Health Insurance Changes on the Horizon

Friday, November 05, 2010

As of January 1st, flexible spending health care accounts will no longer reimburse certain over-the-counter medications -- including sleep aids, aspirin and allergy remedies -- unless they're prescribed by a doctor.  Nancy Metcalf, senior program editor and online columnist at Consumer Reports, talks about this and other impending changes.


Nancy Metcalf

Comments [18]


"People who are lucky enough to have employer-paid health care plans..."

That's 75% of Americans! And that's why the many laudable aspects of healthcare reform have been lost in the partisan debates. Anything that is going to negatively impact what 75% of Americans, especially working Americans, see as part of their benefits packages, that is, what a worker agreed to when s/he decided to accept a job and negotiated or were offered, a salary and benefits package, is not going to wash with the electorate.

The plan makes some important reforms, including ensuring that young children with pre-existing conditions can be and must be covered by their parents' plans. What it lacks are effective cost controls.

Nov. 07 2010 06:11 PM
Owen from Oakland, CA

This guest was terrible. She was defensive and emotional when she could have offered the obvious rationale for this change: because it's supposed to save the government money and slow down the growth of healthcare costs. It's that simple. I'm for the Obama healthcare reform overall, but I'm wary of this change. The law is undermined when its supporters say things like "People lucky enough to have an FSA should shut up"--not in those words, but that was the message.

Nov. 06 2010 11:49 PM
Czellak from New York City

I just heard that there's a problem with medicaid. I hope that newly elected Governor Cuomo does something about the mexican invasion to New York. Fleeing other places where they are doing something about it. As a poor, three generation american, I have to go to Bellevue Hospital for health care. It was OK a few years back. Now it is full of illegal mexicans sucking up our taxed dollars. The only ones making money off them are the rich, Like Major Bloomberg. I am Jewish so I feel free to criticize him.

Nov. 05 2010 09:29 PM
MacJ from Manhattan

Re Vera's comment, yes, medical expenses can be deducted from your taxes but *only* those expenses that exceed 7.5% of your taxable income. FSA's have no such restriction.

I'm also mystified by Andrea's obsession over the prospect of more expensive aspirin. How much aspirin does one consume in a year?? If it's more than two bottles, you should only be doing so under a doctor's supervision, in which case you can get prescription as Nancy explained. If it's two bottles or less, we're talking about losing a tax break of about $3-4. Cry me a river.

Nov. 05 2010 06:28 PM
Paul from Jersey City

I have participated in flex spending plans since the mid 1990s. I find them personally useful, contribute the maximum, and use it every year. But I'm all for getting rid of them entirely.

The change does not make health care less affordable. While Ms. Metcalf dealt well with the trivial nature of excluding over the counter items from this plan, it is important to understand that the plans themselves do NOT help health care affordability.

From a macro perspective, flex spending plans actually make health care more expensive.

They are a tax expenditures - loopholes which exempt some kinds of income from taxation. This particular loophole benefits only those whose employers provide the plans, and tend not to be low end workers.

The loophole results in less government income available to fund health care (and everything else the government does). But it ADDS the administrative complication of these plans. This creates jobs in insurance companies and personnel departments - not the places we'd ideally want to create jobs (which we might rather have in providing direct health care). And these eats up personal (or employee) time in understanding, planning, and submitting claims. This loophole provides real savings for individuals but is a non-productive activity for the economy.

Nov. 05 2010 01:31 PM

I have a primary care doc who is a control freak -- he likes to give 30 day prescriptions for something I've been on since my early 20's (I'm now close to Medicare age). I have to argue almost every refill that I save about 35-40% by getting a 90 day supply at one time. Then, he refused to write a script for refills!

On my last visit he refused to give me a written script in order to use with the $10 gift coupons a couple big box stores occasionally offer. I have to notice the coupon in time to use the coupon, and then make the call in time to get his office to call in a prescription.

He also feels my insurance company does not pay the primary care docs enough, so I wonder if he uses the refills to require extra visits (often I can't get a refill until I've met the "see the doctor" requirement. When I arrive for the appointment, he asks me why I'm there. I tell him his office people told he said he needed to see me in order to write a refill.... Awkward.)

When I was going out of town for a few months, I asked for written copies of my prescriptions in case I lost or misplaced any of my daily prescription pills. He refused and insisted I had to call long distance to have him call a pharmacy to place a limited supply order. Imentioned that could be difficult on the days I was between cities, etc. Got nowhere with him. Control freak.

He drives me crazy -- and once I can choose my doctors he will not be my primary care doc!

So, I fully understand the issue the host raised with the guest about getting something as simple as a written script to enable using the flex accounts for OTC required drugs (I'm on three of those right now). Also, perhaps the guest, given her ability to write about medical matters, gets treated more kindly than regular patients?

Nov. 05 2010 11:49 AM

Finally! Someone with a backbone to stand up for the new health insurance changes.

Nov. 05 2010 11:45 AM

Andrea asks: "Why is the IRS involved in deciding what is pre-tax and what is after-tax?"??? Is she really that naive/dumb, or is she doing a Stephen Colbert imitation?

Nov. 05 2010 11:43 AM
nan in CT

Pls. ask Nancy why no one is talking about how insurance companies are denying coverage to minors, a practice supposedly not allowed under the new law. Companies are "not writing new policies for minors". This is the same thing as denying coverage.

Nov. 05 2010 11:43 AM
Rick from Manhattan

Thank you Nancy. I think your host should get a grip!

Nov. 05 2010 11:42 AM
Alison from NYC

Andrea, Andrea, Andrea.

What you *should* ask about HSAs is how much is being made by insurance companies and money managers on fees for these 'services', versus how useful they are to those who have them!

Deposits in them are around $1.025 billion!

Just another banking and insurance bailout if you ask me.

Nov. 05 2010 11:42 AM
Sue from North Salem, NY

RIGHT ON!!! People who have health insurance through their employers NEED TO GET A GRIP!!!!!

Nov. 05 2010 11:40 AM
Henry from Katonah

I expect my biggest change next year will be that my insurance will not be able to deny reimbursement because of a wellness maximum ( $500/family member). I could not even get a physical with all the tests. Not to mention the other "routine" tests that middle age people are scheduled for every few years.
Thank you,111th congress!
That said, I am sure insurance companies will think up other ways not to reimburse me.

Nov. 05 2010 11:39 AM
Amy from Manhattan

If the payments into these accounts are deducted from paychecks, are they available to freelancers? If so, how does that work?

Nov. 05 2010 11:39 AM
The Truth from Becky

If I hear "obamacare" once more I think I shall puke! Stop the non-sense and be respectful.

Nov. 05 2010 11:36 AM
Lenny from Chinatown

Flexible spending accounts are a FRAUD!

Nov. 05 2010 11:35 AM
Vera from LES

These flexcare plans are a mess.

You can still write off these expenditures on your yearly taxes.

Nov. 05 2010 11:35 AM
Jeff Pappas from Ct.

I recently switched health Ins Co's to save $ by changing from a higher premium / lower deductible to a lower premium / higher deductible and stand to save about 100-150 month. I went through an agent and gave him the info from my old Co which I had for over 4 years. I have no major health issues, yet do take some medicine for anxiety ( I am upset and nervous about not having work for almost 2 years ). I told the agent I did not want to go through any waiting period, did not want to be denied for taking my medicine and did not want any lapse in coverage. He said I would be 100 % accepted or rejected. So I waited till I was accepted to cancel my previous plan.
Then a week or so after I had my new plan they told me I was not covered for that area due to pre existing conditions !!
I about blew a Gasket ! After calling all parties concerned and worrying for over a week I was finally 100 % covered
Apparently I needed a form called " credible coverage " Which NO ONE asked me for before I switched !
Needless to say I am totally put off by this whole experience and want to WARN EVERYONE about these loopholes the Insurance Cos have, also perhaps some ignorance or down right illegal activity
Thanks for listening

Nov. 05 2010 10:25 AM

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