pom's Blog

Category Health Insurance

August 24, 2008
The Tonik Health Plan Copay and You

Let's take a look at the office copay for Tonik health insurance plans. Tonik was designed to give people access to coverage for the things they use most and keep cost down. The office copay definitely fits in this category. First, what does the term copay mean.

First, what is a copay? Officially, a copay is the fixed portion of charges you pay to your provider for covered health care services in addition or separate from any deductible. For example, $20 for an office visit or $15 for a prescription drug. It is similar to coinsurance, but it is a dollar amount instead of a percentage of the charges.

The whole point of a copay is to give you a cost for certain health care services that you can count on. No hidden surprises. If an in-network doctor charges $65 and a specialist charges $95, you can the same flat copay amount and this takes some of the guesswork (and fear) out of going to a doctor when you need care. There are a few qualifications on the Tonik health plan office copays we should look at.

More detail on the Tonik office copays

The copay typically applies to the office consultation itself. It's not uncommon for other services such as labs or simple procedures to be done during an office visit. These servcies outside the consultation would usually go towards your Tonik plan's deductible. For example, let's say you feel pretty lousy and go to your general practice doctor. The copay would apply for this visit. If the doctor decides to run a blood test to make sure it's not a serious issue. You would pay the discounted rate (assuming in-network providers/ covered benefits) for this labwork subject to your deductible. Speaking to the "benefits need and keep cost low", some Tonik insurance plans cap the number of office visit copays you have in a calendar year. After using these visits, additional visits in the same calendar year would be subject to the deductible. This number was based on what the average member needs in a typical year based on the theory that most people will find this perfectly adequate and the premium can be kept lower.

Tonik deductible and network providers

It's important to stay within Tonik's doctor network to get full benefit of the office copays. You will likely pay more out of pocket when using a non-network provider. Luckfully, the PPO network is pretty extensive but it's always important to verify with your doctor of choice that they are in the Tonik PPO network.

Prescription Copays in Tonik

There is also a separate copay for generic only medications. Brand name medications are not covered with the typical Tonik health insurance plan even if there is not generic available as an alternative. The generic copay usually runs $10 and is for a $30 day supply. There is also an option of $20 copays for 60 day supplies when purchased through mail order.

About the Author
Dennis Jarvis is a licensed California broker with extensive knowledge of Tonik health insurance plans.
sb
July 30, 2008
Sorry, but the blog post could not be located.
sb
July 04, 2008
What’s New In Health Savings Accounts And What It Means To You

New in Health Savings Accounts and What It Means To You

Health insurance has seen some good and significant changes recently - especially in the area of health savings accounts (HSA's), and this means that there are more benefits to be passed on to you. In December of 2006, Congress passed some new changes that will affect many people - starting January 1st of 2007. Considering that HSA's were started as recently as 2003, this shows significant progress.

Health savings accounts are actually attachments made to a health insurance plan that has a high deductible (HDHP - High Deductible Health Plan). In order for a particular health plan to qualify as an HDHP, it must have a deductible amount between $1,100 up to $5,500 for singles in 2007, and between $2,200 up to $11,000 for families.

Other features of health savings accounts that enable them to attract those looking to be able to combine savings with health insurance are:

- Deposits are tax deductible

-Amounts used for medical purposes are tax-free

- Accumulates interest

- Money stays in account and builds from year to year

- Money remains under your control

Even with these great features, there are now some that make it even better. Here are some of them and how they can benefit you.

1. Deposit Maximum Deductible - Even If Your Plan Does Not Require It

In previous years the maximum amount that you could deposit into the account was the amount of your deductible on your health insurance policy. The changes now mean that even if your deductible is $2,000 as a single person, you can still deposit up to the maximum deductible of $2,850. You are no longer limited by the deductible and can put into your savings a higher amount to be able to earn a greater interest. There is an even greater amount that can be deposited if you are 55 or older. For 2007, you can deposit an additional $800, and in 2008, this extra amount is raised to $900.

2. Take Advantage of Full Year Deposits Even with Partial Year Enrollment

Even if you now enroll in September, you can still take advantage of a full year's deposit. You are not limited now by how much you can deposit because it is not placed on a monthly basis. Previously, you were allowed to deposit 1/12 of the total amount for each month that you were enrolled. This stipulation has been removed but you still must meet the qualification of a testing period, which means that you must still be enrolled at the end of the 12th month from the time you enroll.

3. Transfer Funds from an FSA or MSA to an HSA

If you already have a Health FSA (Flexible Savings Account), an MSA (Medical Savings Account), or even an HRA (Health Reimbursement Account), then you are allowed to make a transfer from the account to your HSA. You can only do this once, however, in your lifetime, from each type of account, but you cannot make a transfer out of an HSA to any other savings type of plan. The limit placed on this type of transfer is $2,000. The eligibility for this type of transfer further demands that you no longer be eligible for medical care under that plan. There is a time limit placed on when these transfers can be made, and that is January 1, 2012.

Besides being able to make the above transfers, you can also make non tax-deductible transfers from an IRA, too. The only limit is the amount of deductible that is found on your health insurance policy. Again, the once in a lifetime policy applies - with one exception. If you make the first transfer as a single person, you can also make another transfer if you become married within the same year. The total amount contributed cannot be greater than the deductible amount on the policy. Transfers can also be made from one HSA to another.

4. Employees with FSA's can make Contributions to an HSA In Spite Of Grace Period

Under the old way of doing things, if you currently were a member of an FSA plan, then you could not either start an HSA or contribute to one until the first day of the first month after the grace period of the FSA expires. Now, you can make deposits into the account in spite of having an FSA, but you must deposit all of the balance into the HSA. Another stipulation is that you need to have less money in your FSA account than what you had as of September 21, 2006 in order to qualify. If this is not the case, then you still must wait until the end of the grace period.

Each of these new changes in HSA's means greater flexibility for you and for your employer. These policies are now more consumer friendly than ever before. Perhaps it is time for you to start looking into getting your own and combine your needs of lower cost healthcare and a good way to save for retirement, too.

About the Author
Clelland Green simplifies health insurance options to help consumers make the best insurance choices for their needs and budget. To get free, no-hassle health insurance quotes, visit http://www.Benepath.com at any time.
sb
March 29, 2008
Sorry, but the blog post could not be located.
sb
March 29, 2008

Health Insurance Plan Choices for You

Choosing the correct health insurance plan could be extremely daunting task and not as simple as it once was earlier, as you may come across several choices. Although there is no one “top” insurance plan, there are few plans, which could be superior to others for your health requirements and budget. Policy Plans differ in both how continently it is to obtain the services you want and what value you need to pay for it. Even though no health plan would pay for all the costs related with your health check care, some plans would also cover more than others. Nigh on all health plans today carry different ways to decrease needless use of health care at the same time keeping down the costs too. This might influence how simply you achieve the care you desire.

At the moment, there is an actual concentration on healthcare “consumerism”, especially in California, US. Health insurance companies are providing members a growing collection of “consumer driven” applications, which concentrates to assist those in any type of health plan assess healthcare prices, choose doctors and hospitals, which are both money-making and high in excellence, get suitable screenings and examinations and or else superior aid in handling their health. Employers, in the meantime, are direction-finding workers toward cost-effective drugs, health care services, and providers by providing lower co-payments and also some other incentives for some particular choices.

Health insurance plans are generally described as either “indemnity” (fee-for-service) or “managed care”. These kinds of plans vary in significant ways, which are described. With any health plan, though, there is an essential finest that is how much you or your company pays, regularly or monthly, to purchase health insurance coverage. Also, there are frequently other policy payments you need to make, which would vary by plan as well. Bearing in mind any plan, you must attempt to figure out its sum or real cost involved to you and your family, particularly if someone in your relations has a constant or stern health condition.

After a while, as health plans policy vie for your business, the differences between these types of plans have started to blur. Some indemnity plans also offer managed care type choices, and some managed care plans also tend to offer members the chance to use providers that are “outside” the plan policy. This makes it even more significant for you to know how your exacting health plan works. So we would suggest you to study each plan thoroughly before buying in.

Choosing the correct health insurance plan could be extremely daunting task and not as simple as it once was earlier, as you may come across several choices.

Sam Rosy is an expert in analyzing the insurance types especially in California and has produced lot of articles regarding the insurance types and its application.To read Rosy articles on insurance and for further details on Health Insurance California , Blue Cross Insurance California and Individual Health Insurance Plan view the site http://www.goodhealthquotes.com. To Contact Sam Rosy at samrosy@gmail.com

 

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