Page 19 - Diabetes

Medicare Supplement Plans: Also very smart move to save you money on
known as Medigap Plans, these plans your diabetes health care. But knowing
are sold by private insurance compa- which account to select takes some edu-
nies to help cover some of the health- cation on the key differences between
care costs and benefits not covered by HSAs and FSAs. See Table 2 for more
Original Medicare, Part A and Part B. information.
To be eligible to enroll in a Medicare
Supplement Plan, you must be enrolled Key questions
in both Medicare Part A and Part B Which account should you choose? It may
and live in the state in which the plan be best to opt for an HSA if you qualify
is being offered. because the limits are higher and you
Medicaid: A health-care program can carry over your contributions from
funded jointly by states and the federal year to year. If you don’t qualify, sign
government for families and individu- up for the FSA.
als with limited financial resources. It How much should you contribute? Be
provides health coverage to about 69 sure your contribution is enough to
million Americans, including eligible cover your plan’s deductible, expected
low-income adults, children, pregnant medication costs, anticipated doctor’s
women, elderly adults and people with visits and any planned treatments or
disabilities. States establish and admin- surgeries. Use the worksheets typically
ister their own Medicaid programs and provided by employers to help deter-
determine the type, amount, duration mine the ideal amount. These accounts
and scope of services within broad can be quite complicated, so ask your
federal guidelines. Federal law requires human resources representative any
states to provide certain mandatory questions you have.
benefits and allows states the choice
of covering other optional benefits. Over-the-counter (OTC)
Mandatory benefits include services medications
like inpatient and outpatient hospital Under the ACA, insurers must cover
services, physician services, laboratory certain OTC preventive medications
and X-ray services, and home health at 100 percent with no copayments,
services. Optional benefits include coinsurance or deductibles, but only
prescription drugs, case management, when the patient obtains a prescrip-
physical therapy and occupational tion. In addition, FSAs and HSAs also
therapy. For a list of mandatory and reimburse the cost of OTC medicines
optional benefits for Medicaid pro- when they are purchased with a pro-
grams, visit: https://medicaid.gov/ vider’s prescription. Eligible prescribed
medicaid/benefits/list-of-benefits/ OTC expenses include acid control-
index.html. lers, antidiarrheal medications, cold
sore remedies, sleep aids, painkillers,
Health savings accounts respiratory treatments and others. To
(HSAs) and flexible spending get these reimbursed from a FSA or an
accounts (FSAs) HSA, the employee needs to provide
These accounts may be offered by a sales receipt that reflects the date of
employers as a way for you to set sale and the amount of the charge,
aside money to pay for medical costs, along with a copy of the prescription,
referred to as “qualified expenses.” according to the Internal Revenue
These expenses include deductibles, Service.
copayments and coinsurance, and even Optimal diabetes control requires
monthly prescription costs. Sometimes daily vigilance to healthy behaviors. It
employers will also contribute funds to also requires regular medical interven-
these accounts. To pay for qualifying tions by qualified providers and spe-
expenses throughout the year, the cialists and prescription medications.
employee usually receives a debit card. People with diabetes need a quality
These accounts also have tax benefits, health plan to help them secure these
but they differ between plans. Utiliz- interventions and medications at their
ing one of these accounts can be a most affordable costs. †