- How do I know if I am eligible for health insurance coverage?
To be eligible, you must be:
- A North Carolina resident
- Under 65 years old and do not qualify for Medicare
- Discontinue any current health insurance as soon as your policy becomes effective
- When will my health insurance coverage begin?
Your coverage can begin on the 1st or the 15th of the month. If your online application is submitted by the 8th of the month, your coverage can begin as soon as the 15th of that same month. If your online application is submitted by the 22nd of the month, your coverage can begin as soon as the 1st of the following month. Requested effective dates may not be more than 60 days from the date you submit your application.
- How do I renew my health insurance coverage?
Your coverage is automatically renewed when you continue to pay premiums as they are due. BCBSNC must renew your policy unless we discontinue all policies like yours.
- When can I add or remove maternity from my policy?
The maternity rider option can be added to your policy when you first apply for coverage or during the renewal period, November 1 through 30, if the policy has been active for at least six months, or during a qualified life event, which is subject to review and approval. The individual to be covered cannot be pregnant at the time the addition is requested.
- If I visit a doctor or hospital outside the network, am I still covered?
Yes, you can see any doctor you choose, but remember: you save money when you visit a participating, in-network provider. There are more than 18,000 health professionals and over 100 North Carolina hospitals in the our network. Our online provider search can help you find out whether your physician is in our network.
- Do all of your health insurance plans use the same provider network?
Yes, whether you choose Blue Advantage, Blue Advantage Saver or Blue Options HSA, you have access to the same large network of providers.
- What is a Health Savings Account (HSA)?
A Health Savings Account (HSA) is a savings account that offers a tax-advantaged way for consumers to pay for their health care expenses. Usually paired with a High Deductible Health Plan (HDHP), HSAs help consumers pay for current health expenses and save for future qualified medical and health expenses in retirement.
Contributions to an HSA are tax-deductible and distributions can be taken tax-free.
You own and control the money in your HSA. You make the decisions on how to spend the money, within IRS guidelines for eligible expenses. The money in HSAs can be invested to take advantage of the potential for future growth. Investment options vary depending on who is managing the account.
- What is a High Deductible Health Plan (HDHP)?
A High Deductible Health Plan (HDHP) is a health insurance plan offering lower premiums in exchange for first dollar expenses going toward a deductible instead of copayments. The plan generally covers health care expenses after the deductible is met. You can also opt for varying coinsurance rates which can also affect your premium.
Preventative care is usually covered 100% under an HDHP, and there is a cap on the out-of-pocket expenses you are responsible for during the year. HDHPs are frequently paired with HSAs to help you pay for expenses your plan does not cover. You must have an eligible HDHP to open an HSA.
- Can I have other health coverage in addition to my HDHP?
Yes, but to open and contribute to an HSA you cannot be covered by any plan other than eligible HDHPs, except for:
- Dental or vision coverage
- Long-term care coverage
- Accident/disability coverage
- Hospital Insurance Plan (HIP)-type coverage or disease-specific coverage
- Who can open and contribute to an HSA?
You must be covered by an eligible HDHP to open or contribute to an HSA.
An HSA is an individual account; you cannot open a jointly-held HSA. Multiple adults covered under a family plan may each open an HSA, but the collective total of both accounts may not exceed the family contribution maximum. For 2012 the family contribution maximum is $6,250. Note: Although HSAs are individual accounts, the funds in the HSA can be used for your spouse, yourself or a dependent's eligible medical expenses.
A husband and wife enrolled in an eligible family HDHP can:
- Open an HSA in one spouse's name and contribute up to the family maximum. Those funds can be used to pay for medical expenses for anyone covered by the plan.
- Open individual HSAs and contribute to both, but the collective total of both must not exceed the family contribution maximum including any catch-up amounts. This may be an appealing option if you and your spouse are both eligible for catch-up contributions to an HSA after age 55, because each person's catch-up contribution must be made to their own account.
If you later unenroll from your HDHP, enroll in Medicare or become covered by a non-HDHP, you can keep your HSA and continue to use the remaining funds, but you can no longer contribute to it.
- What are the annual contribution limits for an HSA?
Contribution limits are established by the IRS and may be updated each year. In 2012, the maximum annual contribution is $3,100 for individual and $6,250 for a family. Rollover amounts from previous years, medical savings accounts or another HSA do not count toward the maximum annual contribution.
Individuals between the ages of 55 and 64 can contribute an additional $1000 annually in catch-up contributions.
If you are 65 years or older and not enrolled in Medicare you can continue to contribute to your HSA and make catch-up contributions if you are enrolled in a HDHP.
- Can I make contributions if I am not enrolled in an HDHP for the entire year?
Yes. If you are covered by an HDHP on December 1, you are treated as an eligible individual for the entire year. However, if you become ineligible the following year, any excess contributions over a prorated contribution amount is included in income and subject to a tax penalty.
If you are not covered on December 1, your contribution is prorated based on the number of months you had an HDHP plan in place. See IRS guidelines for information about prorating a contribution.
- Can I open an HSA for my child?
No. You cannot establish separate accounts for dependent children, including children who can legally be claimed as dependents on your tax return. You can use your (or your spouse's) HSA funds to pay for your child's eligible medical expenses however, as long as the child is claimed as a dependent on your tax return.
- I turned 55 this year. Can I make the full catch-up contribution?
If you are covered on December 1, you can make the full catch-up contribution regardless of when your 55th birthday falls during the year. If you did not have HDHP coverage for the full year, you must prorate your catch-up contribution for the number of full months you were eligible. See IRS guidelines for information about prorating a contribution.
Each eligible individual covered by a HDHP, (i.e., the policy holder and his/her spouse, if both are at least 55) can make a catch-up contribution of up to $1,000 annually. Each spouse must have an HSA in their name to receive the catch-up contribution.
Note that the total contributions to all HSA accounts under a family plan must not exceed the family contribution maximum. For 2012, the family contribution maximum, before any eligible catch-up contributions, is $6,250.
- What happens if I exceed the annual contribution limit?
Contributions made to your HSA that exceed the contribution limits are not tax-deductible. In addition, a tax penalty is imposed on excess contributions. You can avoid the penalty on excess contributions by withdrawing excess contributions before the last day prescribed by law (including extensions) for filing your federal income tax return for the tax year.
- I don't have earned income, can I have an HSA?
Yes. You do not have to have earned income to fund a Health Savings Account.
- Can someone other than the plan participant contribute to the participant's HSA?
Anyone can contribute to an HSA on your behalf including individuals not covered by the plan, i.e., extended family.
HSA contributions made by a family member on your behalf are tax-deductible by you when you are computing your adjusted gross income.
- When can contributions to an HSA be made?
Contributions to an HSA can be made at any time during the year in any increment, including:
- All at once at the beginning of the year
- All at once at the end of the year
- In equal amounts during the year
Contributions to an HSA for the current year can be made through April 15 of the following year.
- Can HSA funds be invested?
Yes. When your account balance reaches a certain amount, you can invest the excess funds. The same types of investments permitted for IRAs are allowed for HSAs, including stocks, bonds, mutual funds, and certificates of deposit. The investment options for your HSA account are determined by the investments offered by the HSA manager. Mellon Trust of New England is the provider of the HSA for BCBSNC HDHP. After you purchase a BCBSNC HDHP, Mellon Trust will send you a Welcome Kit with further information about the options for your HSA.
- What medical expenses can HSA funds be used for?
Review a list of eligible medical expenses
Review a list of noneligible medical expenses
HSA distributions are tax-free if used for eligible medical expenses as defined by Internal Revenue Code Section 213(d). Non-eligible distributions will be taxed as part of gross income and will incur a tax penalty. After age 65, the tax penalty is dropped, though the distribution is still treated as taxable income. Eligible medical expenses include doctor's office visits, pre-deductible amounts and coinsurance.
- Are claims incurred prior to establishing the HSA eligible for reimbursement?
No. Your HSA is established on the effective date of your Blue Options HSA policy. However, to officially activate your HSA, you must send in your signature card. If you delay, the IRS may infer you intended to open your account at a later date.
Some information about HSAs in this article was sourced from www.ustreas.gov.
