New healthcare laws say OTC products require an RX if you want to use FSA dollars

[GoPackGo]

So people who have legitimate needs go to the Doctor and get a prescription. I guarantee doctors will sign it no problem. So this drives overall medical costs up and not down.

 

[sactoking]

Heh. Few of the younger crowd realize that they'll likely end up with pre-existing conditions, themselves, long before they're old enough for medicare. More than a few older workers end up locked into a particular employer/ health care provider for just that reason. Wish the old guys at the job would move on, leave a path for advancement? They can't, because they're cancer survivors, or heart attack survivors, or they have high blood pressure or diabetes or... any number of pre-existing conditions.

They've usually paid into the healthcare system their entire working lives, and now that they actually need healthcare, the system wants to cut 'em off at the knees...

Ummmm...no. Those older employees with what would amount to a pre-existing condition are perfectly free to switch employers/providers. HIPAA prevents employers' plans from discriminating against a pre-existing condition if that condition was undiagnosed or untreated for 6 months prior to enrollment. If there was a diagnosis or treatment in the 6 months prior to enrolling in the new plan the plan can only limit the condition as pre-existing for a period of 12 months (as opposed to individual plans which can completely exclude a pre-existing condition).

There are actually very few persistent conditions that can't be reasonably treated without active medical supervision for a 6 month span.

 

[WhipperSnapper]

This cartoon sums it up best:

http://www.markfiore.com/political/reform-madness

"...President Obama will personally slay your elderly grandparents and mercilessly drown this innocent puppy."

"Stop this reform madness now before Obama sneaks into your bedroom and feeds Nancy Pelosi your still beating heart!"

"Paid for By Americans for Drug and Insurance Company Prosperity who enjoy Paying More and Getting Less."

 

[hal2kilo]

This cartoon sums it up best:

http://www.markfiore.com/political/reform-madness

"...President Obama will personally slay your elderly grandparents and mercilessly drown this innocent puppy."

"Stop this reform madness now before Obama sneaks into your bedroom and feeds Nancy Pelosi your still beating heart!"

"Paid for By Americans for Drug and Insurance Company Prosperity who enjoy Paying More and Getting Less."

Nice reporting by Fox News lol.

 

[dullard]

Everyone wants their cake, wants to eat it, wants to complain about having to have it and having to eat it.

Very nice post.

 

[dullard]

right now I can use my FSA debit card. This year I spent $2400 on Flex and I came up a bit short so I opted for $3k for next year. The official list of things covered came out after enrollment ended, so I'm going to have to spend $3k no matter what.

There is one final solution so that you can pay as little as possible.

1) If you are paid monthly:
As soon as you get your first monthly paycheck, you will have $250 withheld. Then, quit your job and find a new job. At the new job, don't get an FSA (you can't by law as you already have one). Bingo, you get to use all $3000 and you only put $250 in.

2) If you are paid twice a month, make that only $125 you put in.

3) If you are paid every two weeks, then you only put $115.38 in.

Yet, you get to spend all $3000 and you get the tax deduction on the amount you put in. That is, unless the health care bill discontinued this loophole and I haven't seen anything about that yet (but I may have missed it). The money you gain here comes from those who lost by not spending it all. This is a common trick if you know you are going to quit or retire in the next year.

 

[Jhhnn]

Who is trying to "game" anything? These are all things the law says I can purchase. The condoms are not nearly as big of a deal as they allergy meds and pain reliever. I have terrible allergies and go through a box of Zyrtec D a month. I also have carpal and eat Tylenol and Motrin like candy. I have asked my doctor for something prescription to replace the Zyrtec since I have to sign the meth dealer list every time I buy it and there is nothing he can prescribe. The RX versions of the pain killers mess up my stomach, so I stick with OTC. So that's roughly $50/month I spend on OTC meds. Couple that with the $200/month (average) I spend on my son's diabetes supplies and my anxiety meds and you get $3k/year that I will spend out of pocket.

Your son's diabetes meds and your anti-anxiety meds are *obviously* covered, and there's no reason you physician can't write a prescription for OTC meds. You can save a bundle, a lot more than a tax break, by using generic zyrtec with pseudophedrine. You'll need a prescription to buy the latter online in money saving quantities, and you'll need to figure out the dosage for 2X or 3X daily, since it won't be time release.

http://www.dhmedical.com/gezyotccehcl.html?gclid=CKykn5iL_6UCFUeW7QodSmR8nA

(also available in 5mg strength)

http://www.healthwarehouse.com/fexofenadine-pseudoephedrine-60-120mg-tablets.html

( other strengths & etc widely available online)

 

[Capt Caveman]

Who is trying to "game" anything? These are all things the law says I can purchase. The condoms are not nearly as big of a deal as they allergy meds and pain reliever. I have terrible allergies and go through a box of Zyrtec D a month. I also have carpal and eat Tylenol and Motrin like candy. I have asked my doctor for something prescription to replace the Zyrtec since I have to sign the meth dealer list every time I buy it and there is nothing he can prescribe. The RX versions of the pain killers mess up my stomach, so I stick with OTC. So that's roughly $50/month I spend on OTC meds. Couple that with the $200/month (average) I spend on my son's diabetes supplies and my anxiety meds and you get $3k/year that I will spend out of pocket.

I could very easily not work because I have carpal and severe anxiety and take care of my diabetic son full time. I don't think anyone would look down on a person for not being able to work through all that. Instead I do my best and take advantage of things like Flex Spending and FMLA.

So I guess now the question is:

Which you would prefer? Someone not work and live off the state or a person work, pay his way and contribute to society using the laws that the Federal Government put in place?

You do know that you can buy a year supply of Zyrtec for $15, right? Costco sells under their Kirkland brandname "Aller-tec" (10mg of Cetirizine HCI), 365 tablets for $15. Costco's version of Sudafed is something like $7 for 288 tablets.

You can also buy Costco's equivalent of Tylenol and Motrin for 1/20 of the price as the brand name and 1/5 of the price of the drug store generic brand.

 

[shira]

There is one final solution so that you can pay as little as possible.

1) If you are paid monthly:
As soon as you get your first monthly paycheck, you will have $250 withheld. Then, quit your job and find a new job. At the new job, don't get an FSA (you can't by law as you already have one). Bingo, you get to use all $3000 and you only put $250 in.

2) If you are paid twice a month, make that only $125 you put in.

3) If you are paid every two weeks, then you only put $115.38 in.

Yet, you get to spend all $3000 and you get the tax deduction on the amount you put in. That is, unless the health care bill discontinued this loophole and I haven't seen anything about that yet (but I may have missed it). The money you gain here comes from those who lost by not spending it all. This is a common trick if you know you are going to quit or retire in the next year.

Well, it's not quite this easy. If you quit a job that has an FSA account, you're allowed to make claims against the account only for charges incurred while you were employed. So, in your scenario, if you incurred $3000 in expenses before you quit, you could claim them all. But if you didn't incur any expenses, you wouldn't be able to claim anything, not even the $250 you actually paid into the account.

 

[shira]

Who is trying to "game" anything? These are all things the law says I can purchase. The condoms are not nearly as big of a deal as they allergy meds and pain reliever. I have terrible allergies and go through a box of Zyrtec D a month. I also have carpal and eat Tylenol and Motrin like candy. I have asked my doctor for something prescription to replace the Zyrtec since I have to sign the meth dealer list every time I buy it and there is nothing he can prescribe. The RX versions of the pain killers mess up my stomach, so I stick with OTC. So that's roughly $50/month I spend on OTC meds. Couple that with the $200/month (average) I spend on my son's diabetes supplies and my anxiety meds and you get $3k/year that I will spend out of pocket.

I could very easily not work because I have carpal and severe anxiety and take care of my diabetic son full time. I don't think anyone would look down on a person for not being able to work through all that. Instead I do my best and take advantage of things like Flex Spending and FMLA.

So I guess now the question is:

Which you would prefer? Someone not work and live off the state or a person work, pay his way and contribute to society using the laws that the Federal Government put in place?

The tax laws are always changing. It used to be that health care expenses in excess of 2.5% of Adjusted Gross Income were deductible. That "floor" is now 7.5% of AGI. This year only, if you inherit appreciated property, your basis in the property is not the current value (as it would be in any other year) but the basis of the decedent. So, if you mother dies and leaves you her $750,000 house which she originally paid $50,000 for in 1955, you won't owe any estate tax on the house; but you'll incur a $700,000 capital gain if you sell the house.

I'm truly sorry that you and your son are having the medical problems you describe, and I'm sorry that the change to the tax laws has made your medical burden heavier. But changes to tax laws almost always create both winners and losers. Maybe you'll get a break when other provisions of the new health care law kick in.

 

[ebaycj]

You guys could do with an english style health care system, that way you wouldn't have to pay $75 to use an ambulance :biggrin:

Most insurance plans have at least a $500 (if not $1000) deductible for ambulance / emergency.

 

[ebaycj]

You do know that you can buy a year supply of Zyrtec for $15, right? Costco sells under their Kirkland brandname "Aller-tec" (10mg of Cetirizine HCI), 365 tablets for $15. Costco's version of Sudafed is something like $7 for 288 tablets.

You can also buy Costco's equivalent of Tylenol and Motrin for 1/20 of the price as the brand name and 1/5 of the price of the drug store generic brand.

Costco's generic drug selection and prices own all.

 

[WackyDan]

So in order to get a prescription for an otherwise OTC med, you may have to see your doctor... Which in turn raises your overall health care costs as you will end up paying him for the appointment. - Gee thanks Obama.

Here is the real rub... FSA's will be reduced/capped at $2500 dollars due to the health bill. For those that don't use FSA's that isn't a big deal... But both my last employer and current have a company cap at $5100 which has reduced my out of pocket on my wife's health care costs.

The federal cap, when it is put in place will expose $2600 of my income to federal and state taxes, costing me $700-1000+ in additional income taxes and also raising my out of pocket liability. For someone who relies greatly on that $5100 cap, this is going to cost me dearly.

FSA's were brought about as a means to help Americans manage and cope with rising out of pocket health care costs. Can anyone explain to me why the health reform bill snuck in a federal cap of $2500? Can you? It doesn't help those with chronic health issues and rampant out of pocket costs at all. Thanks Obama. Fuck you very much.

Is it a tax loophole? Yes, but it is one that helps every American and specifically those in middle class America...

 

[WackyDan]

It seems to me that the basic idea was that Flex Spending account were allowed by the government as a way to subsidize some medical costs. They apparently went too far and allowed all kinds of stupid shit to be bought sans tax. And I'm sure there were all kinds of complaints from "real Americans" about working hard to subsidize condoms and meth-ingredients to those "lazy, poor, welfare recipients." (OP probably included.)

As a remedy to this, the pendulum has now swung the other way. And once again, people are complaining that the removal of a near-pointless tax break is now somehow an unfair tax increase on those same "real Americans." (OP included.)

Everyone wants their cake, wants to eat it, wants to complain about having to have it and having to eat it.

Except that some of us use our FSA's primarily to pay for out of pocket costs on medical procedures and co-pays... The last of my 2010 FSA is going to fund the $750 deductible for my wife's last hospital stay... The reduction to the federal cap of $2500 per year is going to fuck us to the tune of roughly $1000. Thanks Obama.

 

[JD50]

So in order to get a prescription for an otherwise OTC med, you may have to see your doctor... Which in turn raises your overall health care costs as you will end up paying him for the appointment. - Gee thanks Obama.

Here is the real rub... FSA's will be reduced/capped at $2500 dollars due to the health bill. For those that don't use FSA's that isn't a big deal... But both my last employer and current have a company cap at $5100 which has reduced my out of pocket on my wife's health care costs.

The federal cap, when it is put in place will expose $2600 of my income to federal and state taxes, costing me $700-1000+ in additional income taxes and also raising my out of pocket liability. For someone who relies greatly on that $5100 cap, this is going to cost me dearly.

FSA's were brought about as a means to help Americans manage and cope with rising out of pocket health care costs. Can anyone explain to me why the health reform bill snuck in a federal cap of $2500? Can you? It doesn't help those with chronic health issues and rampant out of pocket costs at all. Thanks Obama. Fuck you very much.

Is it a tax loophole? Yes, but it is one that helps every American and specifically those in middle class America...

Because apparently democrats don't really give a shit about making healthcare more affordable, if they did, they'd be against this. FSA/HSA's make healthcare much more affordable, especially to the middle class. Isn't that what they've been bitching about?

 

[WackyDan]

Oh come on, how else are we going to give the top 2 per centers a tax break.

That is sarcasm right? Because the top 2 percent probably could give a shit about a FSA given that they generally are not that large... My company caps at $5100 whether you are the janitor or CEO. Health care reform is going to cap all FSA's at $2500 in 2013.

They aren't helping the rich with FSA's, but are actually helping the middle class which need the help. So now they are fucking the middle class more by capping to $2500... That federal cap is nothing but a money grab - exposing more income to taxes. This is one tax loophole anyone who was an advocate for health care reform should have been in favor of them not touching/changing like they did.

FYI.. I maxed my FSA at $5100 this past year and spent every penny of that not on aspirin... but on medical co-pays/procedures for my wife. -an ongoing trend for these last few years. *FSA's are not just about buying OTC meds.

 

[dabuddha]

Luckily for me, insulin is an exception and can still be covered w/o a prescription (though I get a prescription to save my ass money)

 

[JD50]

That is sarcasm right? Because the top 2 percent probably could give a shit about a FSA given that they generally are not that large... My company caps at $5100 whether you are the janitor or CEO. Health care reform is going to cap all FSA's at $2500 in 2013.

They aren't helping the rich with FSA's, but are actually helping the middle class which need the help. So now they are fucking the middle class more by capping to $2500... That federal cap is nothing but a money grab - exposing more income to taxes. This is one tax loophole anyone who was an advocate for health care reform should have been in favor of them not touching/changing like they did.

FYI.. I maxed my FSA at $5100 this past year and spent every penny of that not on aspirin... but on medical co-pays/procedures for my wife. -an ongoing trend for these last few years. *FSA's are not just about buying OTC meds.

hal2kilo is a typical Democrat, fucking the middle class in a vain attempt to fuck the rich.

 

[JD50]

Luckily for me, insulin is an exception and can still be covered w/o a prescription (though I get a prescription to save my ass money)

That's good to hear.

 

[werepossum]

So in order to get a prescription for an otherwise OTC med, you may have to see your doctor... Which in turn raises your overall health care costs as you will end up paying him for the appointment. - Gee thanks Obama.

Here is the real rub... FSA's will be reduced/capped at $2500 dollars due to the health bill. For those that don't use FSA's that isn't a big deal... But both my last employer and current have a company cap at $5100 which has reduced my out of pocket on my wife's health care costs.

The federal cap, when it is put in place will expose $2600 of my income to federal and state taxes, costing me $700-1000+ in additional income taxes and also raising my out of pocket liability. For someone who relies greatly on that $5100 cap, this is going to cost me dearly.

FSA's were brought about as a means to help Americans manage and cope with rising out of pocket health care costs. Can anyone explain to me why the health reform bill snuck in a federal cap of $2500? Can you? It doesn't help those with chronic health issues and rampant out of pocket costs at all. Thanks Obama. Fuck you very much.

Is it a tax loophole? Yes, but it is one that helps every American and specifically those in middle class America...

Because apparently democrats don't really give a shit about making healthcare more affordable, if they did, they'd be against this. FSA/HSA's make healthcare much more affordable, especially to the middle class. Isn't that what they've been bitching about?

The purpose of Democrats' health care activities is not cutting costs, but incrementally establishing the federal government's control of health care. This is because of their belief that health care should be the same for everyone, which can only be true if government completely controls everything. Therefore FSAs/HSAs must be driven out of existence, being the antithesis of federal government control of health care. Since there would be a significant political hit for simply legislating them out of existence, Democrats will continue to cut limits and tighten control until these accounts no longer make sense. Many of us will have to increasingly pay more for health care; we are simply collateral damage in the war for single payer, government-controlled health care.

 

[rudeguy]

Luckily for me, insulin is an exception and can still be covered w/o a prescription (though I get a prescription to save my ass money)

I don't think you can buy insulin without an RX?

:shrug:

It just pisses me off that it gets harder and harder to do the right thing. I know that its still possible to get things taken care of but its not easy to balance doctor's appointments as it is. Having to figure out more just sucks. I honestly don't understand why the government felt the need to change this and I really don't see how this is going to make anyone's life better.

I don't think I can buy bulk Zyrtec D. I believe you can only purchase 24 pills a month because of the meth laws. I can buy big bottles of generic Zyrtec at the Perrigo store for $.025. But I need the D. The Sudafed is what clears me up so I'm not a walking snot bubble.

 

[rudeguy]

That is sarcasm right? Because the top 2 percent probably could give a shit about a FSA given that they generally are not that large... My company caps at $5100 whether you are the janitor or CEO. Health care reform is going to cap all FSA's at $2500 in 2013.

They aren't helping the rich with FSA's, but are actually helping the middle class which need the help. So now they are fucking the middle class more by capping to $2500... That federal cap is nothing but a money grab - exposing more income to taxes. This is one tax loophole anyone who was an advocate for health care reform should have been in favor of them not touching/changing like they did.

FYI.. I maxed my FSA at $5100 this past year and spent every penny of that not on aspirin... but on medical co-pays/procedures for my wife. -an ongoing trend for these last few years. *FSA's are not just about buying OTC meds.

My insurance is a bit odd in that my company gives me a $1700 HSA a year and I have a $2500 deductible before my insurance kicks in for doctor's visits, prescriptions and that kind of thing. That's why I said I average $250/month because some months its $1k and some months its $50. The OTC meds are what affects me the most since I do purchase so many of them because the RX stuff doesn't help.

I spent just shy of $6k this year for insurance and out of pocket expenses. I'm not complaining just to complain...every penny I can save really helps out.

 

[Jhhnn]

Ummmm...no. Those older employees with what would amount to a pre-existing condition are perfectly free to switch employers/providers. HIPAA prevents employers' plans from discriminating against a pre-existing condition if that condition was undiagnosed or untreated for 6 months prior to enrollment. If there was a diagnosis or treatment in the 6 months prior to enrolling in the new plan the plan can only limit the condition as pre-existing for a period of 12 months (as opposed to individual plans which can completely exclude a pre-existing condition).

There are actually very few persistent conditions that can't be reasonably treated without active medical supervision for a 6 month span.

High blood pressure? Diabetes? Heart condition? Transplant recipient? If you're taking prescription meds, then you're being treated...