Health Insurance

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patriot1
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Post by patriot1 »

Just a comment here. The purpose of insurance is to protect against risk - i.e. what might happen. If your parents have an ongoing need for prescription drugs, that is not a risk. You cannot come out ahead insuring for anything like that. Thus the exclusion of pre-existing needs from insurance policies.

Any insurance company that does take on a pre-existing need is just going to recycle your own money after taking some of the top.
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Post by treetops »

The choices may seem bewildering because the need has not been sufficiently refined.

It sounds like your parents are well-enough off to self-insure for extended medical-type services (chiro, eyeware, dental). Insurance in their case may be more appropriate to cover catastrophic events i.e. prescription drugs beyond $x per year, or critical illness - in other words, the big losses. Think of it like auto insurance: are you willing to pay the premium for $0 deductible for damages? No. You proably set it at $500 or even $1000. and you probably (or should) top out your 3rd party liability at $2 mil. Again, both factors cover big losses, not everyday expense.

I have the level one coverage from Great West (aka Carp3), which is very basic, cares nil about pre-existing, and currently is breakeven +. I also have a catastrophic drug policy that kicks in at $4800 per year to cover 100% of drugs after that level. That'll be useful until 65 (Ontario) when the provincial seniors' plan kicks in.

P
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Post by sugarbear »

treetops wrote: It sounds like your parents are well-enough off to self-insure for extended medical-type services (chiro, eyeware, dental). P
Yes - that is the case, and its not a major concern for them to have to self-insure.
treetops wrote: Insurance in their case may be more appropriate to cover catastrophic events i.e. prescription drugs beyond $x per year, or critical illness - in other words, the big losses. Think of it like auto insurance: are you willing to pay the premium for $0 deductible for damages? No. You proably set it at $500 or even $1000. and you probably (or should) top out your 3rd party liability at $2 mil. Again, both factors cover big losses, not everyday expense.
P
That's a great analogy, and I think they would be OK with not having their pre-existing drugs covered. Its the 'what-if' catastophes that you mention that are of concern.

Thanks a lot for your comments.

SB
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Re: Health Insurance

Post by sugarbear »

uhoh wrote: So far, and I've not been able to devote much time to this, I've found that the CAA offers a Follow Me plan (with Manulife) that will take-over after another plan discontinues - you have to register within 60 days. I find it quite expensive which is why I've not commited to it yet - maybe others have better suggestions.
That was a great tip - I checked the NS CAA website and they do offer the Follow Me plan. We haven't dug too deep into that plan yet, but it would be great if they could continue what they have as long as the price is right.

Thanks!
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Post by sugarbear »

patriot1 wrote:Just a comment here. The purpose of insurance is to protect against risk - i.e. what might happen. If your parents have an ongoing need for prescription drugs, that is not a risk. You cannot come out ahead insuring for anything like that. Thus the exclusion of pre-existing needs from insurance policies.

Any insurance company that does take on a pre-existing need is just going to recycle your own money after taking some of the top.
True...so they are no better off by having current drugs covered under the new plan. I think they are OK with that.
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How to deduct premiums for private medical insurance

Post by smihaila »

Hi,

I've noticed that we are allowed to deduct from taxes all the premiums that we paid for private medical insurance plans (including other provincial-specific public drug insurance plans other than basic healthcare). Even if it's the employer who paid those premiums. At least, this is what's explained on my Quebec RL-1 tax slip, for box "J".

My question is this: Is there a specific, absolute date (i.e. January 1 2006 or December 31 2006) under which this "medical expense" must be recorded?
Or we are allowed to choose any date falling in the 2006 tax year?

My goal is to be able to claim together as many medical expenses as possible for 2006 (to go above the 3% income or > $1,800 or something rule).

For that, I'd like set my claim period 2005 Oct - 2006 Oct and to include this insurance premium (which is about $1,600).

Is this possible?

Thank you.
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Re: How to deduct premiums for private medical insurance

Post by YogiBear »

smihaila wrote:I've noticed that we are allowed to deduct from taxes all the premiums that we paid for private medical insurance plans (including other provincial-specific public drug insurance plans other than basic healthcare). Even if it's the employer who paid those premiums. At least, this is what's explained on my Quebec RL-1 tax slip, for box "J".

My question is this: Is there a specific, absolute date (i.e. January 1 2006 or December 31 2006) under which this "medical expense" must be recorded?
Or we are allowed to choose any date falling in the 2006 tax year?

My goal is to be able to claim together as many medical expenses as possible for 2006 (to go above the 3% income or > $1,800 or something rule).

For that, I'd like set my claim period 2005 Oct - 2006 Oct and to include this insurance premium (which is about $1,600).
The normal rule, whether for the "non-refundable tax credit" (i.e., in effect the deduction) on line 381 of your Québec return, or for the "Refundable tax credit for medical expenses" on line 462, is that the eligible medical expenses must have been paid "during a reference period of your choosing (12 consecutive months) ending in the year covered by your income tax return." IOW, any 12 month period (that is most advantageous to you) ending at some point during 2006.

Be sure to verify that your expenses are in fact eligible. Note also, of course, that if the contributions paid by your employer were listed in box J of the RL-1 slip, then they constitute a taxable benefit from employment and were included as part of your total employment income in box A of the same slip (which you report on line 101 of the QC return).
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Re: How to deduct premiums for private medical insurance

Post by smihaila »

Hi YogiBear,
YogiBear wrote: eligible medical expenses must have been paid "during a reference period of your choosing (12 consecutive months) ending in the year covered by your income tax return." IOW, any 12 month period (that is most advantageous to you) ending at some point during 2006.
Ok ok, but could CRA argue that those premiums were paid as a whole right at the end of 2006 (or even beginning of 2007 - when I received the Tax slip), OR that they were paid progressively as smaller amounts equally distributed throughout the whole 2006 year?
This was in fact the key point with my question.
Of course, there isn't other proof to show other than that RL-1 slip. Both of these 2 assumptions wouldn't be advantageous for me :(

I see at the page 8 (chapter 5) of the document which you kindly indicated, that only for Quebec drug insurance plan is this detail mentioned.

Fortunately, it's not the case (my private medical plan is a replacement/alternative to the provincial drug plan).

As a funny thing, for 2005 tax year, I didn't have this private plan and I had to pay for Quebec drug plan - when I filed the 2005 tax return (March 2006). Since I didn't deduct it at that time (because I didn't have this big amount in "j" box of RL-1) and this date also falls in my reference period, I can include it as medical claim, right?
YogiBear wrote: Be sure to verify that your expenses are in fact eligible.
Why wouldn't they be? They are private medical insurance premiums.
YogiBear wrote: Note also, of course, that if the contributions paid by your employer were listed in box J of the RL-1 slip, then they constitute a taxable benefit from employment and were included as part of your total employment income in box A of the same slip (which you report on line 101 of the QC return).
Exactly! I simply forgot to mention about this in the first message. This would be the reason why we, as employees can deduct it, because it's also added to the Quebec employment income (but not to federal's).

Thank you so much for your valuable help, YogiBear.
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Health care insurance in the US

Post by Nemo2 »

[Extracted from Housing Bust by ModeratorA]
dusty2 wrote:50 million middle class with no health care
Bend over for Nurse Hillary

Of those 45 million “uninsured Americans,” the Census Bureau itself says over 9 million aren’t Americans at all, but foreign nationals...........Of the remaining 36 million, a 2005 Actuarial Research analysis for the Department of Health and Human Services says that another 9 million did, in fact, have health coverage through Medicare.

Where are we now? 27 million? So who are they? Bud and Mabel and a vast mountain of emaciated husks of twisted limbs and shriveled skin covered in boils and pustules? No, it’s a rotating population: People who had health insurance but changed jobs, people who are between jobs, young guys who feel they’re fit and healthy and at this stage of their lives would rather put a monthly health-insurance tab towards buying a home or starting a business or blowing it on booze ’n’ chicks.

That last category is the one to watch: Americans 18-34 account for 18 million of the army of the “uninsured.” Look, there’s a 22-year-old, and he doesn’t have health insurance! Oh, the horror and the shame! What an indictment of America!

Well, he doesn’t have life insurance, either, or homeowner’s insurance.
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patriot1
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Post by patriot1 »

Americans 18-34 account for 18 million of the army of the “uninsured.”
Isn't that the age bracket where most people (and almost all non-professional people) have kids? Maybe that has something to do with the US having a 50% higher infant mortality than Canada. Oh and if these people are uninsured, then their kids would be too.
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Post by Brix »

Look, there’s a 22-year-old
Why not a 31-year-old?

Gotta love the "look over there, behind you" school of journalism.
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Post by WishingWealth »

From the OCRegister quote.
...People who had health insurance but changed jobs, people who are between jobs,...
'People who are between jobs' is a rolling number; one will find a job and will be replaced by another person who lost his/hers or is changing jobs.
And they may or may not find a job with healthcare coverage.
And the coverage will often be less.

Regardless, the 45-50 million number is indeed probably inflated. IMO.

Any number or facts when dealing with such important stories will be scrutinized to death by the other side.
If people are stupid enough not to to realize that, too bad, their whole story will be tainted by the weakest parts.
No pity for lousy research work; regardless of the party.

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Re: Health care insurance in the US

Post by brucecohen »

Of those 45 million “uninsured Americans,” the Census Bureau itself says over 9 million aren’t Americans at all, but foreign nationals...
It's always fun to go to the source material and see how Steyn played with it.

The census bureau report is here and the HHS actuarial study is here

The census report does indeed contain a detailed table indicating that 9 million of the uninsured were non-citizens. But non-citizens are allowed to work in the US both temporarily and permanently. The permanents used to be called "resident aliens." I don't know if that's still the case. These people are required to pay the same taxes that Americans do -- including Social Security unless exempted by treaty. When they are sick or injured, they require the same care that American citizens require. Steyn's claim that a Canadian citizen could just hop back across the border is absolutely disingenuous and, as a former Canadian, he knows it. All provincial medicare plans have a minimum residency requirement. Ontario's is three months.

The census report explains that there is a problem in counting the uninsured because people's memories and understanding don't match the precision of the survey. Individuals are asked about their insurance coverage during the previous year. Many apparently confuse that with the current year. And many apparently get confused about the bits and pieces of coverage they had at one time or another.

The actuarial study notes there are four major US govt surveys that seek to count the number of uninsured, each using different definitions and methodology.

One big differentiator is apparently whether you count those who were uninsured for the entire year or those uninsured for only some part.

The actuarial study suggests the most important measure is of those who lacked coverage at any point since they were unduly at risk during that time. It cites the Medical Expenditure Panel Survey that found that 64 million US residents were uninsured at some point in 2001. Just over half lacked coverage for at least one month.

In any event, the count of uninsured US residents is immaterial compared to the structural flaws of the system:
-- Employer-based insurance has created a burden that puts US producers at a competitive disadvantage in the global economy. The automakers provide an excellent example
-- Lack of portability and job security means you and your family might be covered now but not next month
-- Exclusions for pre-existing conditions means your new job may well provide insurance, but that coverage may exclude your current health issues
-- Coverage limits mean even those with employer-based coverage are not fully protected from medical catastrophe
-- Gaps in coverage, especially among the poor, mean more ad hoc use of hospital emergency rooms, an inefficient way to provide care
-- Gaps in coverage and coverage limits also deter people from seeking preventive care. Years ago I read that a major factor in the big difference between US and Canadian infant mortality was the widespread availability of pre-natal care in Canada. I don't know if that's still true, but it makes sense.
That last category is the one to watch: Americans 18-34 account for 18 million of the army of the “uninsured.” Look, there’s a 22-year-old, and he doesn’t have health insurance! Oh, the horror and the shame! What an indictment of America!

Well, he doesn’t have life insurance, either, or homeowner’s insurance.
Unfortunately, males aged 18-25 or so, maybe 30 -- are at relatively high risk of injury, often because they drink too much and drive too fast. Most 18-year-olds don't need life insurance because they don't have dependants and they typically don't need homeowner's insurance because they don't own homes.

The US govt has no problem with whole-population risk-sharing when it comes to funding the military, subsidizing farmers and building highways. Yet somehow whole-population risk-sharing is verboten when it comes to funding health care.
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Post by WishingWealth »

Thanks for the links Bruce; was looking for something official but had come up with too many googlins.

Also, Steyn's crystal ball needs some polishing.
"Weeks after the invasion of Iraq he assured his readers that there would be "no widespread resentment at or resistance of the western military presence"; in December 2003 he wrote that "another six weeks of insurgency sounds about right, after which it will peter out"; and the following March he insisted that: "I don't think it's possible for anyone who looks at Iraq honestly to see it as anything other than a success story." "

From Wikipedia.
http://en.wikipedia.org/wiki/Mark_Steyn

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Post by Inquisitive »

Good heavens. Is it possible Mark Steyn is abusing statistics!??
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Re: Health care insurance in the US

Post by kcowan »

brucecohen wrote:In any event, the count of uninsured US residents is immaterial compared to the structural flaws of the system.
I put together a piece on the US health care system after I retired when I was considering a move to the sunbelt:
Overview of US Health Care System
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Post by WishingWealth »

Krugman in the NY Times.
http://www.nytimes.com/2007/11/09/opini ... nted=print
...
Instead, however, apologists for the status quo offer a barrage of excuses for our system’s miserable performance.

So I thought it would be useful to offer a catalog of the most commonly heard apologies for American health care, and the reasons they won’t wash.

Excuse No. 1: No insurance, no problem.

“I mean, people have access to health care in America,” said President Bush a few months ago. “After all, you just go to an emergency room.” He was widely mocked for his cluelessness, yet many apologists for the health care system in the United States seem almost equally clueless.

We’re told, for example, that there really aren’t that many uninsured American citizens, because some of the uninsured are illegal immigrants, while some of the rest are actually entitled to Medicaid. This misses the point that the 47 million people in this country without insurance are an ever-changing group, so that the experience of being without insurance extends to a much broader group — in fact, more than one in every three people in America under the age of 65 was uninsured at some point in 2006 or 2007.

Oh, and finding out that you’re covered by Medicaid when you show up at an emergency room isn’t at all the same thing as receiving regular medical care.

Beyond that, a large fraction of the population — about one in four nonelderly Americans, according to a Consumer Reports survey — is underinsured, with “coverage so meager they often postponed medical care because of costs.”

So, yes, lack of insurance is a very big problem, a problem that reaches deep into the middle class.
...
Not sure that will change many people's opinion but heck, Paul's got to make a living too.
WW
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Post by Wallace »

Nice post, Bruce. Your comment about 18-22 years old and accidents is absolutely correct.

The average person only faces serious illness a few times in his or her lifetime and may be hospitalised for only a few weeks in his or her life. And the incidence of illness is about 1%. So approximately 1% of the population get sick on any one day. Since the vast majority of these illnesses are minor - colds, coughs, flus - most people recover quickly, often without a visit to a health care professional.

So the sick can actually be viewed as a small minority. The majority go about their day to day business in good health.

I find the differences in health care policy become clearer when viewed in this light - ie as a minority rights issue.

Regards,
Wallace
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Post by gummy »

I put together a piece on the US health care system after I retired when I was considering a move to the sunbelt:
http://members.shaw.ca/beachis/HealthCare.htm
Neat!
I've added that link to the stuff I wrote up, here:
http://www.gummy-stuff.org/health.htm
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Post by kcowan »

gummy wrote:
I put together a piece on the US health care system after I retired when I was considering a move to the sunbelt:
http://members.shaw.ca/beachis/HealthCare.htm
Neat!
I've added that link to the stuff I wrote up, here:
http://www.gummy-stuff.org/health.htm
At the time I did that work, health care was one of the considerations as were:
- US Estate taxes over $60k
- IRA reporting burden staying more than 122 days per year

Since that time a much bigger issue is having excessive assets in USD.
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Private health insurance.

Post by ace.nimrod »

Since I am self employed, and have a family I think its time to buy some extended health coverage. Anyone have any opinions on the various options out there? Right now I'm looking at packages from CoverMe.com (Manulife), Sun Life and Blue Cross.

A bit about me if it matters.. Early 30s, so is my wife. And 2 kids under 5.

Thanks.
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Post by Donut »

I have a neighbour, a self employed carpenter, who took 6 weeks off this summer to travel to Alaska with his truck and 5th wheel trailer. On the way back, in Whitehorse, he took a very bad stroke. He is 46 years old.

His out of Province insurance flew him and wife to Toronto and sent a person to Whitehorse to bring his truck. Total cost $9,000. The insurance then denied liability because of an undisclosed pre-condition.

He has now not worked for 4 months. He is starting to walk but is unable to speak. He will never again be a carpenter. He has no disability or catastrophic illness insurance. We held a fund raiser for him and rasied $20k but it remains a very sad case. If you can afford insurance you should get it and hope you never need it.
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Post by twa2w »

You could try your local chamber of commerce or board of trade - they sometimes offer group rates for members - not sure if they are a good deal or not. Did you graduate from a college or university or are you a licnesed tradesperson? Sometimes you can arrange group type coverage through an alumni assn or through your trade.
For some medical expenses - non catastrophic, you can arrange through some smaller trust companies to set up a medical plan for your employees - ie you and your 'family' if they work for your company. basically you submit your receipts for dental, eyecare etc to the plan, then you turn around and write a cheque on your company to the trust company to cover the expense(plus a fee) - essentially you have just written off your personal med exp through the company. I know Olympic(olympia?) trust does this in Alberta. Not sure on all the details but it was being pushed pretty heavily to the local financial planners as a idea to present to clients who were self employed. really not much different than some big employers do through Sun Life.
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Post by Bylo Selhi »

twa2w wrote:For some medical expenses - non catastrophic, you can arrange through some smaller trust companies to set up a medical plan for your employees - ie you and your 'family' if they work for your company. basically you submit your receipts for dental, eyecare etc to the plan, then you turn around and write a cheque on your company to the trust company to cover the expense(plus a fee) - essentially you have just written off your personal med exp through the company.
Desjardins Financial Security will do this sort of cost-plus passthrough for its group clients of any size. Dunno about Sun, Manulife et al.

In addition to college alumni and trades group, professional societies offer group coverage. Maybe even CAA too.
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Re: Private health insurance.

Post by Gus »

ace.nimrod wrote:Since I am self employed, and have a family I think its time to buy some extended health coverage. Anyone have any opinions on the various options out there? Right now I'm looking at packages from CoverMe.com (Manulife), Sun Life and Blue Cross.

A bit about me if it matters.. Early 30s, so is my wife. And 2 kids under 5.

Thanks.
When I was let go/quit from my employer a few years ago, as part of my package I was given some free advice on self employment and incorporation. I recall being told about some way that you could set up an employee health savings plan for employees and their families of small businesses. If (warning, big "if") I recall correctly, this would involve tax free transfer of cash from the company to an account that could be drawn upon for legitimate medical expenses, again tax-free. There were snags though; there were some use it or lose it rules and the plans can cost money to set up and run.

You may find some useful information here:

http://www.taxtips.ca/smallbusiness/phsp.htm

I have looked briefly at commercial individual plans. The premiums and caps on claims didn't make any sense, they were basically savings plans where you had to be sick to get your money back.

Catastrophic insurance, especially for foreign travel, is another matter. I use Blue Cross, annual coverage for trips up to 60 days costs $189 for each person.
Last edited by Gus on 22 Nov 2007 20:56, edited 2 times in total.
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