Doxcost - The Ultimate Guide To Health Insurance

#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

#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!!!!
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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!

1. Enroll in a qualified High Deductible Health Plan (aka HDHP)
2. Open a Health Saving Account (aka HSA) - click here to see the HSA I use
3. Identify your Enrollment and Effective Date for your plan year
4. Review ALL of your plan options
5. Check your existing savings
6. Calculate Out Of Pocket Maximum
7. Determine Your HSA Contribution Limit (Single, Family, 55+)
8. Make certain your Out Of Pocket Maximum IS NOT higher than your HSA balance
9. Use payroll deduction for your remaining HSA contributions
10. Plan & Prepare to have enough additional ordinary non-HSA savings to make the necessary lump-sum contribution on January 1st of the following year to top-off your HSA to match your annual deductible

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.

#025 - HMO PPO EPO WTF IDK NVM takes a look at the health plan terms you see all of the time, but know nothing about. Scott W. Dowling tells you what you need to know and what you don't. This is the first of two shows discussing so-called networks and how they affect the price of your health insurance.
Health Maintenance Organizations are said to have started as prepaid medical care for loggers in the Pacific Northwest dating back to 1900, but the first prominent HMO was started by Henry J. Kaiser the East Bay Area city of Richmond, California during World War II. Kaiser built and staffed a field hospital for his shipbuilding employees. Kaiser was an industrialist and philanthropist with steel, aluminum and other businesses across the United States. He cared for his employees and the communities where they operated by opening fully staffed hospitals that were the original HMOs.
Learn more about the first HMO here
Preferred Provider Organizations started to pop up in the early 1980s as Health Maintenance Organizations fell out of favor. The more flexible PPO offered similar savings to HMOs while allowing insured patients to see the doctors of their choice. While the BUCA (BlueCrossBlueShield, United Healthcare, Cigna, Aetna) subsidiaries created so-called networks of providers, MultiPlan was and is the largest independent Managed Care Organization involved in the Preferred Provider Organization model's development.
Learn more about MultiPlan NYSE:MPLN
Long before the Health Insurance Portability and Accountability Act was signed into law by Bill Clinton or the Patient Protection Affordable Care Act was signed into law by Barrack Obama, both Democrats by the way, Republican Richard Nixon made the first move into federally mandated employee benefits with The HMO Act of 1973. This law provided financial assistance for the further development of HMOs across the United States and required employers to offer an HMO alternative to traditional insurance if an eligible HMO operated in their area.
Learn more about The HMO Act of 1973
Thanks, as always, for your support. I appreciate you very much! Tell your family, friends, coworkers, boss and firm administrator to listen to Doxcost wherever they get their podcasts.
Our next episode will be Part 2 of HMO PPO EPO WTF IDK NVM where we'll discuss what is changing and evolving in the HMO/PPO world and what it means for you, your family and your company's employees.
Be sure to listen to my pal, Morgan Fingleton, at doxcost.com/music
Sign up for your free Health Savings Account at doxcost.com/lively