2011 OE 100-10007 : Page 3
Mental health coverage Beginning July 1, 2010, the financial requirements and treatment limitations that apply to mental health and substance use disorder claims will be no more restrictive than the predominant limitations or requirements applied to substantially all medical and surgical benefits within each classification of benefits. This means, for example, that copayments for mental health/substance use disorder office visit claims will be the same as the predominant level of medical/surgical copayments for office visits (assuming copayments are applied to substantially all medical/surgical office visits). There are no longer any limits on the number of visits for mental health and substance use disorder treatment. Certain types of mental health and substance use disorder treatment may require pre-notification and authorization. Visit www.healthcare.gov for more specifics. Flexible spending accounts (FSAs) Effective January 1, 2011, you will no longer be able to use your health care flexible spending account (FSA) to pay for over-the-counter (OTC) medications at a pharmacy, supermarket or other retail store without a prescription from your doctor. OTC medications typically include non-prescription pain relievers, allergy, cold and flu medications. Health reform also made it clear that FSAs may still be used to pay for insulin. For the most current definition of OTC medications visit www.healthcare.gov. Most major grocery, department, retail and drug stores will be able to identify, at the cash register, which OTC medical supplies may be purchased with an FSA debit card beginning January 1, 2011. UnitedHealthcare supports the cause of making health care simpler and more affordable for people and is readily complying with the Patient Protection and Affordable Care Act. For additional information and news on the Affordable Care Act, visit www.healthcare.gov. Health savings accounts (HSAs) Effective January 1, 2011, you will no longer be able to use your health savings account (HSA) dollars to pay for over-the-counter (OTC) medicines at a pharmacy, supermarket or other retail store without a prescription from your doctor. If you have a health care debit card you can still use it to pay for prescription medicines, including insulin, if those are eligible expenses under an employer’s health plan. If you have a prescription for an OTC medicine, such as Zyrtec or Prilosec, and use your HSA to pay for it you will need to keep copies of the prescription and receipt for the purchase with your tax records. Beginning January 1, 2011, if your HSA is used to pay for items or services that are not qualified medical expenses, the IRS penalty will increase from 10 percent to 20 percent. Preventive care Certain preventive services must be covered without charging a deductible, copayment or coinsurance when these services are provided by a network provider. The types of preventive services covered are defined by federal law and can vary based on your age, gender and health status. As such, the preventive services covered at no cost share to you may be different than what your plan historically covered. The preventive services included in this provision are described at www.healthcare.gov.
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