Under the last-month rule, if you are an eligible individual on the first day of the last month of your tax year , you are considered an eligible individual for the entire year. You are treated as having the same high-deductible health plan coverage for the entire year as you had on the first day of that last month. The total contribution for the year can be made in one or more payments at any time up to your tax-filing deadline . However, if you wish to have a contribution made between January 1 and April 15 treated as a contribution for the preceding tax year, please contact the HSA bank.
You cannot use HSA funds to pay for qualified medical expenses incurred before you enrolled in a high-deductible health plan. In order to establish an HSA, you must enroll in a high-deductible health plan. Your eligibility to contribute to an HSA is determined by the effective date of your high-deductible health plan coverage. Once funds are deposited into your HSA, those funds can be used to pay for qualified medical expenses tax-free, even if you no longer have high-deductible health plan coverage.
The funds in your account automatically roll over each year and remain in the account indefinitely until used. Once you discontinue coverage under a high-deductible health plan and/or get coverage under another health plan that disqualifies you from an HSA, you can no longer make contributions to your HSA. However, since you own the HSA, you can continue to use it for future qualified medical expenses. To enroll in a high-deductible health plan, complete the Blue KC application process.
The Blue-Saver® PPO health insurance plan is a high-deductible health plan that allows you to establish an HSA as part of your health benefits. When you enroll in the Blue Saver plan, you may be offered the opportunity to establish a HSA with one of our preferred banks. You will be presented with appropriate banking authorizations and disclosures necessary for Blue KC to work with the bank that will establish your HSA. Please note all financial institutions offering HSA products must comply with the USA Patriot Act, requiring your HSA bank to collect and verify information about you when processing your HSA application.
Once your HSA has been established, you will be mailed a welcome kit and HSA debit card from the bank. A Health Savings Account allows members enrolled in a qualified high-deductible health plan to contribute funds on a tax-free basis into the member's account. These funds are used for payment of qualified medical expenses as defined by the IRS. Unused funds in an HSA roll over in the member's account at the end of each calendar year. If you're an HMO member, you will need to receive services from an in-network HMO provider.
However, you will be able to receive emergency or urgent care services no matter where you are. For details about your coverage, please review your Blue KC certificate, which outlines the benefits and exclusions related to your health insurance plan. You can view your certificate by logging in and accessing the Plan Benefit section. The maximum amount that may be contributed to your HSA for any year is a certain amount established annually by the IRS.
This amount depends on whether you have individual or family coverage under your qualified high-deductible health plan. The same annual contribution limit applies regardless of whether the contributions are made by an employee, an employer or both. A qualified health-deductible health plan is a health plan with an annual deductible for an individual or a family that meet the minimum deductible amount published annually by the U.S. The annual out-of-pocket expenses required by the high-deductible health plan also does not exceed the out-of-pocket maximums published by the U.S. Out-of-pocket expenses include deductibles, copayments and other amounts the member must pay for, but do not include premiums or amounts incurred for non-covered benefits. Each payment you make for covered healthcare services you've received from your providers such as a physical exam counts toward your deductible.
Once Blue KC processes the claims we receive from your providers showing the payments that you have made for covered healthcare services, we apply those payments toward your deductible. Your PersonalBlue health insurance plan includes a prescription drug coverage plan with set copayments for both generic and brand name prescription drugs. The PCA portion of your plan cannot be used to reimburse you for these copayments. You can continue to use the funds in your account tax-free for out-of-pocket health expenses. If you enroll in Medicare, you can use your account to pay Medicare premiums, deductibles, copayments and coinsurance under any part of Medicare. If you have retiree health benefits through your former employer, you can also use your account to pay for your share of retiree medical insurance premiums.
The one expense you cannot use your account for is to purchase a Medicare supplement insurance or "Medigap" policy. Distributions used for any other purpose are includable in income and may also be subject to an additional 20 percent tax. This 20-percent penalty tax does not apply to distributions made after your death, disability or attainment of age 65. To change a PCP, log in and visit you Profile by clicking on the icon by your name in the top right corner of your homepage.
In the Coverage Information section you'll see a list of covered members for your Blue KC policy. From here select "Change PCP" for the appropriate member and you can search for and designate a new PCP. Once we have processed your PCP change request, we will send you a new member ID card that contains the information of your newly selected PCP.
You may also call the Customer Service number listed on your member ID card to change your PCP. Please note that if you have health insurance through your employer, you may be required to contact your group benefits administrator to change your PCP. After the funds in your PCA have been used, you will be responsible for a certain amount of your healthcare costs until your deductible amount has been met.
You do have the benefit of the negotiated prices for healthcare from network providers, but you will pay for all of the healthcare until your individual or family deductible is met. Use your HSA debit card or other means provided by your HSA bank to pay for qualified medical expenses. You should only use the debit card at healthcare-related locations.
This may include an Internet transaction as long as the items being purchased are qualified medical expenses. You may also use your HSA debit card for online capabilities such as online bill pay. Yes, funds may be withdrawn and used to pay for qualified medical expenses for you and/or your tax dependent without a tax penalty.
For purposes of medical deductible of a child of divorced or separated parents, they can be treated as a dependent of both parents. Each parent can include the medical expenses he or she pays for the child, even if the other parent claims the child's dependency exemption. Please consult a legal or tax adviser concerning questions you may have. A deductible is the amount that you are responsible for paying annually for healthcare services. Exceptions are outlined in your Blue KC certificate, which lists the exclusions related to your health insurance plan. A copayment, or copay, is the dollar amount that you pay to a provider at the time you receive a service.
For example, you might pay a $30 copay each time you visit your allergy doctor. The copay amount is defined in your Blue KC certificate, which outlines your responsibilities for health insurance plan payments. Allowable charges are the maximum amount payable to you under your health insurance plan for a particular service. Contracted providers have agreed to accept this amount as payment in full. For example, if the provider charges $100 for a service and Blue KC pays $80 as the allowable charge, the provider cannot ask the member to pay the remaining $20. Keep in mind, however, that some health insurance plans have coinsurance.
In those cases, members are required to pay a percentage of the allowable charge. For specific details about your plan, review your Blue KC certificate, which outlines your payment responsibility. Billed charges are the amount charged or billed by your healthcare provider for the services/supplies you received.
Not all provider charges will be paid by your health insurance plan. Your children's coverage while they are away from home depends on the type of health insurance plan you have. If you have health insurance through your employer, check with your group benefits administrator for more information. If you do not have health insurance through an employer and instead pay your monthly premiums directly to Blue KC, call the Customer Service number listed on your member ID card. There are two times you can make a change to your enrollment options. Your employer schedules an open enrollment period once a calendar year when all employees may make changes to their health insurance plan.
You may also make a change during a special enrollment period if you acquire a new dependent or if your coverage is terminated under another health insurance plan. If you have health insurance through an employer, your group benefits administrator, typically someone in your Human Resources department, can help you make changes to your health insurance plan. Sometimes providers send statements to their patients before Blue KC has finished processing and paying the claim. You might see a note on the bill that says "Insurance Pending." We will send you an Explanation of Benefits once we have processed your claim. If you are still unsure if you owe the provider, call their billing office.
Please note, if your provider was not in the Blue KC HMO network, you will be responsible for paying all services and fees for seeing that provider. You can view your EOBs and details about your claims, including how much you owe, by logging in and visiting the Claims and Usage section. In addition, excess contributions are subject to a six-percent excise tax. Rollover contributions do not count in determining whether an excess contribution has been made.
If you have health insurance through your employer, check with your group benefits administrator to have a dependent added to your plan. He or she has the information and/or forms you need to add your dependent to your health insurance plan. When you see an out-of-network provider, we send a check to you for the covered amount of those services. We will send you an EOB that explains how that amount was calculated.
If the provider you saw is out-of-network you will be responsible for paying the provider directly. We will send you a payment for the amount that is covered by your plan. Yes, you must pay your copayment when you see your in-network provider. Your copayment amount depends on the health insurance plan you have and the services you are receiving from your provider.
Give the following article a thorough read to find out how to read a blue cross blue shield insurance card. Routine Preventive care is a care benefit that is not subject to a deductible. Once your PCA funds are exhausted and the remainder of your deductible has been met, your health insurance plan will start paying.
A majority of in-network expenses will be covered by your health insurance plan. Once your out-of-pocket maximum has been met, your health insurance plan pays 100% of your covered expenses. Many people are insured under more than one health and/or dental insurance plan at the same time. Because of dual insurance, Medicare Secondary Plans and Coordination of Benefit requirements, Blue KC needs to determine primary insurance based on the facts of each situation. Most health insurance and dental plans include a COB provision that defines these requirements.
This provision prevents payments from all Plans from exceeding the total allowable expense. Getting a checkup now will help your PCP learn about your medical history before any health issues occur. If someone other than your spouse is named the beneficiary of your HSA, the HSA will no longer be considered an HSA as of the date of your death. Rather the beneficiary is required to include the fair market value of the HSA assets as of the date of death in his or her gross income for the taxable year that includes the date of death.
How Do I Find My Bcbs Policy Number The included amount is reduced by the amount in the HSA used, within one year of your death, to pay your qualified medical expenses that incurred prior to your death. If your spouse is the named beneficiary of your HSA, your HSA becomes the HSA of your spouse upon your death, subject to the completion of documents as required by your bank. A Primary Care Physician is the physician you choose to be your primary source for medical care. Your PCP coordinates all your medical care and knows your specific health history. You can designate a physician who specializes in family practice, general practice, internal medicine or pediatrics and is in your network as your PCP.
Each dependent on your health insurance plan will also need a designed PCP. Everyone on your health insurance plan may have a different PCP. If you have paid your premium and need to access medical care or prescriptions, but have not yet received your ID card, you can obtain the services you need. Blue Shield will work with you to ensure that your medical care or prescriptions are covered appropriately. In this case, you must file your request to terminate coverage no later than the last day of the fall health insurance coverage period.
International healthcare coverage is available for employers, individuals and students, providing peace of mind for everyone from short-term travelers to long-term expatriates, for destinations around the world. The information provided is intended to provide general information only and does not attempt to give you advice that relates to your specific circumstances. State laws and regulations governing health insurance and health plans may vary from state to state.
Further, any information regarding any health plan will be subject to the terms of its particular health plan benefit agreement and some health plans may not be available in every region or state. After you see a provider for healthcare services, your provider will send a claim for those services to Blue KC. The claim is paid directly from your PCA funds. Blue KC will send you an Explanation of Benefits showing what was paid to the provider. Blue KC is committed to keeping you informed when it comes to your health insurance plan.
PersonalBlue is a type of health insurance plan that pairs a PPO plan with a Personal Care Account also known as a Health Reimbursement Arrangement . Your employer puts money in the PCA that is used to pay for a portion of your PPO deductible. You only have to help pay for the deductible after your HRA balance has been spent. And if you don't use all of the money in your PCA, some or all of it will typically roll over for use in the following year. Once you turn age 65, you can also use your account to pay for things other than qualified medical expenses.
If you do choose to use your account for other expenses, the amount withdrawn will be taxable as income but will not be subject to any other penalties. Individuals under age 65 who use their accounts for non-medical expenses must pay income tax and a 20 percent penalty on the amount withdrawn. Sometimes it's unclear as to whether or not a member has both parts A & B of Medicare.
