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Medical Insurance

Can I itemize medical deductions on my federal tax return if I already received reimbursement for those expenses from my healthcare flexible spending account (FSA)?

If you did not have a FSA, you would be able to claim certain medical expenses as deductions on your taxes. However, since you do have an account, taxes were never taken out of your FSA contributions. For that reason, medical expenses paid for with FSA money cannot be included on your tax return. You should speak with a tax consultant when determining what expenses are eligible for deduction.

What are some tips for dealing with an insurance denial for my immunoglobulin (IG) replacement therapy?

Below are some “how to” tips from a clinical immunologist that has been successful in overturning IG denials. This is followed by a link to the IDF website that includes additional information including sample appeal letters that should be tailored to the patient’s clinical history.

Is IVIG or SCIG treatment covered under Medicare Part B or Part D?

If you have a primary immunodeficiency disease with the diagnosis codes 279.04, 279.05, 279.06, 279.12, or 279.2, your IVIG/SCIG treatment is reimbursed under Medicare Part B. If your provider submits the IVIG/SCIG service claim under Part D, it will most likely be denied. Your provider will have to reprocess and submit those IVIG/SCIG claims through Medicare Part B.

What are some tips for applying for Social Security Disability?

  • When filing a claim, it is best to obtain the most current records from your relevant treating sources, for example, your immunologist, rheumatologist, etc., and submit them at the time of the application. This will help expedite your claim. You should also obtain letters from your treating physician and other specialists with supporting objective evidence such as lab findings, MRIs, x-rays, etc stating that you are unable to sustain a 40 hour workweek. This will greatly support your claim.

What are some of the important health care reform changes that have already gone into effect as a result of The Patient Protection and Affordable Care Act (PPACA)?

  • Adult children may remain as dependents on their parents’ policy until their 26th birthday.
  • Children under age 19 may not be excluded for pre-existing conditions.
  • No more lifetime or annual caps on health coverage.
  • Free preventative care for all people.
  • The “doughnut hole” is in the process of closing for Medicare patients, making prescription medications more affordable for seniors.
  • Insurance plans are available for persons who have not been able to purchase medical insurance because of a pre-existing condition.

What is the difference between co-pay and a coinsurance?

A co-pay requires the insured to pay a specified amount of out-of-pocket expenses for health care services such as doctor visits and prescriptions drugs at the time the service is rendered, with the insurer paying the remaining costs. Co-pay fees will vary among insurers but are typically very affordable. For example, a co-pay plan may require the insured to pay $25 per doctor visit or $10 per prescription up to a specified coverage limit.

What is COBRA?

COBRA, the Consolidated Omnibus Budget Reconciliation Act, gives workers who lose their health benefits the right to choose to continue group health benefits provided by their plan under certain circumstances.

What is HIPAA?

The Health Insurance Portability and Accountability Act, better known as HIPAA, amended the Employee Retirement Income Security Act (ERISA) in 1996, to provide new rights and protections for participants and beneficiaries in group health plans. Understanding this amendment is important to your decisions about future health coverage.HIPAA includes protections for coverage under group health plans that:

What is an Indemnity Plan?

An Indemnity Plan is commonly known as a fee for service or traditional plan. If you select an Indemnity plan you have the freedom to visit any medical provider. You do not need referrals or authorizations; however, some plans may require you to precertify for certain procedures. Most indemnity plans require you to pay a deductible. After you have paid your deductible, indemnity policies typically pay a percentage of “usual and customary” charges for covered services; often the insurance company pays 80% and you pay 20%.


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