Health Savings Accounts - An American Innovation in Health Insurance
ArrayINTRODUCTON - The term "disease" is commonly used in the United States to describe any program that helps pay medical expenses, if private insurance, social security program or a non-finance the social protection insurance from the government. Synonyms for this usage are "health coverage, the coverage of health care and health benefits" and "health insurance". In a more technical term used to describe all forms of insurance that provides protection against accidents and maladie.En America, the health insurance industry has evolved rapidly in recent decades. Most people in 1970 who had health insurance liability. liability insurance is often called upon to pay. It 's a traditional health insurance in which the medical provider (usually a doctor or hospital) is paid a fee for Each Service Provided to Patients covered under the policy. An important category is associated with the compensation plan is the health care consumer-driven (CASS .) plans for the health of consumers has led to enable individuals and families to have more control over their health care, including when and how to access that kind of care they receive and how much they spend on services care plans are sante.ca still associated with a higher deductible, the insured must pay out of pocket before you can claim the insurance money. Consumer-driven health care plans include health plan reimbursement (HRA), flexible spending accounts (FSAs) The high-deductible health plans (HDHps), Archer medical savings accounts (EMC) Health Savings Accounts (HSA). These include health savings accounts are the most recent and has grown rapidly in recent savings account décennie.SANTÉ is what? A health savings account (HSA) is cash savings tax advantaged account available medical taxpayers of the United States. The funds in the account are not subject to federal income tax at the time of filing. These can be used pay for eligible medical expenses at any time without tax liability fédéral.Une Another feature is that funds dedicated to health savings account roll and accumulate from year to year if not spent. These can be removed by the employees retire without any obligation tax. Withdrawals for qualified expenses and interest earned are not subject to federal income tax. According to the Treasury Office, "A Health Savings Account is an alternative to traditional health insurance, there is a savings product that offers a way different consumers pay for their care santé.HSA help pay for current health expenses and save for future qualified medical and retiree health care on a tax-free. "Thus, the health sector savings is an effort to increase the efficiency of health care systems in the United States and Encourage people to be more prudent and responsible to their health needs. Falls Into It 's the category plans, consumer- Driven Health Care santé.Origine épargneLe account health savings account was created under the Medicare Prescription Drug, improvement and Modernization Act approved by the U. S. Congress in June 2003 by the Senate in July 2003 and signed by President Bush on 8 December 2003.Admissibilité-The following persons are entitled to open a health savings account - Those who are covered by a high-deductible Health Plan (HDHP). - Those who were not covered by other insurance plans. - Those who were not enrolled in any Medicare4.Donc limit of personal income, which could help should not and do not need earned income to contribute to A. In return, however, can be implemented by those who depend on someone else's tax. While HSAs may be established independently by children.What 'is a high-deductible health plan (HDHP)? Entry into a high-deductible Health Plan (HDHP) is a necessary qualification for anyone wishing to open a health savings account. Indeed, the HDHPs had driven by the modernization of the Medicare law has introduced the CGS. A High Deductible Health Insurance Plan is a disease that has some level of deduction. This limit must be crossed before the insured may request the insurance money. The warranty does not cover first dollar medical expenses. As an individual you must pay the initial costs is called Out-of-pocket.Dans a number of HDHPs cost of vaccination and preventive health care are excluded from the meaning that the individual is reimbursed for them. HDHPs can be taken both by individuals (and self-employed) and employers. In 2008, HDHPs are offered by insurance companies in America with franchises ranging from a minimum of $ 1.100 and $ 2.200 for an independent self and family coverage. The maximum limits of pocket for HDHPs is $ 5.600 for a car and $ 11.200 for the autonomy and the inclusion of the family. These limits are allowable IRS limits are called by the Internal Revenue Service (IRS). In the relationship between relief HDHPs and the premium paid by policyholders is inversely propotional say the higher deductible, the lower the premium and vice versa. The main advantages of the alleged to have HDHPs) to reduce health care costs, causing patients to become more cost conscious, and b) make insurance premiums more affordable for the uninsured. The logic is that when patients are fully covered (eg health plans, with low relief), tend to be less health conscious and therefore less sensitive to the cost of fetching a savings account soigner.Ouverture santéUne person can register for HSA with banks, insurance credit unions and other approved companies. But not all insurance companies offer health insurance plans HSAqualified is important to use an insurance company that offers this type of insurance plan qualified. The employer can then establish a plan for employees. However, the account remains the property of the individual. Registration Hotline HSA qualified health insurance is available in all states except Hawaii, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, Vermont and Washington.Contributions Offering compteContributions Health HSA can be performed all the conditions, which owns account, an employer or any other person. When made by the employer's contribution is not included in the income of the employee. When an employee, it shall be considered exempt from federal taxes for 2008, the maximum amount that can be contributed (and obvious) to an HSA from all sources: $ 2.900 (self-only coverage) $ 5.800 (family coverage) These limits are set by Congress U. S. through legislation and are indexed annually for inflation. For people over 55 years, there is a special provision that allows them to get over $ 800 filing for 2008 and $ 900 for 2009. The maximum amount that a real person may therefore depends on the number of months is covered by HDHP contribute (pro rata) from the first day of a month. For the family, for example if you have HDHP coverage from January until June 30, 2008 1.2008, and then cease to have HDHP coverage, you may contribute to HSA or 6.12 of $ 5.800 $ 2.900 2008. If you have family HDHP coverage from January to June, 1.2008 30, 2008, and have self-only HDHP coverage from 1 July 2008 to December 31, 2008, may contribute to HSA over 6 12/06 x $ 5.800 / 12 of $ 2.900 or $ 4.350 for 2008. If all conditions, opens its doors HDHP on the first day of the month, you can contribute to HSAs on the first day itself. However, if he / she has opened an account at one the other day first, then can contribute to the HSA from next month. Contributions may be submitted by April 15 next year. Contributions to the HSA beyond the contribution limits must be withdrawn by the person or subject to an excise tax of a person shall pay tax on the excess amount can be retiré.Cotisations employeurL'employeur contributions on behalf of the employee under a plan salary reduction plan called the 125th Division is also called a piano bar. Contributions in the piano bar are made on a basis that is before taxes are excluded from employee income. The employer must contribute on a comparable basis. comparable contributions are all contributions to HSAs for employers who are: 1) the same amount or 2) the same percentage of the annual franchise. However, part-time employees who work less than 30 hours per week can be handled separately. The employer can then classify those workers who opt for coverage in yourself and those opting for family coverage. The employer can automatically make contributions to the SSA on behalf of the employee unless the employee chooses not to have explicitly these contributions by the employer. HSALe Withdrawals from the HSA is owned by the employee and he / she may be qualified expenses if necessary. He also decides what to contribute, how to remove the costs eligible to be considered and that such investments will be made to increase the bill. Another feature is that the funds remain in the account and the role of each year. There is no use it or lose it rules. HSA participants do not have to obtain prior approval from their HSA trustee or fund their medical insurer to withdraw, and the funds are not subject to income tax if it was made for "eligible medical expenses. Expenditure include the cost of medical services and products covered by the health plan but subject to cost sharing, such as deductible and coinsurance, or copayments, and many other medical expenses not covered, such as dental, vision and chiropractic, durable medical equipment such as glasses and hearing aids, and transportation costs related to medical care. Without a prescription, prescription drugs are eligible. However, qualified medical expenses must be incurred after the HSA is tax-free créé.distributions may be withdrawn from the HSA qualified medical expenses of those covered by the HDHP, spouse (if n is not covered) by the individual and any dependents (even if not covered) individual.12 of The HSA account can be used to pay expenses eligible for the previous year Provided that such expenses were incurred after the HSA has been established the individual must keep receipts for expenses covered by HSA, as they may be required to prove that withdrawals from the HSA for qualified medical expenses are been made and can not be used otherwise. Thus the individual may have to produce receipts before the insurance company to prove that their luggage has been reached. If withdrawal is made for medical expenses not qualified then the amount withdrawn is treated as taxable persons (in addition to income) and is therefore subject to an additional penalty of 10 percent. Normally, money can be used to pay medical insurance premiums. However, under certain circumstances, the exceptions are autorisées.Ce -1) to pay for health coverage plan, while receiving unemployment benefits or the federal government. 2) COBRA continuation coverage after leaving employment with a company that provides health insurance coverage. 3) qualified long-term care insurance. 4) Medicare premiums and expenses of pocket, including deductibles, co-pays, and coinsurance for Part A (hospital services and hospital), Part B (physician and outpatient services), Part C (Medicare HMO and PPO plans) and Part D (prescription drugs). However, if the individual becomes disabled or reaches age 65, and withdrawals from savings account health are considered exempt from income tax and penalty of 10 percent, whatever the purpose for which withdrawals are made. There are several methods by which funds can be withdrawn from the CGS. Some provide HSA account holders with debit cards, some with checks and some options for a process similar to medical insurance reimbursement "growth HSADepuis health savings accounts was established in January 2004, there has been a phenomenal growth in their number. From about 1 million subscribers in March 2005, the number grew to 6.1 million people registered in January 2008.14 This represents an increase of 1.6 million since January 2007, 2.9 million dollars since January 2006 and 5.1 million by March 2005. This growth was visible in all segments. However, the strong growth of groups and small groups was much higher in the individual category. According to forecasts by the Treasury Department UP, HSA will increase the number of insured to 14 million by 2010. These policies provide coverage for 14 million U.S. 25-30000000 citoyens.Dans the individual market, 1.5 million people were covered by HSA / HDHPs purchased in January 2008. coverage based on the number of people affected, 27 percent of new policies purchased individual (defined as those purchased during the most recent full month or quarter) were enrolled in HSA / HDHP. In the market for small group , the force was 1.8 million in January 2008. In this group, 31 percent of new registrations were all in the HSA / HDHP category. Large Group had the highest number with 2.8 million people registered to since January 2008. In this category, six percent of all new listings were HSA / Category HDHP.Avantages CGSLes supporters CGS consider a number of benefits from them. First you think, because they have a high threshold frank, the insured will be more health conscious. Therefore, they are more sensitive to costs. Excesses high encourage people to be more cautious about spending on health and health care and makes them want to shop for bargains and be more vigilant against abuses in the health sector. This, it believes, will reduce the rising costs of health care and increase efficiency of health care in the United States. HSA eligible plans typically provide tools for decision support that includes members to a certain extent, the information on the cost of health care services and quality of health care providers. Experts suggest that reliable information on the cost of health care services and the special quality of certain health care providers to involve more actively included in the decision to purchase health care. These tools can be provided by insurance carriers health insurance plan to all subscribers, But May be more important for members allowable HSA plans have an incentive to make informed decisions Greater quality and cost of healthcare providers and services.On believes that the lower premiums associated with HSAs / HDHPs allow more people to enroll in medical insurance. This means that low-income groups without access to health insurance will able to open HSAs. Undoubtedly, higher deductibles are associated with HSA qualified HDHPs, but it is estimated that the tax savings and lower premiums under the HSA will cost less than other insurance plans. The funds available to the HSA may be located from year to year. There is no use it or lose it rules. This leads to an increase in the savings account holder. The funds can be accumulated tax free for future medical expenses if the desired sweetness. Thus, economies of HSA can be cultivated through investissements.La nature of these investments is determined by the insured. The remuneration of savings in the HSA are exempt from income tax savings may revoke the holder of the HSA after turning 65 years without paying taxes or fines . The account holder has complete control of his account. He / She is the owner of the account since its inception. A person can withdraw money if necessary, without doors. So the owner decides what to put in his account, as pay and how to save for the future. HSAs are portable in nature. This means that if the holder changes his job, loses his job or move to another location, he / she can still keep compte.Donc, if the account carefully, then you can transfer your wishes into account health savings management authority to another. Thus, portability is an advantage of HSAs. Another advantage is that most HSA plans to provide first dollar coverage for preventive care. This is true for virtually all HSA plans offered by large employers and over 95% of plans offered by employers are small. And 'also true over half (59%) plans that have been acquired by particuliers.Tous plans offer first dollar benefits for preventive care including annual exams, vaccinations, and care for children wellchild, mammograms and pap tests, 90% included screening for prostate cancer and 80% included screening for colon cancer. Some analysts believe HSAs are more attractive to young and healthy because they do not have to pay out of pocket expenses frequent. On the other hand, should pay lower premiums for HDHPs meet unforeseen aident.Comptes health savings are so great for employers. The advantages of choosing a savings account for a traditional health plan health insurance can directly affect the bottom line of the budget to benefit from an employer job. For example, health savings accounts rely on a high insurance deductible, which reduces the premiums of the plan of the employee. Thus, all contributions to Health Savings Account are pre-tax, lowering the gross wage and thereby reduce the 'amount of fees, the employer must CGSLes payer.Critique opponents of Health Savings Accounts would do more harm than good to the health insurance system in America, some groups of consumers, as EU consumers, and many medical organizations such as the American Public Health Association, rejected HSA because in their opinion, have only health, young people and make the health care system more expensive for everyone. According to Stanford economist Victor Fuchs, "The main effect to put more of it on consumption is to reduce the redistributive element of social insurance. Some others believe that healthy people to remove HSA from the pool to raise insurance premiums and that is all left. HSAs encourage people to look out for more than themselves and spread risk less. Another concern is that the money people, except HSA will be insufficient. Some people believe that HSAs do not allow sufficient savings to cover the costs. Even the person who contributes more than ever and takes the money would not be able to cover the costs of health care in retirement if inflation continues in CGS health.Children opponents include figures like John Garami insurance commissioner, who spoke a recipe dangerous destabilization of the health insurance market and to make matters worse for the uninsured. Another criticism is that they benefit the rich poorer. Those who earn more will be able to get tax relief of more than who earn less. Critics point out that the increase in insurance premiums, deductibles and removes much of the income of low income. So the low income groups receive tax breaks because they are not significantly already pay little or no taxes. Other tax breaks hand on HSAs and HSA savings on income from savings from other cost billions of dollars in tax revenue for the Treasury public.The Treasury Department has estimated it would cost the Government HSA 156,000,000,000 dollars over a decade. Critics say this could increase significantly. investigations were conducted on various HSAS efficacy and some have found that account holders are not particularly happy with the HSA plan and many are still ignorant about the functioning of the CGS. This 2007 study of American workers by human resources consultancy Towers Perrin showed satisfaction with account-based health plans (ABHPs) was low. People were not happy with them, generally in relation to people with more traditional treatments health. Respondents said they were uncomfortable with the risk and do not understand how fonctionne.Selon the Commonwealth Fund, the first experiments have high-deductible health plans reveals low satisfaction eligible, out-of-pocket costs high, and problems access costs and expenses. Another survey conducted by the Research Institute has discovered the benefits that people enrolled in HSA eligible health high deductible plans are less satisfied with many aspects of their health care than adults in the more detailed plans People in these plans allocate substantial amounts of income for their health care, particularly those with poor health or lower incomes. The investigation also found that adults in high-deductible health are much more likely to delay or avoid needed care, or to switch medications because of cost. The problems are particularly pronounced among those with health problems or incomes over faibles.Les political leaders were on their critical voice of CGS . Representative John Conyers, Jr. issued the following statement criticizing the HSAS "The plan the president for health care is not to cover the uninsured by making health insurance affordable, or even lower cost care health. Its real purpose is to make it easier for companies to dump their loads of health insurance for employees, give tax breaks for the wealthy, and increase the profits of banks and financial intermediaries. The policies of health care prepared at the request of special interests do nothing to help the average American. In many cases, can make health care more accessible. "In fact, the report of a U.S. Government Accountability Office, released April 1, 2008 indicates that the rate of enrollment in the HSA is higher for groups high and low for revenus.Une study entitled" Health Savings Accounts and High Deductible Plans Health: this is an option for low-income families? Catherine Hoffman and Jennifer Tolbert was sponsored by the Kaiser Family Foundation reports the following main conclusions regarding CGS: a) the premium for health insurance HSA-qualified insurance may be less traditional, but these travel plans of many financial risks individuals and families through higher deductibles. b) premiums and out-of-pocket costs for health plans, HSA-qualified consume a significant portion of the budget of a low family income. c) Most people on low incomes and families do not face high enough tax liability to benefit significantly from tax deductions associated with HSAs. d) People with chronic diseases, disabilities and needs of others with high medical costs may face even more out of pocket costs under HSA-qualified health plans. e) Cost sharing reduces the use of health care, particularly primary and Preventive Services, and people on low incomes Those who are sick and are particularly sensitive to Increases in cost sharing. f) health savings accounts and high deductible plans should not significantly increase insurance coverage among non assurés.Choisir santéMalgré benefits plan offered by the HSA, you may not be suitable for everyone. While choosing an insurance plan, they must take into account the following factors: first prize to be paid. Inside cover and benefits under the plan. Third various exclusions and limitations. Portability quarter. Fifth Costs Out-of-pocket as insurance co-pays and deductibles. 6 Access to doctors, hospitals and other providers. How much and how often the seventh pay for care. All eighth existing health problem or physical disability. Type ninth available.The tax saving scheme should be chosen according to their needs and abilities financière.BIBLIOGRAPHIE1 Questions and Answers About Health Insurance-A Consumer Guide, published jointly by the Agency for Healthcare Research and Quality (AHRQ) and Plans America's Health Insurance (AHIP) 2 http://www.en.wikipedia.org/wiki/Health_savings_account March 2002 AHIP Survey of Health Insurance Plans 4 "How High is too high? Implications of high-deductible health plans" Davis, Karen, Michelle Doty, and Alice have the April issue of the Common Fund assets, 2005 5 http://www.fdhc.state.fl.us/schs/pdf/hsa_tri-fold_brochure.pdf CENSUS HSA HDHP 6 / 2008 by Hannah Yoo, Politics and Research Center, the health insurance plans of America 7 "savings accounts HEALTH entered first experience with accounts and health plans, John E. thickness Director, Healthcare 8 Thomas Wilder and Hannah Yoo, a study of the effects of preventive health savings account (HSA) plan in July 2007, "America's Health Insurance Plans, November 2007 9 Gladwell, Malcolm, "The myth of" moral hazard "," The New Yorker (08/29/2005) Baseline survey in October 2008, the Bank 11 Health Benefits 2007 Annual Survey of the employer, the Kaiser Family Foundation 12 From savings accounts and health plans Top Franchise health: they are a good choice for families on low incomes? Catherine Hoffman and Jennifer Tolbert for the Kaiser Family Foundation, October 2006 13 Medicare prescription drugs, improvement and Modernization Act of 2003
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