By Scott W. Dowling
5
55 ratings
The podcast currently has 36 episodes available.
#036 Power To The Patients - Why You Need To See Prices explains why Hip Hop artists Fat Joe, Rick Ross, Busta Rhymes, Method Man, French Montana and Chuck D are spot on in the public service announcement demanding price transparency in health care.
Watch the PSA here
#034 Is Your HSA Ready For Next Year explains the steps you need to take now to be prepared for January 1st so that your HSA has you 100% covered for the entire year.
#035 - Why You Need To Tell Your CEO You Want Fountain Health explains why you need to speak up so that you and your family can be healthy and well with the proactive and preventative benefits from Fountain Health compared to what you only have now.
#033 - If you don't know about Fountain Health, you are missing out on the most revolutionary idea to hit health insurance since 1965 and the advent of Medicare. Scott W. Dowling explains how Fountain Health is better than your traditional plan - saving lives while saving money. Learn what makes Fountain Health different and how it helps your company, your employees and their loved ones.
#032 - So How's Your HSA Look In The Middle Of The Year helps you to determine if you are short of dollars needed to cover an accident or sickness right now and the rest of the year, how you can fix that now and whether or not you need a new strategy for 2023.
Scott W. Dowling explains the calculation needed to figure out if you are short of HSA funds in the middle of the year. You may need to contribute to your HSA out of your own pocket now, he explains.
And, if your employer is contributing based on the number of payroll periods during the year, you may wish to rethink your strategy for 2023 so that you are 100% covered next year and every year thereafter.
Maximum Out of Pocket Cost - Current HSA Balance = (Deficit or Surplus)
A Surplus means that you have enough in your HSA to cover the Maximum that you have to pay for any and all health insurance claims you are responsible for in your health plan.
A Deficit means that you will be short of dollars needed to cover the Maximum Out Of Pocket costs that you are responsible for in your health plan. Further, you'll want to determine how much you will receive from your employer towards your HSA over the remaining pay periods of the year. If the combined total of Deficit + Remaining Employer Contribution is still less than the maximum you can contribute for the year, then you should contribute that amount immediately, using your personal savings, which can be deducted from your tax return next spring.
HSA Annual Contribution - (Deficit + Remaining Employer Contribution) = Amount You Should Contribute Now From Personal Funds
#031 - HSA - How To Start Your New Year illustrates what you need to do at the start of 2022 to be 100% covered and have peace of mind no matter what health insurance claims you may incur during the year.
#030 - Why Your High Deductible Health Plan Is Not As High As You Think exposes the misperception that an HDHP is too expensive. Scott W. Dowling provides a real world example - from close to home - that illustrates why there is no advantage to having a traditional low deductible plan and how it ultimately costs you more compared to a High Deductible Health Plan.
Focus on Out Of Pocket Maximum - Not Deductible
The total amount you may spend on an insurance claim includes the amount you pay for the insurance premium plus the total amount you pay Out Of Pocket. Out of Pocket includes deductibles and coinsurance amounts. The maximum Out Of Pocket cost is expressly stated in the plan description. Make certain to locate the maximum Out Of Pocket amount in the plan description when you are comparing your options. Even plans with $250 or $500 deductibles can have maximum Out Of Pocket amounts over $10,000 and even $15,000 annually.
The Goal: Pay the least amount of premium AND the least amount in claims
Your goal is to pay the least amount of money while ensuring you are 100% covered. The money you pay for premium is part of the total you need to consider when comparing your options. Lower deductible plans cost more in premium than higher deductible plans. Out Of Pocket costs are capped at a certain amount as stated in the plan design. The maximum Out Of Pocket states the limit that insurance plan will start to cover all of your remaining annual expenses at 100% - meaning you have nothing further to pay for claims during that annual period. Know your Out Of Pocket maximum.
A High Deductible Health Plan with a Health Savings Account costs less overall
A High Deductible Health Plan (HDHP) with a Health Savings Account (HSA) costs less in annual premium than a traditional PPO or HMO plan. Depending on your tax bracket, a traditional PPO or HMO plan can cost 20% to 30% or more for Out Of Pocket costs compared to an HDHP with an HSA. When you pay your Out Of Pocket costs with your HSA, the money you spend has not been taxed. When you pay your Out Of Pocket costs for a traditional PPO or HMO plan, the money you spend has already been taxed. For example, an individual in the second lowest marginal tax bracket, 22%, will spend 28% MORE on Out Of Pocket expenses. $10,000 paid from your HSA is the same as $12,820 if you have a traditional PPO or HMO. A PPO or HMO costs a lot more money!
I prefer Lively HSA (full disclosure, I receive a nominal fee from Lively...at no cost to you)
Surprise! Blowing Through Your Out Of Pocket Maximum On One Claim Is Very Easy To Do
This example may be relatable for many of you who either participate or are parents of those who participate in competitive athletics. All of the kids in the family have been competitive athletes into college. Our rugby player had an unfortunate accident that required surgery - on his thumb! A broken thumb doesn't sound that bad, but after 3 days of visiting a clinic, getting an x-ray, a second opinion and then surgery including 9 screws and a plate, the total claim came in at over $15,000. And that's at the network discount! We're easily through the annual Out Of Pocket maximum......for a broken thumb!!!!
Thanks, as always, for listening to Doxcost. We appreciate you very much! Please tell your family, friends, coworkers, boss, office manager and/or firm administrator about Doxcost. Listen wherever you get your podcasts.
www.doxcost.com
Hear more music from my pal, Morgan Fingleton, here!
#029 - How To Structure Your Health Savings Account gives you a list of ten (10) easy steps to ensure that you are 100% covered by your High Deductible Health Plan and Health Savings Account from the Get-Go!
An Embedded Deductible is an important plan feature for non-single policyholders (i.e. married couples, single-parent heads of household and families. An embedded deductible limits the deductible for anyone covered person to the individual deductible. If the deductible for a plan is $5,000 for an individual and $10,000 for a married couple, head of household or family, anyone covered person need only meet the individual deductible of $5,000 rather than the $10,000. Should another family member have a claim in the same year, the next person in the family must also meet another $5,000 deductible.
I receive nominal compensation from Lively HSA at absolutely no cost to you. Learn more about Lively here
Over 55 years old? You can (and should) add an additional $1,000 every year to your HSA which is allowed by the IRS in order to allow you to catch-up as you have fewer years to contribute before reaching Medicare-eligible age.
Over 55 years old AND married?? See above AND open a SEPARATE HSA account for your spouse. Your spouse is eligible to add and additional $1,000 every year to your spouse's HSA. The IRS does not allow you to add $2,000 to one account. Consider opening your spouse's account where I have mine, with Lively HSA.
Thanks, as always, for your support! I appreciate you very much. Tell your family, friends, co-workers and your boss about Doxcost. Listen on Apple Podcasts or where ever you get your shows.
#028 - What Is A High Deductible Health Plan And How Can It Help Me? explains what kind of health insurance plan you can have so you can open and fund a Health Savings Account. Scott explains the basics so that you can get 100% covered and spend the least amount of money possible.
High Deductible Health Plan Requirements
In order to open and fund a Health Savings Account, the Internal Revenue Service requires that a the insured be enrolled in an eligible High Deductible Health Plan. The requirements are straight-forward.
Learn more in IRS Publication 969 linked here
*To be an eligible High Deductible Health Plan, the plan must:
*Limits apply to 2021 tax year
HSA Rules for 2021
Disconnect between HDHP and HSAs - More Education Needed
The Journal of the American Medical Association commissioned a study on Health Savings Accounts that concluded few US adults enrolled in High Deductible Health Plans are using HSAs to save for health care. As a result, more education is needed to make HDHPs and HSAs more valuable and effective.
See the JAMA study here
We're on a mission to get you 100% covered and spend the least amount possible. Please subscribe and tell your family, friends, co-workers, boss, office manager, HR director or firm administrator to listen to Doxcost on Apple Podcasts or wherever you get your shows.
Next up, we'll talk about affordability - how to structure your HDHP/HSA to get started.
I appreciate you very much! See ya next time.....
Clarence Davis, #28 Oakland Raiders - Sea Of Hands - watch here
Like the music on Doxcost? Listen to my pal, Morgan Fingleton, here
#027 - Your employer is really your health insurance company. Two out of every three (67%) Americans who get their health insurance through their employer are in a self-funded insurance plan - which means your employer is paying the claims, not an insurance company.
2020 Kaiser Family Foundation Survey - 2 out of 3 Employers Are Self-Funded
Scott considers the unfortunate comments of someone who has met their insurance plan's annual out of pocket maximum in June and wants to load up on perceived "Free" benefits that their plan provides for them over the course of the next 6 months. Scott explains why that perception is backwards and how it harms their employer, coworkers and themself.
If you have health insurance through your employer, you are not alone. About half of the United State's population receives health insurance through their employer, which covers 157 million Americans. If your employer has over 1,000 employees, it is nearly a certainty that your employer is your insurance company. If you work for an employer with fewer than 200 employees, you have a 1 in 4 chance that your employer is self-funded. More and more small employers are learning about self-funding......talk to your boss, office manager or firm administrator about getting a self-funded health insurance plan for your company.
Why You Get Your Health Insurance Through Your Employer
When the employer is self-funded, the employer pays claims on behalf of the employee. The employer relies on an Administrative Services Only (ASO) contract with a Third Party Administrator (TPA), which can be an independent firm or sometimes is a division or department within an insurance company. The employer may purchase Stop Loss insurance, with which the employee is not directly involved.
Learn More About Trends In Employer Self-Funded Health Plans here
Thanks, as always, for your support! Tell your family, friends, coworkers, boss, office manager and firm administrator to listen and subscribe to Doxcost on Apple Podcasts or wherever you get your shows!
Next episode, we'll take a deeper look at the High Deductible Health Plans that make you eligible for a Health Savings Account.
Like the music on our show? Be sure to listen to my pal, Morgan Fingleton, here
The podcast currently has 36 episodes available.