Health Insurance
How to choose and use health insurance is one of the biggest financial decisions Americans face. Browse Investopedia’s expert-written library to learn more.
Health Insurance
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You can cover the costs out of pocket, but this is usually unaffordable for most people. Instead, try asking your doctor for a referral to another healthcare provider that does accept Medicare, do your own research, or visit an urgent care facility. Most urgent care offices accept Medicare.
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Yes, you may appeal an insurers' denial of your claim. Typically, your insurer will expect you to work with your physician's office to provide justification for the need for the treatment, drug, or device, and it still may not be approved. You may appeal beyond your health insurance company with the state insurance commissioner.
Learn More: What Does Health Insurance Not Cover? -
Try to sign up during the enrollment period: three months before you turn 65 through the three months after your birthday. Next, if you lose other drug coverage, make sure to sign up for Part D within 63 days. Last, make sure you have proof of credible drug coverage in your records so you can prove you do not deserve a penalty.
Learn More: Avoid the Part D Premium Penalty -
The Internal Revenue Service (IRS) typically does not allow FSA funds to pay for health club or gym membership dues. However, the IRS allows FSA funds to be used to pay separate fees charged at health clinics or physical therapy centers for specific activities when prescribed by a doctor.
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Yes. Tax-deductible medical costs include payments to doctors, dentists, surgeons, inpatient hospital care, acupuncture treatments, participation in weight-loss programs, and more. The Internal Revenue Service has a list of examples of deductible medical expenses on its website.
Learn More: Are Health Insurance Premiums Tax-Deductible? -
Most vision care plans provide discounts on laser eye-correction surgery. Vision care plans have different offerings—some offer minimal services; others may help cover treatments for eye surgery.
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Medicare Advantage
Also known as Medicare Part C, Medicare Advantage is offered to people ages 65 and older and disabled adults who qualify. The coverage is the same as Part A hospital, Part B medical coverage, and, usually, Part D prescription drug coverage, with the exception of hospice care.
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Medical Expenses
Medical expenses—which are tax-deductible within certain limits—are the costs to treat or prevent an injury or disease, such as health insurance premiums, hospital visits, and prescriptions.
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Medical Cost Ratio
The medical cost ratio (MCR) is a metric that assess the profitability of medical insurance companies. It consists of claims paid divided by the premiums collected. The ACA requires insurers to spend at least 80% of premiums on healthcare, with any excess required to be rebated to consumers.
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Preexisting Condition
A preexisting condition is a health condition such as diabetes, cancer, or heart disease, that existed prior to applying for health or life insurance. Under the Affordable Care Act (ACA), health insurance companies can’t refuse coverage or charge more for preexisting conditions.
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Health Insurance Deductible
A health insurance deductible is a set amount of money that an insured person must pay out of pocket every year for eligible healthcare services before the insurance plan begins to pay any benefits. The amount of the deductible varies depending on the health insurance plan you choose.
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Health Savings Account (HSA)
A health savings account (HSA) is a tax-advantaged account to help people save for medical expenses that are not reimbursed by high-deductible health plans. No tax is levied on contributions to an HSA, on the HSA’s earnings, or on distributions used to pay for qualified medical expenses.
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Medical Underwriting
Medical underwriting involves researching an applicant’s medical history in order to identify risk factors and price coverage. In recent years, regulations have limited the use of medical underwriting in determining rates.
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