With health care reform’s fourth year, we’ll see more provisions being implemented. How will that affect the health insurance plan that allows you to have a health savings account or an HSA? Basically, it comes down to whether you got a policy before or after the Affordable Care Act became law. Let’s look at the difference that makes.
All HSA-qualified Policies in 2014
Annual and lifetime limits on coverage are not permitted by 2014. In addition, waiting periods before coverage takes effect on group plans cannot exceed 90 days.
Both child and adult applicants must be covered independent of health problems, too. And, children may retain coverage under a parent’s policy until the age of 26.
HSA-qualified Policies Purchased prior to Health Care Reform
You can tell if you have one of these plans, known as grandfathered plans, because insurance companies are legally required to notify you when they issue you material about the plan’s benefits. Any plan in effect by March 23, 2010 is considered grandfathered. You should find such notifications with annual enrollment information and summary plan descriptions.
If you have a grandfathered plan, you will not be required to purchase a new government-approved “metal” plan in 2014. Because the new plans must accept anyone regardless of health conditions, economists are predicting much higher claims costs for the new plans – and probably larger rate increases. So it may be prudent to keep your current grandfathered plan if you have one.
HSA-qualified Policies Purchased after Health Care Reform
According to the law, non-grandfathered insured, small group plans cannot have individual deductibles over $2,000 or family deductibles in excess of $4,000, as indexed for inflation based on premiums. However, this is in conflict with other areas of the law, so it is likely that group HSA plans will be allowed to have higher deductibles.
These plans may not require co-insurance, co-payments or deductibles in excess of the out-of-pocket maximum that applies to HSA-qualified plans.
State regulations will also define categories of health benefits that must be covered:
- Ambulatory patient services
- Emergency services
- Lab tests
- Maternity care and newborn care
- Mental health services
- Pediatric services
- Preventive health care
- Rehabilitative services and devices
- Substance abuse services.
As we get closer to 2014, we offer to review your current policy and compare it new plans. If you currently have coverage with us just request Our Annual Comprehensive Policy Review to be sure you have the best fit for your situation.
Wiley Long is President of HSA for America, and a passionate advocate for consumer-based solutions that will improve price transparency and lower health insurance and medical costs for people purchasing individual and family health insurance plans.