Frequently Asked Questions About Individual and Family Insurance Plans
Below are frequently asked questions about Independence Blue Cross health
insurance plans for individuals and families. Click on a topic below to view a
list of related questions. If you have additional questions, please
email
us your specific questions.
Health
Insurance Basics
What is an HMO?
What is a PPO?
What’s the difference
between HMO and PPO plans?
What is a premium?
What is a copay?
What is coinsurance?
What does out-of-pocket
maximum mean?
What is a primary care
physician (PCP)?
Can I change my primary
care physician (PCP) after I have chosen one?
What is a specialist?
What is a referral?
What does
precertification mean?
What is durable medical
equipment?
What does in-network
mean?
What does out-of-network
mean?
What is an Urgent Care
center?
What is a Retail
Clinic?
What is an HSA
account?
What is a deductible?
How can I find a
doctor?
Is my current doctor in
network?
Can I choose any
doctor?
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Covered
Benefits
What services do all
plans cover?
What do the metallic
levels mean?
Is routine eye care
covered?
Are emergency services
covered?
Is maternity covered?
Is mental health
covered?
What are the
ConnectionsSM Health Management Programs?
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Tiered
Network
What is a tiered
network?
Are there certain
services that are covered at the same cost regardless of tier level?
What happens if I am
admitted to a Tier 2 or 3 hospital through their Emergency Room?
What is unique about the
Keystone HMO Proactive plans?
Why should I choose a
Keystone HMO Proactive plan with a tiered network?
Are all providers from
the Keystone Health Plan East HMO network assigned a tier?
Will my cost-sharing
always vary based on the provider and tier I choose?
How did you determine
which tier providers are assigned to?
What percentage of
providers are in Tier 1 – Preferred?
How often will providers
change tiers?
How can I find out which
tiers my doctors and hospitals are in?
If my doctor refers me to
a specialist in Tier 2 – Enhanced or Tier 3 – Standard, is there anything I can
do?
Do I need to worry about
tiers in the event of an emergency?
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Prescription
Drugs
Are prescription drugs
covered?
How does my prescription
drug benefit work?
Is there a maximum
prescription drug benefit?
What is the difference
between generic and brand medications?
Do my benefits include
mail-order service?
Are birth control pills
covered under my plan?
What is a formulary?
What is the FutureScripts
Preferred Pharmacy Network?
What pharmacies are
excluded from the Preferred Pharmacy network?
How many pharmacies are
available in the FutureScripts Preferred Pharmacy Network?
Are low-cost generics
available?
Does the prescription
plan cover non-formulary medications?
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HSA
Plans
What is a health savings
account (HSA)?
What is a high-deductible
health plan (HDHP)?
What are the benefits of
an HSA?
How do I set up a health
savings account (HSA)?
If I open an HSA, are
there any limits on the amount I can contribute to it?
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Applying
How do I apply?
Can I apply for health
coverage for my family
Can I add my spouse or
child at a later date?
Can I add my domestic
partner to my health plan?
Can I add my fiancée to
my health plan?
Can I apply for multiple
plans?
Who should I contact if I
have questions about how to fill out an application?
How long will it take to
apply for a health plan?
Do I need to give my
Social Security number?
What if I don’t have an
email address?
What happens if I don’t
purchase health insurance?
When do I need to
purchase health insurance?
Is financial help
available for purchasing health plans?
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Premiums
What are my payment
options?
Will my actual rate be
different from my rate quote?
How long are the rates
valid?
How do electronic
payments through ACH work?
When will the initial
payment come out of my account?
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Online
Application Process
Who do I contact for
technical questions about using ibx4you.com?
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Health Insurance Basics
What is an HMO?
HMO stands for health maintenance organization. An HMO is a type of health
plan that requires you to select a family doctor, often called a primary care
physician or PCP. You need a referral from your PCP to see a specialist in the
HMO network, such as a cardiologist (heart doctor). Typically, only emergency
services are covered if you go outside the health plan network.
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What is a PPO?
PPO stands for preferred provider organization. A PPO is a type of health
plan that allows members to see providers in and out of the network. You pay
lower costs when you see network providers. But you can go outside the network
and pay more for your services.
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What’s the difference between HMO and PPO plans?
In an HMO, you choose a family doctor, called a primary care physician (PCP),
who provides the services you need. Your PCP refers you to other doctors or
health care providers within the HMO network when you need specialized care.
Typically, only emergency services are covered if you go outside of the plan
network. HMOs usually have the lowest premiums.
In a PPO, you don’t have to choose a PCP, and you can go to doctors in or out
of the health plan’s network. You can see doctors, hospitals, and other health
care providers of your choice, such as a heart doctor, but you will pay more if
your doctor does not participate in your health plan’s network. PPOs tend to
have higher premiums than HMOs.
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What is a premium?
A premium is the fee you pay to your insurance company each month to pay your
share of your health plan’s costs. This is separate from the deductible,
copayments, and coinsurance amounts you pay when you use your benefits to
receive covered services.
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What is a copay?
A copayment, or copay, is the fee you pay when you see a doctor or get other
services. For example, $20 to see a doctor or $100 to go to the emergency room.
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What is coinsurance?
The percentage you pay for some covered services. If your coinsurance is 20
percent, your health insurance company will pay 80 percent of the cost of
covered services, and you will pay the remaining 20 percent. The amount you pay
is typically not based on the full retail price of the service. It is based on a
discounted rate negotiated by your insurance company with heath care providers
like doctors and hospitals.
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What does out-of-pocket maximum mean?
No matter what, you will not pay more than the out-of-pocket maximum for each
health plan. This is the maximum amount that you will have to pay under your
plan. Any care for covered services you get after you meet your out-of-pocket
maximum will be covered 100 percent. The estimated standard out-of-pocket max
for 2014 is $6,350 for individuals and $12,700 for families.
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What is a primary care physician (PCP)?
A PCP is the doctor you see for most of your health care needs. HMO plans
require you to choose a PCP, who will refer you to a specialist when needed.
PPOs do not require that you choose a primary care physician.
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Can I change my primary care physician (PCP) after I have chosen
one?
Yes. Once you are a member, it’s easy to change your PCP. Simply login to
ibxpress.com to make the change, or call 1-800-275-2583. PCP changes become
effective on the first day of the following month.
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What is a specialist?
A specialist provides medical care for certain conditions in addition to the
treatment provided by your primary care physician (PCP). For example, you may
need to see an allergist for allergies or an orthopedic surgeon for a knee
injury. Under an HMO plan, you need to obtain a referral from your PCP to
receive benefits for care provided by a specialist. Under our PPO plans, you
never need a referral to see a specialist.
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What is a referral?
If you have an HMO plan, your family doctor (or PCP) will need to write you a
referral before you see other network providers, such as a dermatologist. No
need to pick up a piece of paper, our referrals are done electronically.
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What does precertification mean?
This may also be called preapproval or pre-authorization. Basically, you may
need additional approval from your health plan before you receive certain tests,
procedures, or medications. It’s a way to make sure the services you’re getting
are safe and effective.
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What is durable medical equipment?
Durable medical equipment includes, but is not limited to, the following:
hospital beds, crutches, canes, wheelchairs, walkers, peripheral circulatory
aids, cervical collars, traction equipment, physiotherapy equipment, oxygen
equipment, and ostomy supplies. You should always check with both your provider
and Independence Blue Cross to determine whether an item is considered to be
durable medical equipment.
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What does in-network mean?
Your health care coverage is considered in-network when you use a provider
who participates in our network of more than 42,500 doctors and 100 hospitals.
For HMO plans, it’s the Keystone Health Plan East network. For PPO plans, it’s
the Personal Choice® network which gives you access to see doctors in network
across the country, plus you have the option to visit doctors out-of-network at
a higher cost. To see if a provider or hospital is considered in-network, use
our
Find a Doctor tool.
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What does out-of-network mean?
Your health care coverage is considered out-of-network when you visit a
doctor or hospital that does not participate in our network. With an HMO plan,
you only have coverage for in-network providers, while PPO plans allow you the
freedom to see both in- and out-of-network providers.
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What is an Urgent Care center?
Urgent care centers are stand-alone clinics where board-certified doctors
treat illness or injury requiring immediate medical attention. You can use these
centers when your doctor is not available immediately and your illness or injury
is not life threatening, such as a cut requiring stitches or continual nausea.
Care in an urgent care center will cost you less than the same care in a
hospital emergency room. For conditions that feel life threatening, such as
severe shortness of breath or chest pain, sudden or unexplained loss of
consciousness, severe abdominal pain, or a cut or wound that won’t stop
bleeding, seek the care of the closest emergency room.
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What is a Retail Clinic?
A retail clinic is a space within a pharmacy or other retail store that is
staffed by nurse practitioners. You can use these clinics when your doctor is
not available and your injury or illness is minor, such as a sore throat,
earache, or skin rash. Care at a retail clinic will cost you less than the same
care in a hospital emergency room.
Please note that if you go to a retail clinic in a Walgreens or Rite Aid
store, and your prescription coverage uses the Preferred Pharmacy Network, you
will need to go to another pharmacy in order to have your prescription covered
by your health plan. The Preferred Pharmacy Network includes over 50,000
pharmacies, including most major chains and local pharmacies. CVS is part of the
Preferred Pharmacy Network; Walgreens and Rite Aid are not.
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What is an HSA account?
A health savings account, or HSA, helps you save money for health expenses,
tax-free. You don’t pay taxes on the money you put in, the money you take out,
or any money you earn on the account. The IRS determines what qualifies as a
health expense, which includes your out-of-pocket costs (copays, deductibles,
coinsurance), along with some services not covered by a health plan, such as
Lasik surgery.
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What is a deductible?
A deductible is the amount you pay each year before your health plan starts
paying for covered services. For example, if your plan has a $1,000 deductible,
you will need to pay the first $1,000 of the costs for the services you receive.
Once you have paid this amount, your insurance will begin to pay a portion or
all of your health care costs depending on the plan.
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How can I find a doctor?
The
Find a Doctor tool
allows you to search for doctors within the Independence Blue Cross network.
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Is my current doctor in-network?
When you search for a doctor, you will need to select the plan network. You
will then be able to see which doctors are in and out of network for that plan.
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Can I choose any doctor?
If you have an HMO plan, you are only covered for doctors and hospitals
within the HMO network. With a PPO plan, you are covered for doctors and
hospitals both in and out of network. If the doctor or hospital you choose is
out of network, then you may have to pay for your health service.
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Covered Benefits
What services do all plans cover?
All plans offered to people who purchase their own health insurance must
include a core set of essential health benefits by 2014, as shown in the chart
below.
In addition, insurers will cover 100 percent of the cost of many preventive
services, such as wellness visits, immunizations, screenings for cancer, and
other diseases. That means you will not pay any deductible, copayments, or
coinsurance for many preventive services that can help you stay healthy.
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What do the metallic levels mean?
With the new health care law, the federal government is creating four
categories of coverage or metallic levels for plans offered to small businesses
(2–50 employees) and people that purchase their own insurance. Plans will be
assigned one of these metallic levels based on how much of the cost for health
care services is covered by the health insurance company. These “metal”
categories — bronze, silver, gold, and platinum — will make it easier for you to
compare health plans among health insurance companies. All products will cover
essential health benefits like doctor visits, prescription drugs, X-rays, and
hospital stays. The major differences will be in what you pay when you need
these services and the monthly cost of the health plan.
How the metallic levels compare on costs:
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Is routine eye care covered?
Routine eye care for adults is covered by Keystone Health Plan East HMO plans
only. Routine eye care for children under age 19 is considered an essential
health benefit and available with all plans. To learn more, refer to the
Benefits at a Glance for each plan.
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Are emergency services covered?
Yes. You are covered for medically necessary services for unexpected
illnesses or emergency care no matter where you are.
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Is maternity covered?
Maternity and newborn services are considered an essential health benefit and
are covered by all plans.
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Is mental health covered?
Mental health and substance abuse services, including behavioral health
treatment, is considered an essential health benefit and available with all
plans.
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What are the ConnectionsSM Health Management Programs?
Like our Healthy LifestylesSM programs, the Connections Health Management
Programs are value-added programs available to you free of charge. Connections
provides:
- information and support when you are facing medical decisions or treatment
options;
- help when you are living with chronic conditions such as diabetes or asthma.
- access to IBC Health Coaches, a 24/7 point of contact that provides
individualized and coordinated advice and support. IBC Health Coaches can look
at your condition(s), prescription drugs, recent diagnostic or therapeutic
activities, and patterns of treatment and offer meaningful assistance as they
you through the health care spectrum. Health Coaches can provide:
- information on everyday health concerns, such as headaches and joint pain;
- help if your employees are facing a significant medical decision, such as
treatment options for back pain, breast or prostate cancer, or surgery;
- personalized calls about chronic conditions or health concerns; information
about what types of questions to ask the doctor.
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Tiered Network
What is a tiered network?
If you haven’t heard of a tiered network plan, that’s because it’s brand new
to the Philadelphia region. It works just like a typical HMO in that you can
visit any doctors and hospitals in the network, and you select a primary care
physician who refers to you specialists. But now you can save on your
out-of-pockets costs when you visit certain health care providers.
All Keystone Health Plan East HMO providers have been grouped into three
tiers based on cost and quality measures. While all of the doctors and hospitals
in our network must meet high quality standards, some are able to offer more
cost-effective care. If they cost less, then you’ll pay less. It’s that simple.
You can check what tier a doctor has been put in by searching for them in our
Find a Doctor tool.
- Tier 1 – Preferred: Members pay the lowest cost-sharing for
most services.
- Tier 2 – Enhanced: Members pay a higher cost-sharing for
most services compared to Tier 1 – Preferred.
- Tier 3 – Standard: Members pay the highest cost-sharing for
most services.
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Are there certain services that are covered at the same cost
regardless of tier level?
Yes. Many covered services will cost the same amount to you no matter the
tier level of the provider or facility you choose. These are:
- Emergency room
- Ambulance
- Urgent care
- Pharmacy
- Behavioral health
- Transplants
- Outpatient lab/pathology*
- Routine radiology/diagnostic*
- MRI/MRA, CT/CTA scan, PET scan*
- Physical/occupational therapies*
* when you receive services at a designated site referred by your Primary
Care doctor
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What happens if I am admitted to a Tier 2 or 3 hospital through their
Emergency Room?
Emergency room fees are the same no matter which tier hospital you choose.
However, if you are admitted to the hospital from the ER, your out-of-pocket
costs for the hospital stay will be determined by the tier that hospital is in.
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What is unique about the Keystone HMO Proactive plans?
The Keystone HMO Proactive plans still include the full Keystone Health Plan
East HMO network of providers. However, with our Proactive plans, doctors,
hospitals, and other types of providers in the Keystone Health Plan East HMO
network have been assigned to one of three benefit tiers. For most services, you
can save money when you visit providers in lower tiers.
There are some services, such as preventive care and emergency room, physical
therapy, occupational therapy, and mental health, which have the same
cost-sharing regardless of the provider’s assigned tier.
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Why should I choose a Keystone HMO Proactive plan with a tiered
network?
Keystone HMO Proactive plans are ideal if you’re looking for a more
affordable plan. They tend to have lower monthly premiums, plus they give you an
opportunity to save even more on your cost-sharing by visiting providers in Tier
1 – Preferred. When you choose a Keystone HMO Proactive plan, you don’t have to
stick with just one tier. You can choose Tier 1 Preferred providers for some
services and providers from Tier 2 – Enhanced or Tier 3 – Standard for other
services. The choice is yours each time you receive care. You can check the
tiers of your current doctors and providers using our
Find a Doctor tool.
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Are all providers from the Keystone Health Plan East HMO network
assigned a tier?
Yes, all doctors, hospitals, and other health care providers from the
Keystone Health Plan East HMO network are assigned a tier; however, there are
some services that have the same cost-sharing across all tiers. Examples include
preventive care and emergency room, physical therapy, occupational therapy, and
mental health. Refer to the summary of benefits for more details.
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Will my cost-sharing always vary based on the provider and tier I
choose?
No. There are some services that have the same cost-sharing across all tiers.
Examples include preventive care and emergency room, physical therapy,
occupational therapy, and mental health. Only certain provider types will have
cost-sharing that varies based on the tier assignment. Refer to the summary of
benefits for more details.
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How did you determine which tier providers are assigned to?
We assigned our HMO network providers to one of three tiers. These tier
assignments were based on relative cost, quality (if available) and the tier of
the facilities in which your PCP typically refers IBC patients for hospital and
outpatient surgical services. While all of the doctors in our network must meet
high quality standards, many offer the same services at a lower cost.
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What percentage of providers are in Tier 1 – Preferred?
Nearly 50 percent of doctors and hospitals are in Tier 1 – Preferred, so you
have plenty of choices on where you receive care. And you don’t have to stay
within one tier. For example, you can choose to see Tier 2 – Enhanced providers
for some services and Tier 3 – Standard providers for other services.
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How often will providers change tiers?
Independence Blue Cross will re-evaluate its tier assignments annually.
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How can I find out which tiers my doctors and hospitals are
in?
You can see all of the Keystone Health Plan East HMO network hospitals
arranged by tier and county by viewing the
Tiered
Network Hospital List. You can also see which tiers your doctors and
hospitals are assigned by using our
Find a Doctor tool.
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If my doctor refers me to a specialist in Tier 2 – Enhanced or Tier 3
– Standard, is there anything I can do?
Yes. You can speak with your doctor about why he or she chose the specialist.
You can explain to your doctor that you have a tiered network plan and that you
prefer to see a Tier 1 – Preferred specialist if possible.
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Do I need to worry about tiers in the event of an emergency?
No. If you have an emergency, you should visit the nearest hospital.
Emergency room services, in addition to a few other services, have the same
cost-sharing across all tiers. Please note that if you are admitted to an
in-network hospital from the emergency room, the cost-sharing for inpatient
hospital care will apply based on the tier of the in-network hospital. If you
are admitted to an out-of-network hospital following an emergency room
admission, the Tier 3 – Standard level of benefits (highest cost-sharing) will
apply.
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Prescription Drugs
Are prescription drugs covered?
Yes, prescription drugs are covered for all of the individual plans. Please
refer to your plan details for more information.
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How does my prescription drug benefit work?
The prescription drug program is administered by FutureScripts®, an
independent pharmacy benefits management company. The FutureScripts network
includes more than 60,000 retail pharmacies, including most national and
regional chain pharmacies and many neighborhood pharmacies. Some plans utilize
the FutureScripts Preferred Pharmacy Network, described below in another
question.
Each time you go to a participating pharmacy to fill a prescription, simply
present your ID card. How you will be charged will depend on your plan type.
- Copay plans — You pay either the copay or coinsurance
specified for the generic formulary, brand formulary, or non-formulary brand
drug you have been prescribed. If your plan has a maximum copay amount, that
means that IBC will cover any expenses beyond that amount for a particular
prescription, and you only need to pay that maximum copay amount. If you use an
out-of-network pharmacy, then you will be required to pay 70 percent coinsurance
instead of a copay.
- HSA plans — These plans have a prescription deductible that
is integrated with the medical deductible. This means that you pay for
prescriptions in full until your medical deductible has been reached. Once the
deductible has been met, you are either covered 100 percent (Personal Choice PPO
Bronze Reserve) or you pay the copay (Personal Choice PPO Silver Reserve)
specified for generic formulary, brand formulary, or non-formulary brand drugs
from in-network pharmacies. When using out-of-network pharmacies, you will need
to pay 50 percent coinsurance.
NOTE: The metal tier of your health plan will also
impact your prescription costs:
- Platinum — These plans have set copays for generic
formulary, brand formulary, and non-formulary brand drugs when purchased at in
in-network pharmacy. When using an out-of-network pharmacy, you will be required
to pay 70 percent coinsurance instead of copay.
- Gold and Silver — Generic formulary drugs are assigned a
copay, while brand and non-formulary brand drugs have specified coinsurance
amounts (the exception being the Silver Reserve plan, which follows the above
HSA plan model). These plans do have a maximum copay amount. This means that IBC
will cover any expenses beyond that amount for a particular prescription. When
using out-of-network pharmacies, you must pay 70 percent coinsurance.
- Bronze plans — For HMO bronze plans, generic formulary
drugs are assigned a copay. Brand and non-formulary brand drugs are integrated
into your medical deductible, meaning you will pay full price for these drugs
until your deductible is met. Once the plan’s deductible is met, you will
receive brand drugs at no out-of-pocket cost. For PPO bronze plans, all drugs
are integrated into the medical deductible, meaning you will pay full price for
any drugs until your deductible is met. Once the plan’s deductible is met, you
will pay the particular plan’s assigned copay or coinsurance amounts for the
drugs in question.
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Is there a maximum prescription drug benefit?
No. In accordance with health care reform provisions effective October 1,
2010, all of our plans have unlimited prescription drug benefits.
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What is the difference between generic and brand
medications?
A generic drug is an equivalent version of a brand drug with the same active
chemical ingredients and equivalency in strength. A brand drug has a patented
marketing name.
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Do my benefits include mail-order service?
Yes, as long as you use a participating pharmacy in-network. You can receive
a 90-day supply of maintenance medications for two applicable copayments
(generic/brand/non-formulary) through the mail-order service. (Typically, this
represents a savings of one copayment.) To get started with mail-order service,
login to ibxpress.com.
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Are birth control pills covered under my plan?
Yes. Birth control pills (oral contraceptives) and injectable contraceptives
are examples of preventive, wellness and disease management services under the
list of essential health benefits and covered 100 percent by all plans.
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What is a formulary?
The formulary is a list of medications that have been selected for their
medical effectiveness, positive results, and value. The formulary includes all
generic medications and a defined list of brand medications. You maximize your
benefits when you purchase formulary medications.
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What is the FutureScripts Preferred Pharmacy Network?
New for 2014, IBC will introduce a new pharmacy network called the
FuturesScripts Preferred Pharmacy Network.
This network is a smaller version of our full FutureScripts pharmacy network,
which is currently available on our existing individual portfolio. Pharmacies
not a part of the Preferred network are considered non-participating or
out-of-network pharmacies. The FutureScripts Preferred Pharmacy Network allows
us to achieve greater cost savings, and ultimately a lower premium for the
member.
The FutureScripts Preferred Pharmacy Network is included on 6 of our 13 base
plans:
- Personal Choice PPO Bronze
- Keystone HMO Bronze
- Personal Choice PPO Bronze Reserve
- Keystone HMO Gold Proactive
- Keystone HMO Silver Proactive
- Personal Choice Catastrophic
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What pharmacies are excluded from the Preferred Pharmacy
network?
Compared to the FutureScripts network, there are two pharmacies excluded from
the FutureScripts Preferred Pharmacy Network: Walgreens and Rite Aid. If a
member elects to get a prescription filled at Walgreens or Rite Aid, it will be
considered an out-of-network claim and the member will be responsible for the
total upfront cost of their prescription drug(s) at the pharmacy, with partial
reimbursement afterward via a paper claim submission.
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How many pharmacies are available in the FutureScripts Preferred
Pharmacy Network?
With this preferred network, members will continue to have access to more
than 50,000 pharmacies, such as CVS, Wal-Mart, and Target, in addition to
independent pharmacies.
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Are low-cost generics available?
Yes, many of our health plans feature a low member cost-share for certain
designated prescription drugs at participating retail and mail order pharmacies.
Your cost for these drugs would be $4 for a 30-day supply, or $8 for a 90-day
supply via mail order. Generic drugs are as safe and effective as brand-name
drugs and they cost less.
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Does the prescription plan cover non-formulary medications?
Yes. You have access to non-formulary medications; however, you pay less when
you select formulary medications. You maximize cost savings when selecting a
generic drug.
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HSA Plans
What is a health savings account (HSA)?
An HSA is a tax-advantaged savings account that can be used to save for
health care expenses. You must be enrolled in an HSA-qualified high-deductible
health plan to be eligible to open an HSA. There is a maximum amount that you
can contribute to an HSA each year, but if you don’t use all of the money within
your benefit period, it rolls over to the next year.
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What is a high-deductible health plan (HDHP)?
An HDHP is a health insurance plan with a minimum deductible of $1,250* (for
self-only coverage) or $2,500* (for family coverage). The annual out-of-pocket
cost (including deductibles and copays) cannot exceed $6,350* (for self-only
coverage) or $12,700* (for family coverage). HDHPs have first-dollar coverage or
no deductible for preventive care and higher out-of-pocket cost (copays and
coinsurance) for non-network services.
*These amounts are indexed annually for inflation.
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What are the benefits of an HSA?
An HSA provides several benefits including:
- tax-free interest or other earnings on your assets;
- a tax deduction for the contributions you make (You are eligible for a
deduction even if you don’t itemize your tax deductions on Internal Revenue
Service [IRS] Form 1040.);
- ability to build funds for your medical care needs (contributions remain in
your HSA from year to year until you use them).
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How do I set up a health savings account (HSA)?
You can use our preferred vendor, Bank of America, an independent company, to
set up an HSA or you can pick any bank you like. To set up your Bank of America
HSA, simply check the box in Section A of the plan application that reads: “Yes,
I’d like an HSA account set up through Bank of America.”
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If I open an HSA, are there any limits on the amount I can contribute
to it?
Yes, there are limits on the amount that you may contribute to an HSA. These
limits are set by the federal government and are generally updated each year to
account for inflation.
For 2014, HSA contribution limits are:
- $3,300 for individual coverage;
- $6,550 for family coverage;
- $1,000 in additional catch-up contributions for individuals between ages 55
to 65.
The contribution limits include all contributions made on behalf of the
individual (including contributions made by an employee, an employer, a
self-employed person, or a family member).
If you have more than one HSA, the annual contribution limit applies to the
total of all HSAs. You can decide how to contribute to your HSA (one time or
multiple times throughout the year) as long as you don’t exceed the maximum
allowable annual contribution.
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Applying
How do I apply?
You can
apply
online or you can call 1-888-475-6206 to request a packet and learn more
about our products.
Applying online is simple and secure. In addition, online applications are
processed more quickly and you can check the status of your application at any
time.
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Can I apply for health coverage for my family?
Yes. You can apply for health coverage as a(n):
- individual;
- individual and spouse;
- individual and child(ren);
- family.
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Can I add my spouse or child at a later date?
Yes. You can apply to add a spouse or child at a later date if you experience
a significant life event, such as marriage, birth or adoption of a child, or
change in employment.
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Can I add my domestic partner to my health plan?
No. Your domestic partner can apply individually for coverage. We do not
currently provide combined coverage for domestic partners.
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Can I add my fiancée (female) or fiancé (male) to my health
plan?
No. Your fiancée or fiancé can apply individually for coverage. Once you are
married, you can request that your spouse be added to your existing coverage.
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Can I apply for multiple plans?
No. You must select one plan when you apply for an individual health plan.
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Who should I contact if I have questions about how to fill out an
application?
Please call 1-888-475-6206 between 8 a.m. and 8 p.m. or
email us your question
or comment.
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How long will it take to apply for a health plan?
On average it takes between 20 – 30 minutes to apply and enroll for a health
plan depending on your family’s needs.
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Do I need to give my Social Security number?
Yes. We need your Social Security number to verify your identity. Our site
uses the latest security methods to protect the information you give us.
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What if I don’t have an email address?
There are many free email services where you can register for an email
account. Some examples are
Gmail and
Yahoo Mail. If you prefer not to create
an email address, paper applications are available by request. You can request a
hard copy application by calling 1-888-475-6206 or our
secure
web-based form.
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What happens if I don’t purchase health insurance?
Unless you meet certain requirements, you will pay a penalty to the
government if you do not have a health plan. You will be charged the greater of
these amounts for the years listed:
- 2014 penalty: $95 or 1% of your taxable income
- 2015 penalty: $325 or 2% of your taxable income
- 2016 penalty: $695 or 2.5% of your taxable income
You may be able to avoid the penalty if you are facing serious financial
problems, have certain religious beliefs, or meet other rules. To get more
information, visit
healthcare.gov.
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When do I need to purchase health insurance?
The new health care law requires that you have health insurance beginning
January 1, 2014. You may begin shopping for plans on October 1, 2013, through
March 31, 2014. However, in order to have coverage that begins January 1, 2014,
you will need to purchase your plan by December 15, 2013. If you experience a
life event change, you will be able to apply for a plan after March 31, 2014.
Life event changes can include the birth of a baby, moving to a different state,
losing your employer insurance, or becoming eligible for different products due
to income changes.
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Is financial help available for purchasing health plans?
The government will be providing advance tax credits, or subsidies, to help
people who purchase their own insurance, including working families. The
subsidies will be based on how much money you make each year, the number of
people in your family, and the age of the people in your family. If you qualify,
you may be able to get one of the following:
- free health insurance through Medical Assistance, also known as Medicaid;
- lower monthly premium costs plus a break on the cost-sharing you pay each
time you need medical care;
- lower monthly premium costs.
The chart below shows guidelines for subsidy eligibility. If your yearly
income is at or below the threshold shown below, then you may qualify for a
subsidy. The enrollment process will include checking whether you are eligible.
Family Size Yearly Income Threshold
1 $45,960
2 $62,040
3 $78,120
4 $94,200
5 $110,280
6 $126,360
7 $142,440
8 $158,520
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Premiums
What are my payment options?
If you apply online, you have the option to pay monthly using electronic
payments, credit/debit card payment (first payment only – Visa or MasterCard)
form or you can select the “Bill Me” option to pay by check at a later date. If
submitting a paper application, you can include a check for the first month’s
premium, complete the credit/debit card payment (first payment only – Visa or
MasterCard) form or complete the Electronic Payments form to authorize monthly
electronic payments.
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Will my actual rate be different from my rate quote?
All of the rates provided on our website are final rates. If you navigate
from our site to the Health Insurance Marketplace to register for and are
approved for a subsidy, your subsidy amount will be provided by the government
to IBC and will be reflected in your quoted rates.
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How long are the rates valid?
Rates are valid for one year and will be updated annually on January 1.
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How do electronic payments through ACH work?
With electronic payments, you authorize your monthly payment to be
automatically withdrawn from your account. It’s a worry-free way to help ensure
you won’t miss a payment and risk losing your health insurance coverage. You
don’t have to write and send in checks. With electronic payment, your premium is
taken care of even when you’re away on business or vacation.
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When will the initial payment come out of my account?
Credit and debit card payments are processed for approval at time of
purchase. Payment by automatic checking may take several days to complete.
Generally, the initial payment will come out of the customer’s account within
1–3 business days (which is typical bank processing time). Any payment that
fails to clear due to insufficient funds could impact your coverage effective
date.
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Online Application Process
Who do I contact for technical questions about using
ibx4you.com?
Please call 888-475-6206 between 8 a.m. and 8 p.m. Or,
email us your question
or comments.
http://www.ibx4you.com/faq/index.html#q97
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Vũ Quý
