plan and a savings account that is
tax-free when used for qualified medical expenses. Self-employed individuals
and small businesses are eligible.
See IRS
Publication 969 for details.
|
|
12.
What are the
primary advantages of an HSA?
(click
to return to question)
Contributions
are 100% tax-deductible.
Be2l
Savings Account, up to 65% (for individuals) or 75% (for families)
of the deductible amount annually.
Consumer-driven: You
set the priority.
Unused money in
account rolls over into following year. Money in account grows tax-deferred.
After
retirement, you can withdraw the accumulated HSA savings tax-free to pay for out-of pocket medical expenses (e.g., nursing home care and other expenses not covered by
Medicare).
|
|
13.
What is a "Fee-for-Service" plan?
(click
to return to question)
A fee-for-service plan is an alternative or a
supplement to health insurance.
Participants receive discounted, negotiated rates (typically 15-50%
discounts) from providers in major PPO networks, and agree to pay at the time
of service.
|
|
14.
What is a catastrophic health plan? (click to return to question)
A
catastrophic health plan provides coverage for major medical, surgical, and inpatient hospital stays.
|
|
15.
Will
a catastrophic health plan cover my office visits? (click to return to question)
No. |
|
16.
What
is a Health Savings Account (HSA)?
(click
to return to question)
A
Health Savings Account plan is a combination of a qualified
high-deductible health insurance plan and a savings account that is
tax-free when used for qualified medical expenses (hence the name,
“Health Savings Account”). U.S. citizens under the age
of 65 are available. Health Savings Accounts were introduced
in January 2004, as the successor to the Medical Savings Account (MSA)
pilot program. See IRS
Publication 969 for details.
|
|
17.
What are the
primary advantages of an HSA?
(click
to return to question)
Contributions
are 100% tax-deductible.
Because
high-deductible policies cost less than low-deductible policies, employers
and individuals save money.
The
money saved goes into a separate account for incidental medical expenditures. The account covers routine medical expenses (see IRS
Publication 502) that are usually not covered by traditional health
plans (e.g., dental care, eye glasses or contact lenses, hearing aids).
An
employee AND their employer may contribute to the employee's Medical
Savings Account, up to 100% of the deductible amount annually. Consumer-driven: You
set the priority.
Unused money in
account rolls over into following year. Money in account grows tax-deferred.
After
retirement, you can withdraw the accumulated HSA savings tax-free to pay for out-of pocket medical expenses (e.g., nursing home care and other expenses not covered by
Medicare).
|
|
|
