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Changing health insurance plans, mid-year, will also affect your HSA-eligibility. Make sure your review your prospective health insurance plan to understand if you will retain your HSA-eligibility.

Changing Health Insurance: HSA Contributions and Eligibility

Healthcare

Open Enrollment

HSA Account Rules

Lauren Hargrave is a writer from San Francisco who focuses on technology, finance and wellness. She follows comedians like most people follow bands and believes an outdoor sweat session can cure almost any bad mood. She’s also been writing her first novel for so long, her mom doesn’t ask about it anymore.

Lauren Hargrave

Health Insurance

have or was offered job-based insurance?

am unemployed?

HSA Max Contributions

Health Insurance  keywords you should know from deductible, co-pay, and premium to annual out-of-pocket maximum.

Health Insurance — Key Words That You Should Know

If you’ve lost your employer health plan, or if you’re self-employed, unemployed, or your employer doesn’t offer healthcare, you’ll need to purchase a health plan on your own.

Your Guide to Buying Individual Health Insurance

Benefits

Lively is the modern HSA experience built for—and by—those seeking stability in the ever-shifting healthcare landscape. By harnessing modern innovation and deep industry expertise, Lively is committed to bridging today’s savings with tomorrow’s unknowns. Unlike traditional institutions hindered by bureaucracy, Lively’s commitment extends beyond initial set up to providing dedicated, ongoing support and education for every step. So each HSA can reach its maximum potential with minimal headache. 

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Healthcare Benefits

Opening an HSA unlocks the triple-tax savings. No matter if you are an individual, family, self-employed or company owner, you can open an HSA.

Can I Open a Health Savings Account On My Own?

Becoming unemployed can be an incredibly stressful time. If you're unsure of what is going to your healthcare while you are unemployed, here are a few things you can do to ensure you will have access to healthcare during this time. 

What Happens to My Healthcare When I Become Unemployed?

am self-employed?

HSA (Health Savings Account)

Callie is a marketer in NYC, currently working to help empower people to make their best financial decisions.

Callie McGill

Losing your job doesn't just mean losing a source of income, it can also mean losing healthcare benefits. Discover your options for healthcare in this blog.

Lose your job? Here is what to know about your health insurance options

Since the COVID-19 pandemic has taken over the world, U.S. jobless claims have surged to record highs. If you’ve recently become unemployed, unable to work because you’re caring for a loved one or you’ve seen your hours reduced or projects disappear, you’re not alone. There are resources available to both help replace your income and ensure you have health insurance during this uncertain time.

## Resource #1: Unemployment Insurance

In order to qualify for unemployment insurance you must meet two criteria:

1. You must have been employed by a company which paid for unemployment insurance for you, and then you must have become unemployed by no fault of your own (i.e. you didn’t quit and weren’t fired for gross misconduct).
2. You must have met your state’s criteria for time worked and wages earned. 

Before March 2020, if you were a freelancer, contract worker or a part-time employee for whom your employer did not offer unemployment benefits, you were not eligible to apply for unemployment insurance. But due to recent acts signed into law: the Family First Coronavirus Response Act (FFCRA), the Coronavirus Aid, Relief and Economic Security (CARES) Act and the Pandemic Unemployment Assistance (PUA) Act, unemployment benefits have been extended to include the above-mentioned workers as well as increase the amount of time workers are eligible for relief and the amount of money they will receive.

You must apply for unemployment benefits through the state in which you worked. If you worked in multiple states, you should apply through the state in which you currently live. To find your state’s unemployment insurance office, visit this page on the [Department of Labor’s website](https://www.careeronestop.org/LocalHelp/UnemploymentBenefits/find-unemployment-benefits.aspx). 

Once you apply for benefits, you’ll likely receive an explanation of those benefits from your state. These documents should include how much you can expect to get each week and for how long, as well as continuing eligibility requirements. 

## Resource #2: COBRA

If you received employer-sponsored health insurance through a group plan and you lost that insurance once you lost your job or had your hours reduced to the point where you no longer qualified for the group health plan, you are eligible to continue your health insurance coverage through COBRA.

Once you lose your job, your employer notifies the health plan administrator and that administrator is then responsible for reaching out to you with your COBRA options. Under COBRA, you can choose to cover just yourself, you and your spouse, or you, your spouse and your dependent children. Even if you covered the entire family under your employer-sponsored health plan, you’re not required to maintain the same level of coverage under COBRA. It might not make sense to do so since you, as the employee, are now responsible for paying 100% of the plan premium.

One benefit to maintaining COBRA coverage is, if you have a High Deductible Health Plan (HDHP) with an HSA, you can continue contributing to your HSA while on COBRA. As always, those HSA contributions are tax-deductible.

## Resource #3: Health Insurance Purchased Through the Marketplace

In light of the disruption many people have experienced due to the global pandemic, Healthcare.gov has opened a new special enrollment period. You can use the search function available on the site to look for plans available in your area. Depending on your income, you might be eligible for premium subsidies that could lower your monthly cost of insurance.

## Resource #4: Medicaid

Medicaid is a state-run health insurance program for which you can qualify based on income, family size, disability status and other factors.  Some states have recently expanded their Medicaid coverage to include more people, some have not.  To see if you qualify for Medicaid coverage, visit this page on the [Healthcare.gov website](https://www.healthcare.gov/medicaid-chip/medicaid-expansion-and-you/).

## Resource #5: Your HSA

Even if you’ve had to stop contributing to your HSA, the money you’ve saved can be an important resource during these trying times. In most cases, you can’t use it to pay for premiums, but you can use this money to pay for out-of-pocket medical expenses. Just make sure you only use the money on qualified medical expenses (if you’re under the age of 65) so you don’t incur a tax penalty.

You can use your HSA to pay for premiums under these scenarios:

1. Long-term care insurance as stated under [IRS publication 502](https://www.irs.gov/pub/irs-pdf/p502.pdf)
2. Health Care Continuation (such as COBRA premiums)
3. Coverage when receiving federal or state unemployment benefits
4. Medicare premiums (Part A and Part B) and other healthcare coverage if you are 65 or older (other than premiums for a Medicare supplemental policy, such as Medigap)

Losing your job and health insurance is a stressful life event in and of itself, but when coupled with the uncertain times brought by the COVID-19 pandemic, it can feel catastrophic. But rest assured, there are resources out there for you to help you weather this storm.


<p>When you lose your job, time becomes an enigma. Every moment drags on, but hours can also pass inexplicably. While it’s natural to feel a void or depressed after a layoff, you will have to take some action right away. Specifically, you’re going to have to figure out a new way to maintain health insurance coverage. Not sure how to do that? Read on for some advice to help navigate the process.</p>

<h2><strong>When does coverage end?</strong></h2>

<p>Before you leave your job, ask the human resources department when your health insurance coverage ends. It may end the day your job terminates, or your coverage may extend through the end of the month or longer. “I wouldn’t expect or plan for an employer-sponsored benefit, but larger businesses with more cash may offer you some discounts on premiums for a time,” said R.J. Weiss, a Certified Financial Planner based in the Chicago area.</p>

<p>If you have a few extra days of coverage, take advantage of it. Booking appointments while you’re still covered may help you <a href="https://livelyme.com/4-tools-to-help-you-calculate-healthcare-costs">save on medical costs</a> later.</p>

<h2><strong>Consider your options</strong></h2>

<p>Buying your own health insurance after a job loss can feel overwhelming. While some options will be the same as those you’d experience if you were <a href="https://www.valuepenguin.com/self-employed-health-insurance">self-employed</a>, others are specific to individuals without work. However, if you compare your options, you can find insurance that works for you.</p>

<h3><strong>COBRA may not be best</strong></h3>

<p>When you lose your job, your employer will generally offer COBRA to you. COBRA allows you to continue your health insurance benefits after your employment ends. The catch? You have to pay for the full coverage, which is likely quite expensive. Without your former employer footing some of the bills, the rates can be astronomical.</p>

<h3><strong>Apply for state insurance programs</strong></h3>

<p>For some people, an affordable health insurance option may be a state health insurance program such as <a href="https://www.medicaid.gov/state-overviews">Medicaid</a>. Depending on your state’s rules, your household size and your income, you may qualify for free or reduced-cost insurance.&nbsp;</p>

<p>Don’t just check on Medicaid for yourself. Your children may qualify for free or low-cost insurance through the Children’s Health Insurance Program (CHIP).&nbsp;</p>

<h3><strong>Head to the healthcare marketplace</strong></h3>

<p>If you don’t qualify for free options, the next place to look is the <a href="https://www.healthcare.gov/">health insurance marketplace</a>. Sa El, a licensed health insurance agent and founder of Simply Insurance in Atlanta, recommends immediately looking into the exchange, as you will have a qualifying event of a job loss, and you may also qualify for assistance depending on your financial situation.</p>

<p>The Federal healthcare exchange (or your state’s exchange) allows you to compare the cost of various plans. When you buy the plan through the healthcare exchange, you may qualify for discounts called premium tax credits.&nbsp;&nbsp;</p>

<h3><strong>Look to your family for help (and coverage)</strong></h3>

<p>Another good option for coverage is to join a family member’s insurance plan. In general, you need to enroll in a family member’s plan within 30 days of losing your own employer-based coverage. Spouses and children may be allowed to join a family member’s employer-sponsored health insurance plan after a job loss or another qualifying life event.</p>

<p>A spouse isn’t the only family member who may have coverage options for you. Depending on your age, you may be able to join your parents’ health insurance plan. Throughout most of the country, health insurance plans allow dependents up to age 26 onto their parents’ plans. In New York, where health insurance is heavily regulated, you may qualify for your parent’s insurance plan until you’re <a href="https://www.valuepenguin.com/best-cheap-health-insurance-new-york">29</a> years old.</p>

<h2><strong>Pay premiums with health savings accounts</strong></h2>

<p>Trying to figure out how you’ll pay for your health insurance while you’re scrambling to line up a new job? You may be able to use money from your health savings account (HSA) to pay the monthly premium. Anyone who pays for COBRA or receives unemployment compensation can, under state or federal law, use HSA funds to cover premiums.</p>

<p>You can also use the money in your HSA to pay for qualified medical expenses such as prescription drug costs, medical co-pays or the cost of getting treatment. But be careful with contributing to your HSA during a period of unemployment. You’re only allowed to contribute to an HSA if you have a qualified high-deductible health insurance plan.</p>

<h3><strong>Mind the gap</strong></h3>

<p>In the past, people who lost their job had to worry about <a href="https://www.healthcare.gov/fees/fee-for-not-being-covered/">paying extra taxes</a> if they went without health coverage for too long. However, the federal individual mandate that required people to buy insurance was repealed for 2019. That means most people won’t pay penalties if they have an insurance gap. But the individual mandate hasn’t disappeared everywhere. States including Massachusetts, New Jersey, Washington D.C. and California have their own penalties for people who don’t carry insurance.</p>

<p>Even if you won’t be penalized, you’ll need to act quickly to avoid a coverage gap. Jen Smith, a writer, lost her staff position and health insurance coverage when she was 30 weeks pregnant. After exploring a few options, she moved quickly and joined her husband’s insurance plan. Shortly after getting coverage, she had a seizure and had to be hospitalized. “Thankfully, the insurance coverage backdated to the start of the month, so I had the coverage I needed,” Smith said.</p>

<p>How quickly do you need to act? In most cases, you should try to have coverage in place within 30 to 60 days of losing your job.</p>

<p>If you don’t opt to join a family member’s plan, you’ll have 60 days to enroll in COBRA coverage or buy insurance through the exchanges. Once that window closes, your options for coverage are much more difficult.</p>

<h3>The bottom line</h3>

<p>Losing your job may make it tough to move forward but maintaining health insurance coverage is critical to your overall well-being. Consider your options and choose a plan that works for you and your wallet.</p>


<p>If you’ve lost your employer health plan, or if you’re self-employed, unemployed, or your employer doesn’t offer healthcare, you’ll need to purchase a health plan on your own.&nbsp; This used to be a daunting process that required contacting an insurance broker and trusting he or she was signing you up for the best plan to fit your needs.</p>
<p></p>
<p>Now, you can find the information you need to compare plans, you can ask questions and you can apply all online.</p>
<h2>Step 1: Determine the Kind of Coverage You Need</h2>
<p>Your first instinct might be to choose the cheapest plan.&nbsp; And if you’re a <a href="https://livelyme.com/millennial-hsa/">healthy young person who rarely goes to the doctor</a> and doesn’t take regular medication or have severe allergies or a pre-existing condition that needs maintenance, that cheapest, most basic plan might work for you.</p>
<p>If you don’t fall into the lowest maintenance category, there are some things you need to consider:</p>
<ul>
<li>Is it important that you keep your doctor? If so, you should ask your doctor for a list of insurance providers he or she accepts and make sure you choose one from that list.&nbsp; If your doctor doesn’t accept your insurance, you might have to choose a different doctor or pay completely out-of-pocket for each visit.</li>
<li>Do you regularly see a specialist for a chronic condition? If so, you will want a plan that covers specialist visits.&nbsp; If you like the specialist you are currently seeing, you need to ask the doctor for a list of insurance providers he or she accepts, and make sure to choose one from that list.</li>
<li>Do you regularly take medications and if so, are you sensitive to the brand? If you want the option to choose between brand name and generic medications, you will need a healthcare plan that gives you that flexibility.</li>
<li>Do you want the option to save money in a <a href="https://livelyme.com/what-is-an-hsa/">Health Savings Account</a> (HSA)? If so, you must purchase a <a href="https://livelyme.com/what-is-a-high-deductible-health-plan-hdhp/">High Deductible Health Plan</a> (HDHP) because you can only contribute to an HSA account if you’re concurrently enrolled in an HDHP.</li>
</ul>
<p>For more information on the difference between PPOs, HMOs and HDHPs, check out our article on <a href="https://livelyme.com/comparing-health-insurance-plans/">comparing health insurance plans</a>.</p>
<h4>Step 2: Research Your Options</h4>
<p>The plans available to you depend on your location, your financial situation and the time of year in which you are applying.&nbsp; In order to purchase the majority of healthcare plans, you must sign up for them during what’s called, “open enrollment”.</p>
<h4>Open Enrollment</h4>
<p><a href="https://livelyme.com/blog/employer/open-enrollment-2018-strategy/">Open enrollment</a> is the 6-12-week period your state allots for residents to purchase health insurance.&nbsp; For the majority of states, you can purchase health insurance between November 1<sup>st</sup> and December 15<sup>th</sup>.&nbsp; In California, enrollment is open from October 15<sup>th</sup>&#8211; January 15<sup>th</sup> and in Washington, D.C., it’s open from November 1<sup>st</sup>&#8211; January 31<sup>st</sup>.</p>
<p>If you’ve missed the open enrollment, you can still sign up for a long-term health plan if you’ve had a life event such as getting laid off, getting married, and having a baby, or if you qualify for Medicaid.&nbsp; If neither of these apply to you, you can buy short term health insurance so that you’re covered until the next open enrollment window.</p>
<h4>Medicaid</h4>
<p>Medicaid is a free or reduced-cost, government funded healthcare program for people with low incomes.&nbsp; The rules for Medicare have changed with many states expanding the pool of people who qualify, so even if you haven’t qualified in the past, you might now.</p>
<h4>Finding Available Plans in Your Area</h4>
<p>You can find out if you qualify for Medicaid and search for health plans available in your area on the same website: Healthcare.gov.&nbsp; This is a federally-run site that allows you to search for plans based on your zip code, it can tell you whether or not you qualify for a tax credit or other savings based on your income and it can show you a side-by-side comparison of up to three plans at a time.</p>
<p>While Healthcare.gov will show plans offered in the Affordable Care Act (ACA) Marketplace, and those offered by private insurers, you are only eligible for tax credits or other savings on premiums if you sign up for an ACA health plan.</p>
<h4>Step 3: Choose Your Plan</h4>
<p>When comparing the available health plans, it’s important to have the answers to your questions from step 1.&nbsp; Healthcare.gov will give you a comprehensive chart, showing each plan’s monthly premium, visit and prescription copays, whether it’s <a href="https://livelyme.com/hsa-eligibility-details/">HSA compliant</a>, the annual deductible, your maximum out-of-pocket expenses, and more.</p>
<p>If you’re cost-sensitive, make sure to take into consideration all of your likely health costs, not just the monthly premium.&nbsp; You can also apply for assistance in paying for your health insurance premiums on Healthcare.gov.&nbsp; Once you’ve chosen the plan you want, you can apply for it directly on Healthcare.gov or the insurance carrier’s website.</p>

<p>Opening an HSA unlocks triple-tax savings. From there, you can save, spend or invest your HSA, as it fits your lifestyle and needs. No matter if you are an individual, family, self-employed or company owner, you can open an HSA. We will show you the requirements to open an HSA.</p>
<p></p>
<h2>Individual HSA</h2>
<p>Any individual with a qualifying High Deductible Health Plan can open an HSA account and contribute either to the individual or family limit. HSA eligibility is not connected to your employment, but rather your <a href="https://livelyme.com/hsa-eligibility-details/">health insurance plan</a>.</p>
<p>HSA accounts are lifetime accounts that go with you from job to job. In 2019, <a href="https://livelyme.com/2019-hsa-contribution-limits">individuals can contribute up to $3,500 and families can contribute up to $7,000</a>. HSA contributions are not limited by income level or tax brackets.</p>
<h4>HSA Contribution Requirements for Individuals or Families</h4>
<ol>
<li>In 2018, <a href="https://livelyme.com/hsa-eligibility-details/">HSA-eligible health insurance</a> must have an annual minimum deductible of $1,350 for individuals and $2,700 for families.</li>
<li>In 2018, the annual out-of-pocket maximum can’t be more than $6,750 for individuals and $13,300 for families.</li>
</ol>
<p>These are the contribution requirements but are not tied to HSA spending or investing. HSA-eligibility is only tied to how much you can contribute into your HSA account. Once you have HSA funds in your account, you can use those funds for qualified out-of-pocket medical expenses or <a href="https://livelyme.com/tax-free-retirement-income/">save for retirement</a>, regardless of your HSA-eligibility status. So in other words, if you have HSA funds in your account and then switch to a different health insurance (a non-HDHP), you can still use your HSA funds towards your qualified medical expenses and yes, they are still tax-free!</p>
<h4>Individual HSA Tips</h4>
<ul>
<li><a href="https://livelyme.com/add-1-hsa-day-1/">Add $1 to your HSA on Day 1</a> &#8211; Penny fund your HSA so it is considered &#8220;established&#8221;. From there you can backdate any expenses to that date, even if you add the funds later. It&#8217;s a great HSA benefit!</li>
<li><a href="https://livelyme.com/can-i-invest-my-hsa-money/">Invest your HSA Funds</a> &#8211; Save for tomorrow by investing your HSA funds. Under IRS regulations you can invest in a variety of investment options, including individual stocks, bonds, CDs, ETFs, or mutual funds.</li>
<li><a href="https://livelyme.com/stealth-ira/">Save for Retirement</a> &#8211; Add flexibility and savings to a retirement plan and any existing retirement accounts like an IRA or 401(k), by adding an HSA. After 65 years of age, you can use an HSA just like a 401k or IRA for non-qualified medical expenses.</li>
</ul>
<p>If you need help understanding how much money you can contribute to your HSA, we built a free <a href="https://livelyme.com/signup-eligibility/">HSA eligibility calculator</a>. Individuals or families can open a health saving account to save tax-free dollars for medical expenses for today, tomorrow or years to come.</p>

<p>Changing health insurance plans, mid-year, will also effect your HSA-eligibility. Make sure you review your prospective health insurance plan to understand if you will retain your HSA-eligibility. We will outline how to pro-rate your HSA contributions to stay IRS complaint if your new health insurance plan is not HSA-eligible.</p>
<p></p>
<h2>Is Your New Health Insurance Plan HSA-Eligible?</h2>
<p>In order to determine if you can continue contributing to your HSA, you must first determine if your new health insurance plan is HSA-eligible. But don&#8217;t worry, we have outlined all of that for you <a href="https://livelyme.com/hsa-eligibility-details/">here</a>.</p>
<p>As a quick reference point, in 2019, your <a href="https://livelyme.com/2019-hsa-contribution-limits">health insurance</a> must have an annual minimum deductible of $1,350 for individuals and $2,700 for families. In addition, the annual out-of-pocket maximum can’t be more than $6,750 for individuals and $13,300 for families. This definition only applies to the in-network services.</p>
<p>So what must you do if you switch to a health insurance plan that is not HSA-eligible to stay IRS compliant?</p>
<h4>Prorated HSA Contributions When You Change Health Insurance Plans</h4>
<p>If you change or end your health insurance plan and are no longer covered by an HSA-eligible health insurance plan, like an <a href="https://livelyme.com/what-is-a-high-deductible-health-plan-hdhp/">HDHP</a>, you are subject to pro-rated HSA contributions amounts.</p>
<p>The most straightforward way to understand HSA contribution limits for mid-year changes is to contribute based on a pro-rated calendar schedule. HSA eligibility is determined on the 1st of every month. For example, if your HSA-eligible health plan ended on May 15th, your HSA (individual or family) would be prorated for 5 months (out of 12) for 2019 &#8211; January to May.</p>
<p>Based on the current 2019 HSA contribution limits ($3,500 for individuals and $7,000 for families), this prorated 5 months of eligibility would calculate to $1,458 for individuals and $2,916 for families.</p>
<h4>Other HSA-Eligibility Factors to Consider</h4>
<p>This proration of HSA contributions would also come into effect in the following scenarios. This is in addition to health plan eligibility.</p>
<ul>
<li>You can’t have or be eligible to use a general purpose Flexible Spending Account (FSA). Limited purpose FSAs are allowed for dental, vision, and dependent care if your HDHP doesn’t cover those services.</li>
<li>You can’t be claimed as a dependent on someone else’s tax return.</li>
<li>You can’t be enrolled in Medicare (Part A and Part B) or Medicaid.</li>
</ul>
<p>You can read all the details about HSA-eligibility <a href="https://livelyme.com/hsa-eligibility-details/">here</a>.</p>
<h4>What if I Over-Contributed to my HSA?</h4>
<p>Using the formula above you can also determine if you have over-contributed to your HSA. If you have over-contributed to your HSA, you have two options:</p>
<div>
<ul>
<li>Reverse your HSA contributions before the applicable year&#8217;s tax filing deadline. This assumes you have not already spent these HSA contributions on qualified out-of-pocket medical expenses and your HSA provider will allow you to do this (like Livey).</li>
<li>You can opt to pay the IRS tax penalty for excessive HSA contribution of 6%. This can be paid as part of your yearly tax return. It will be noted on your <a href="https://www.irs.gov/pub/irs-pdf/f5329.pdf">IRS Form 5329</a>.</li>
</ul>
</div>
<h4>What About Existing HSA Funds?</h4>
<p>While HSA contributions require eligibility, using your HSA (and any existing funds), does not. You can continue to use your HSA funds, tax-free, to pay for qualified out-of-pocket medical expenses. You may also continue to invest your HSA funds for years to come. After you are 65 years old, you can use your HSA funds for anything, not just qualified out-of-pocket medical expenses.</p>
<p>When you consider changing your health insurance plan, consider the additional financial impact it will have on your health benefits, like an HSA. While your health insurance is often the primary factor in healthcare decisions, don&#8217;t neglect the other connected health benefits, especially the ones that can reduce your out-of-pocket medical costs (hint, hint, an HSA).</p>

<p id="49c6" class="graf graf--p graf-after--h3">Today marked a historic day for the U.S. Our 45th president has been sworn into the presidency. Many people are looking to see what Donald Trump and his administration will do with regards to healthcare. While the wheels are in motion to make changes that will impact the Affordable Care Act (ACA), there are many unanswered questions.<br />
<br />
While we wait, we thought we could provide some education to people considering getting health insurance or whose health insurance could be affected by potential changes.</p>
<h2>Health Insurance Terms</h2>
<p id="684e" class="graf graf--p graf-after--p">Below are common words and phrases typically used in conjunction with obtaining <a href="https://livelyme.com/2018-healthcare-report/">health insurance</a>. Our goal is to provide a brief explanation of each to better prepare yourself for any potential decisions you may have coming.</p>
<ul class="postList">
<li id="7fff" class="graf graf--li graf-after--p"><strong class="markup--strong markup--li-strong">Copay</strong> –a copayment is a fixed fee for a covered service under a health insurance plan that you pay at the time of service. Covered services may include all medical/health benefits that are made available to you by that plan. Typically, copays can be seen for doctor’s office visits, specialist office visits, drug prescriptions, making an emergency room visit, etc.</li>
<li id="fca1" class="graf graf--li graf-after--li"><strong class="markup--strong markup--li-strong">Deductible</strong> — this is the amount of money that you as the individual (or family) has to pay out-of-pocket before insurance kicks in any amount of money for services. Copays generally do not accumulate towards your deductible, though in many plans they do accumulate towards your annual out-of-pocket maximum.</li>
<li id="2704" class="graf graf--li graf-after--li"><strong class="markup--strong markup--li-strong">Co-insurance</strong> — this is a shared percentage responsibility for you and your insurance carrier to pay bills after the deductible is met (e.g., 80%/20%) and together they always add up to 100%. So for example, a customer pays the 20% after the deductible, while the health plan pays the larger 80%. The percentage (post-deductible through annual out-of-pocket max) varies by plan.</li>
<li id="8837" class="graf graf--li graf-after--li"><strong class="markup--strong markup--li-strong">Annual out-of-pocket maximum</strong> — this is the most amount of money an individual (or family) has to pay in any given year. This is usually a combination of copays, deductibles, and coinsurance. Once this number is met, your insurance company covers 100% of the costs.</li>
<li id="d1b2" class="graf graf--li graf-after--li"><strong class="markup--strong markup--li-strong">Lifetime maximum</strong> — this is a term that you don’t see all too often anymore due to the ACA. Under the ACA, lifetime maximums are no longer allowed for plans issued after September 2010 for in-network based services. Prior to that, a health insurance plan was able to cap benefits (e.g., $2 million per year or lifetime). Certain grandfathered plans may still have this feature so be on the lookout for it.</li>
<li id="a409" class="graf graf--li graf-after--li"><strong class="markup--strong markup--li-strong">Premium</strong> — all of the variables above determine what your monthly premium (amount you pay on a monthly basis for the privilege to be insured) will be. It is important to consider how often you need covered services and what kind. Based on those factors, a high or low deductible plan could be better for you.</li>
</ul>
<p id="7fc9" class="graf graf--p graf-after--li graf--last">It is important to note that this is not meant to be an exhaustive list of what you can expect to see in a <a href="https://livelyme.com/comparing-health-insurance-plans/">health insurance plan</a>. Further, everyone’s situation is unique and you should evaluate it based on its own details. Just because a health plan is good for one person, doesn’t mean it will automatically be good for you. Be sure to ask the appropriate questions for your situation. It is always better to make an informed decision (if possible) than a blind one!</p>
<p>If you need more help with HSA decisions, check out <a href="https://livelyme.com/blog/">our blog</a>. We will make you a healthcare benefits expert in no time, without any extra work or effort on your end.</p>
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