Yes, Dental Implants Are HSA Qualified Expenses.

Six years ago I wrote a blog about dental implants. Yesterday morning I had the hole in my mouth plugged with my first implant.  Strangely, I got a comment on my post from six years ago suggesting dental implants are not qualified for HSA reimbursement.  I am still scratching my head over that one.

Anyway, I am here to state once again that Dental (not to be confused with breast) Implants are still considered qualified medical expenses.  IRS Publication 502 states:

Treatment to alleviate dental disease include services of a dentist for procedures such as X-rays, fillings, braces, extractions, dentures, and other dental ailments. But see Teeth Whitening under What Expenses are Not Included Later…

Now you might say, “Hey Amigo, that language does not say implants are included” but the point is they are not specifically excluded (nor are crowns or bridges) however dentures are specifically included. And under exclusions Publication 502 states:

Generally, you cannot include in medical expenses the amount you pay for unnecessary cosmetic surgery. This includes any procedure that is directed at improving the patient’s appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease. You generally cannot include in medical expenses the amount you pay for procedures such as face lifts, hair transplants, hair removal (electrolysis), and liposuction. You can include in medical expenses the amount you pay for cosmetic surgery if it is necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease.

Example.

An individual undergoes surgery that removes a breast as part of treatment for cancer. She pays a surgeon to reconstruct the breast. The surgery to reconstruct the breast corrects a deformity directly related to the disease. The cost of the surgery is includible in her medical expenses.

In can say unequivocally, chewing meaningfully promotes the proper function of the body.

If you are still scratching your head, click here or here or here for additional references that specifically address dental implants.  Until someone in Congress or the President decide chewing is not meaningful to the function of the body, you are good to go with those implants.

Healthcare.gov Customer Service – Think Edge of Tomorrow/Judgement Day

So almost two months ago now, I got a letter from Healthcare.gov advising me that I needed to verify income.  Sad, when one is unemployed, but a hoop one is willing to jump through when suckling off the government milk jug.  Supposedly, said information could be submitted online, but we could never figure out how to do it.  But being compliant citizens in need of insurance, we made a copy of the letter, along with copies of all the related proof of non-income and mailed it into the address provided on their letter.

Case closed right?  Nope. Only just beginning.

Toward the end of September we received a letter the Healthcare.gov advising that they received information from us, but unfortunately “life event changes” may not be made by mail and must be transacted online.  Life Event Change?  Huh? I didn’t make no stinking Life Event Change.  So they got my info…but put it in the wrong place.  No worries, just ignore until further notice; a strategy successful for about a week.

Last Friday night at about 7:00 p.m., in the middle of dinner no less, the phone rings and it’s my friends at Healthcare.gov  advising that they need my income info.  Oh boy, here we go.  We explained that the government clearly received our information based on the letter they sent us and asked the representative if they would track it down.  Nope, the customer service (hah) rep can’t touch that and refers us back to the 1-800 customer service # so we can speak with someone who can help us.

Called that # today and did a repeat of the call last Friday night.  It’s an “amazing” infinite loop.  They want us to send in all the information again because danged if they are going to try to hunt anything down from their end.  They made note in the file that we had called in and supposedly we will not put our insurance at risk.  I think the enrollment period for next year is in about a month, so my strategy now is to roll my eyes a few times, ignore their harassment and absolute incompetency, and hope the problem either goes away.  Or maybe the paper work that I sent in finds its proper home.

Have you been to the netherworld of Healthcare.gov?  It’s starting to make me feel like I am in Tom Cruise’s fantasy world, but without the payout.

Shock in my Jock. What Obamacare is Doing to Me. Survey Says…It’s Twisted Sister

This blog is like an old friend, and it’s been a long time since I spent any time with it/him/her. But friends are forgiving, right?

So where have I been and why should you care?? I am about to come off a magical ride back into corporate America after the years I spent as an entrepreneur in the HSA/HDHP space which answers the “Where” question. And if you are still reading at this point, the answer to the more important “Why” question? Well, I am back into the individual health insurance market right after the crunch of the enrollment deadline for the “Affordable Care Act.

As I wade through the morass (I like that word, morass, because I can use the word “ass” with no shame. If I can figure out how to use the word “assassin” in this article I will use it as it is one of my favorites, and I will let you figure out why) a classic line from my favorite Billy Joe Shaver song, “Georgia on a Fast Train” races out at me.

 “I Got a good Christian raisin’ and an eighth grade education, Ain’t no need in y’all a treatin’ me this way”

WARNING: I FEEL A RATHER LONG ARTICLE COMING ON SO HERE COMES THE PUNCHLINE IF YOU WANT TO BAIL.

On one hand our government is treating us like we are absolute idiots and assuming (there’s that word again) they have got it all figured out for us. On the other hand, they can’t figure out how to explain it to us. Who is the idiot here? Here’s a thought for our supreme leader and his party; Please respect our eighth grade educations.

If one has to have a master’s degree in healthcare policy, administration, and insurance to figure this thing out, how’s does one suppose the rest of us are going to do it?

This is quite a pre-ramble to my own personal story, but a bit of ranting and complaining is always good for the creative juices, so thanks for bearing with me. You may find some similarities to your own situation here.

First item, I am learning a lot by being forced into this process. However, unlike the last time I was in the individual insurance market and was able to figure it out myself, this go round, after my initial plunge, I have had to turn it over to an insurance broker.

Until January 2013, I had an HDHP through Humana (Humana One) which was a bare bones policy with a $10,400 deductible for my family and no drug benefits. It did cover physicals for the family. I paid $310 per month for that policy. When I went back into Corporate America I continued with their HDHP/HSA group option.

Today, from a broker, I received quotes both on and off the Federal Exchange. It should be noted that I have been RIF’ed from my job, and that is why I am being forced to sort this out. I have been out of the individual market for exactly one year, and if I purchase the cheapest HSA qualified HDHP the premium will be $778 per month. So, the “Affordable Care Act” for me represents a $151% premium increase and a $1,600 increase in my deductible. I do get “mental health” coverage, which, after writing this blog I might need in order to address with my budding insanity or inevitable substance abuse treatment resulting from my looming poverty.

If I elect to go off the exchange, the broker found me a high deductible health plan similar from Assurant Health with benefits similar to the on exchange plan, but the premium is $946 per month. I can go COBRA which until I started doing my research was going to be my worst option, but it is actually $18 less per month that the Assurant plan and the deductible is 47% less.

So now I am trying to figure out what my subsidy from my fellow tax payers will be if I go on the Exchange. But here are the things that have me scratching my head.   First, the less I work, the more affordable my healthcare becomes. Second, the government is happy to give me subsidies for something I don’t want (their plan) but won’t give me subsidies for something I do want (my former employer’s COBRA plan). Third, why is it that a year ago I could afford to cover 100% of my family’s healthcare insurance needs, but now, based on my expected income, the Government, if I go through the Exchange it is trying to force me to put my child on the state CHIP/Medicaid program? Fourth, why should any person, driven to purchase insurance through the exchange, expect a health care product equal to or better than what our veterans receive? Fifth, how did my 7.1 million fellow Americans who elected to go through a government exchange figure out what insurance made sense for them and for what % of them is their healthcare more affordable?

To be continued, because….after beginning this article 2 weeks ago, the saga goes on…

The Sting of Obamacare

My wife is sick so I brought her to the doctor.  Fortunately I have insurance for 5 more days before I have to give up my group plan.  I then have the COBRA option $950 per month or self-insure, with my only option (not affordable, but least expensive) looking like a plan from The Federal Government Exchange.  And everything I have just said is the “good news.”

 I am sitting in the waiting room waiting room and there is a sign on the reception counter that says,

 “Neither Piedmont Hospital nor Piedmont Physicians Will be participating in any new Government Healthcare Plans that are Marketplace, Pathways or Exchange Products.”

Apparently this is not absolutely true, because the receptionist told me there is one Humana National POS plan that my Doctor, his group, and their Hospital will accept.  But I have no idea what the cost is (and I am not encouraged).

I did not pick my Doctor because of my insurance.  I picked my insurance because of my Doctor. Logical Mr. Spock?

Will someone please explain to me the silver lining in ObamaCare for me?  Legitimate answers only please.  This is intended as an honest question so please, take a deep breath, release it.  Now you can respond.

What has Obamacare Done To/For You Lately?

I have to come up with $635 this year to fund the 21% premium increase Humana is subjecting me to for the privilege of a $10,400 deductible and no drug plan.  I do receive well care and the benefit of Humana negotiated rates for my family’s doctor visits and lab work.  I still save a ton of $ over a traditional health insurance plan and still receive the tax and savings benefit of my Health Savings Account but no thanks to Humana for that.

If anything, the overall health of my family has improved over the past 3 years since I switched to a high deductible health plan so the premium increase is neither the result of higher utilization of the benefits nor a general decline in health.  And it certainly is not the result of a stratospheric increase in the cost of the care we have received.

Our insurance costs are increasing primarily due to uncertainty created by the chaos of Obama Care.  Insurance companies are in business to make $ for their shareholders and as the government creates a burden for them, they simply pass it right on to their customers.  In this case, that would be me.

Pretend for a moment you were in business for yourself making widgets.  You are a pretty good business person and for every widget you manufacture, you make 20% profit.  You compete in the market with other widget makers and through competition, your prices are held at a reasonable level.  One day the government decides that because your widgets serve the greater good of society, everyone should be able to buy them.  As a business person, this sounds pretty good right?  Because the size of your market just increased exponentially.  But here’s the rub, not everyone can afford your widgets and in some cases they don’t even want them.  Normally, if you had control over your business, you would simply refuse to sell widgets to those who could not pay, but the government has said you must sell widgets to everyone, regardless of their ability to pay.  Well, you are not in business to lose money so, maybe you do some things to enable you to produce your widgets for less money which is a good thing, but you were pretty efficient to begin with.  If you still want to make 20% profit, what do you do now??  You increase the price of widgets to those who can afford them to maintain your profit and offset the losses from sales to widgets to those who can not pay for them to begin with.

In a nutshell, you are Humana, and I just got a 21% premium increase.  Now I have to come up with $635 to cover basically the same benefits I already have.  Suffice it to say, my privates are frosted over this latest insult, but it could be worse.  What if I had a traditional insurance plan and was paying, say $1,000 per month for my insurance and was hit with a 21% increase?  Annualized, I would have to come up with an additional $2,500 just to cover the premium increase.   That’s a pretty big nut in my book.

So looking at your own situation, how big is your nut and what has Obama Care done for you lately?  Is it the panacea we were led to believe it would be?  In the land of purple frogs and leprechauns, perhaps it is.

Tic Tacs Are Not Qualified Medical Expenses….But They Should Be.

A week or so ago I caught a bit of Man vs. Wild on the Discovery Channel and got a huge laugh when Bear Grylls trapped, skinned, and then proceeded to eat skunk.  I laughed hard at the smell he had to endure and could not begin to imagine the horror of that smell.   A bit of Schadenfreude I suppose.

I had no idea what was soon to beset me.

This weekend I had to opportunity to go see the musical “110 in the Shade.”  A play, that looks at the day in the life of a town suffering through a miserable drought in the early part of last century.   It was a pretty good play, but the smell of skunk Bear Grylls had to endure, had nothing on the waft that beseeched my family as we sat there attempting to enjoy the play.    I have never smelled anything so gag inducing as the road kill breath that periodically drifted into our personal airspace.  It was so bad, that every few moments I found myself gagging and my face contorting to disfigurement that would make Jim Carey proud.  My body was convulsing in obvious distress.  I’m not sure if a pallet of Tic Tacs could have cut the bite of that breath.

I’m sitting there thinking in between convulsions, that roadkill baking in the road in the 110 heat of some hot Texas highway had nothing on that breath.  Then I was wondering if maybe a possum had died, and someone had flung it under my seat.  It was all I could do not to retch and vomit.

We had great seats, but at the first intermission we happily downgraded our seats to get away from that vile smell.   While the first act was certainly breathtaking, the second, undistracted, was far more breathmaking.

If you have an HSA, sorry, but tic tacs are not qualified medical expenses.  However, if you were in a theatre the other day and found by the end of the show, seats had emptied out all around you, you may have a medical condition for which dipping into your health savings account might be a very good idea.

Yes, Dental Implants Are Qualified HSA Medical Expenses.

I wrote some time back about a trip to my dentist that resulted in me losing a molar.  It was also the first time in my life I felt empathy for all people who would rather jump out off a plane (with a parachute of course) than go see a Dentist.  Until that day, I had never endured much more than a routine filling and prided myself in the strength of my teeth and what a fabulous person was for having taken such good care of my pearly whites.  Pride is a dangerous thing….

So finally after having walked around with a hole in my mouth for the past year, I’m going in, in a couple of weeks to see what the actual cost of the implant will be.  In the world of consumer driven health I am certainly going to see if the price is negotiable and will report back on that in a future blog.  I’m expecting the rack rate to be in the $4K-$5K range.  My wife has already told me “Merry Christmas,” and I told here I’d just as soon had the $49 cordless screw driver that I got last year.

All kidding aside.  If I do brace myself and have the procedure done, it is a qualified medical expense and I can take it from my HSA.

HSA Rules 2010

It continues to boggle my mind that our most read blog on this site is related to rules.  Pretty much any article related to rules is going to induce the kind of crust in ones eyes that one gets from a good case of pink eye.  We are talking Rip Van Winkle kind of sleep for sure.

That said, “HSA Rules” not only on this site but across the internet at this very moment, on this very day, it is one of the leading keyword searches related to Health Savings Accounts.  It’s possible, if you are reading this, I’m guessing you are being pulled toward the HSA revolution or maybe you’ve already been sucked in.  In the next couple of months, if you are fortunate enough to have employer subsidized health insurance, you may be pondering seriously high deductible health plans during your enrollment period.  If you are self insuring you could be looking at them now.

And since we are all about answering the question “what is an HSA”, it seems only fitting that if you blasted through cyberspace and somehow landed on this page reading this article, and this sentence specifically; it seems only fair that we get you to a place that can get your question answered.  If you will click right here you will be shot through cyberspace just a little bit further onto, what I believe is the best site to learn about and understand HSAs.  It is called HSAeducator.com, and unlike some other sites it is not trying to sell you something or confuse you.   You should be able to get most, if not all of your questions answered there.

It’s all pretty much laid out on one page to keep from inducing sleep, but as you read it, should you want to learn more about high deductible health plans or anything else HSA related just click through the next page and read ‘til you feel like an HSA expert.

Oh, and one more thing, there is a pretty good starter page of frequently asked questions about HSAs if you have a question.  If you can’t find the answer, just post your question on the HSAeducator forum (you will have to register) and one of the many HSA experts will try to answer it for you.

But wait…could there possibly be more???  If you have already set up your HSA and are looking for a great and free way to put more money into it, you should definitely check out www.myHSArewards.com  where you can save money into your HSA when you make everyday purchases.  It is a new program and represents a total no brainer way to save more $s for your health care.

Dear Mr. President,

You are a very smart man.  Please read this article by Alan Reynolds that appeared in the September 7th printed edition of Forbes magazine.

Sincerely,

WhatisanHSA 

Free Our Health Care WOW!!

Over the past almost 60 days, the link to the “Free Our Health Care NOW” petition has been the 5th most clicked link out of the 200 or so postings on this site.  Which means you (if you were one of them) helped contribute to the over 1,012,000 signatures to date on the petition.  I first stumbled across the petition in Forbes Magazine in early June, and several radio talk show hosts have helped blow the doors off this thing by encouraging folks to give some thought to their health care as well as the general and future health of our nation. 

Like a snowball down the side of a mountain, the engagement of the American public in the discussion around their future health care has been profound in my opinion, and the snowball has an enormous amount of momentum which will hopefully influence, in a positive and productive manner, the ultimate outcome of the debate.

If you have already taken a look at the petition and it represents a vision of healthcare with which you approve, I would encourage you to share it with as many friends and colleagues as possible (please feel free to send the link to this posting or straight to the petition).  If you have not yet seen the petition, have a look below and you can take it on your own from their.  Be a part of keeping  the momentum going through September and as long as the debate continues.

Over 1 million signatures.  I would say this is definitely a Free Our Health Care WOW kind of moment.

http://www.freeourhhealthcarenow.com