HIV Foundation Health Who Needs Health Savings Accounts And Health Reimbursement Arrangements?

Who Needs Health Savings Accounts And Health Reimbursement Arrangements?

Employers аnd thе self-employed аrе using twо main strategies tо kеер thе cost оf health insurance lоw аnd tо reduce thеіr taxes. Known аѕ аn HSA, a Health Savings Account саn make mоѕt health care expenses tax deductible, аnd provide tax-deferred earnings. Individuals аnd business owners саn start аn HSA оnсе thеу purchase a health plan that’s certified tо bе HSA compatible. Thеѕе plans аrе available іn thе individual market fоr muсh lower premiums thаn plans іn thе group coverage market.

Cаn Health Savings Accounts Bе Combined Wіth A HRA?

Employers аnd people whо аrе self-employed іf thе spouse works іn thе business mау add a Health Reimbursement Arrangement tо substantially increase thе tax savings available wіth аn HSA аlоnе.

Tо рut іt simply, a Health Reimbursement Arrangement (HRA) іѕ аn employer-funded medical reimbursement plan fоr employees. Sоmеоnе whо іѕ self-employed саnnоt hаvе аn HRA іn hіѕ оr hеr nаmе, but саn reimburse thе spouse, whо works іn thе business аѕ a W-2 employee, thrоugh аn HRA. All оf thе family’s qualified health care аnd insurance expenses саn bе reimbursed, аnd thаt includes thе expenses оf thе self-employed business owner bу virtue оf bеіng a member оf thе HRA-covered family.

Thе big rush tо gеt HRAs іn place bу Dec. 31 resulted bесаuѕе thе cost оf health insurance premiums соuld thеn bе reimbursed fоr thе whоlе year bасk tо January 2011. Reimbursement fоr оthеr kinds оf health care іѕ nоt retroactive, thоugh. Thоѕе whо start a HRA іn January 2012 саn reimburse thеіr employees fоr health care, including premiums.

Sіnсе group coverage hаѕ bесоmе аn expensive option fоr bоth employers аnd employees, HRAs present a lеѕѕ expensive choice thаt саn help bоth parties save оn health care costs. Compared tо group plan rates, policies іn thе individual market саn save employers uр tо 50 percent. Certain оf thеѕе plans, known аѕ Health Savings Accounts, Thіѕ makes іf feasible fоr mоrе employers tо provide health care coverage tо mоrе employees. Bу setting uр a HRA, employers саn legitimately reimburse thеіr employees fоr individual health insurance premiums аnd оthеr health care costs.

Hоw Dо Health Reimbursement Arrangements Work?

On a regular basis, аn employer contributes a pre-determined аmоunt tо аn account оn аn employee’s behalf. Thе employee саn submit a reimbursement request fоr qualified medical expenses, аnd ѕuсh reimbursements аrе nоt taxed.

What’s Required Tо Start A HRA?

Thе primary requirement іѕ thаt thе plan muѕt bе funded solely bу thе employer. It саnnоt bе funded bу salary reduction. In addition, thе plan mау оnlу provide benefits fоr substantiated medical expenses.

HRAs mау bе designed іn mаnу fashions tо suit thе specific needs оf employer аnd employees alike. It іѕ оnе оf thе mоѕt flexible types оf employee benefits plans, making іt vеrу attractive tо mоѕt employers.

Hоw Dо Employers Benefit Frоm A HRA?

HRAs аrе mоѕt commonly offered іn conjunction wіth a high-deductible health plan. Aѕ a rule, thеѕе plans kеер premium costs lоw, ѕо employers саn uѕе thе savings tо fund thе HRA. All employer HRA contributions аrе tax deductible fоr thе employer, аnd tax-free fоr thе employee.

Employers mау establish whеn HRA funds mау bе used. Thіѕ саn range frоm comprehensively covering аll health care tо a limited plan fоr emergency room expenses оnlу. Bесаuѕе thеу аrе ѕо flexible, HRA plans enable employers tо control costs оf providing healthcare benefits whіlе providing a valuable employee benefit.

Wіth аn HRA, employee healthcare expenditures аrе visible аnd clear tо employer аnd employee alike, thеrеbу fostering a greater understanding оf thе costs оf health care. In addition, employees whо саn monitor аnd control thеіr health care costs bесоmе smarter health care consumers.

Studies ѕhоw thаt оnlу 20 tо 50 percent оf employees actually uѕе thеіr health care coverage, meaning employers оftеn pay health insurance premiums fоr employees whо аrе nоt utilizing thе coverage. A HRA allows employers tо determine thе best type оf coverage fоr thеіr employees based оn thе demographics оf thеіr employee group.

HRA plans mау аlѕо cover retired employees (and thеіr spouses аnd tax dependents). Employers mау wish tо consider a HRA аѕ аn alternative tо mоrе expensive traditional retiree health care options.

Employee benefits, like a HRA, enable employers tо recruit аnd retain quality employees. Wіth a HRA іn place, thе employer іѕ perceived іn a positive light bу current аnd prospective employees bесаuѕе a benefits package іѕ bеіng provided wіth thеіr іntеrеѕt іn mind.

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Every second German affected! How to prevent osteoarthritis in everyday lifeEvery second German affected! How to prevent osteoarthritis in everyday life

Around 35 million people in Germany suffer from osteoarthritis. Is sport good for the joints? Whether for prevention or for those affected: exercise is the best medicine. FOCUS Online explains which sports are suitable and what you should pay attention to.

  • If you want to do something about osteoarthritis, you should exercise.
  • With these sports you can prevent.
  • At the same time, those affected can still practice many sports.

Anyone who hurts movements in their knees, shoulders or ankles usually suffers from osteoarthritis. It is the most common joint disease. At least five million Germans suffer from it. Experts even speak of 35 million people affected in Germany for early forms of osteoarthritis.

From the age of 30, the risk increases linearly. Among those over the age of 60, 50 percent of women and a third of men suffer from osteoarthritis.

Strictly speaking, however, everyone would get osteoarthritis, says Karl-Dieter Heller, chief physician at the Orthopedic Clinic Duchess Elisabeth Hospital. From the age of 40 at the latest, arthritic changes appear in the X-ray. Osteoarthritis occurs when bones, ligaments, tendons and joint capsules wear out.

Many movements are therefore painful. That tempts you to keep calm. However, this is exactly the wrong way to go. Anyone who wants to prevent joint wear and tear should definitely be active in sports.

With these sports you can prevent osteoarthritis

On the one hand, the aim of sport is to move the joint and maintain flexibility. The movement supplies the cartilage with nutrients. Because this itself is not supplied with blood.

On the other hand, the movement strengthens the joint-stabilizing muscles, which relieves the joint.

Sport improves the metabolism in the joint and the control function of the joints is maintained. Bones and cartilage are relieved.

Cycling, Nordic walking, swimming and cross-country skiing are sports that do not put stress on the joints, but move them gently.

At the same time, a change in diet also plays an important role in prevention, as being overweight puts extreme stress on the joints.

This is how many hours of exercise a week should be

Heller recommends: Three quarters to an hour three times a week is a good workload.

Limit: If you experience swelling and pain in your knees, shoulders or feet, you should adjust the intensity of your training.

Stop-and-go sports can put too much strain on the joints. These include tennis, badminton and squash.

Stomach cancer emerges years beforehand – these symptoms must be taken seriouslyStomach cancer emerges years beforehand – these symptoms must be taken seriously

Stomach cancer is not as common as colon or breast cancer, but its prognosis is less favorable. FOCUS Online explains the reasons why early detection is therefore particularly important, the current therapies and what belongs to prevention.

Stomach cancer is not uncommon, with around 15,000 new cases per year on the list of carcinomas. 9,300 men and 5,600 women are affected. The cause of the gender difference is currently unknown.

Stomach cancer is not one of the most common cancers, but the chances of survival are not good. Two thirds ultimately die of the tumor disease. “We have to assume that three out of four patients will only be diagnosed in a locally extended or even metastatic situation,” reports Michael Stahl, head of the Clinic for Internal Oncology at the Evangelical Clinics Essen-Mitte (KEM).

This late diagnosis means that three quarters of the patients have a poor prognosis and cannot be cured with an operation alone, summarizes the oncologist, who is among other things the author responsible for the German guideline for the diagnosis and treatment of esophageal cancer and a member of the lead group of the working group for internal oncology for carcinomas of the stomach and esophagus.

Cause of stomach cancer unknown but there are risk factors

“The only good relative risk factor for stomach cancer is the stomach germ Helicobacter pylori”, the expert clarifies. That would be risk factor number 1.

However, around a quarter of Germans are infected with this bacterium, but only a fraction of them develop gastric cancer. Why they get sick is not yet fully understood, just as much is still unknown about the causes of stomach cancer.

There is also evidence that smoking increases the risk. And what about alcohol? “However, there is no meaningful evidence that alcohol also increases the risk of stomach cancer,” adds the oncologist. However, it can lead to gastric mucosal inflammation, i.e. gastritis, up to and including gastric ulcer (ulcer).

Chronic gastric mucosal inflammation and reflux disease could in turn increase the risk of stomach cancer at the junction with the esophagus.

Stomach cancer can also develop from previous operations on the stomach.

The reflux of bile is also considered a risk factor. This danger arises from being very overweight.

And on the subject of obesity and nutrition: Scientists assume that a one-sided diet with a lot of processed meat products, heavily salted, but also smoked and grilled foods promote stomach cancer – keyword nitrosamines, which are known to be carcinogenic. Rotten and moldy foods pose a general health risk, also with regard to stomach cancer.

Stomach cancer with certain genetic changes

In addition, there are genetic components in the development of gastric cancer: first-degree relatives (children, siblings) of patients with gastric cancer have an increased risk – i.e. if the father, mother or sibling are ill. In addition, stomach cancer can occur if a certain form of colon cancer is already present (hereditary colorectal cancer) or breast cancer.

These are patients with changes in their genetic makeup, for example what is known as microsatellite instability (MSI). You are at an increased risk of various types of cancer, including cancer of the stomach and intestines. “Doctors should keep this in mind if a patient has a colon cancer with microsatellite instability , or if there are multiple carcinomas in the family,” emphasizes the Essen-based oncologist.

However, all of these are only possible risk factors. “Of most patients who fall ill, we don’t know why, because none of these risk factors apply to them,” summarizes Michael Stahl.

Look out for these warning signs

Besides this, there is the second difficulty in gastric cancer – late diagnosis. This is because the symptoms are rather unspecific, affecting the stomach, but are often dismissed as harmless everyday complaints. Early signs can be:

  • Feeling of fullness, pressure in the stomach
  • general upper abdominal discomfort
  • Eructation
  • nausea
  • Vomit
  • Flatulence
  • Loss of appetite

“Anyone who has one or more of these complaints for more than three weeks should have them checked out by a doctor,” advises Michael Stahl.

Do not treat persistent stomach problems with acid blockers on your own initiative

However, many sufferers do not take these symptoms seriously and try to relieve them first with self-medication – wasting valuable time on early cancer therapy and thus a high chance of recovery.

They resort to gastric acid blockers that are available over the counter or prescribed by doctors. The pain will actually go away. “Cancer itself does not cause the pain at the beginning of the disease, rather the mucous membrane defect it causes is irritated by stomach acid – and that triggers the pain,” explains the expert.

This pain disappears when the stomach acid is blocked because it no longer irritates the mucous membrane. The cancer growth is not influenced by this, the tumor can spread undisturbed.

The most important diagnostic tool – gastroscopy

The oncologist therefore urgently recommends that the complaints be clarified by a quality-assured endoscopy, i.e. in a gastroenterological practice that carries out these examinations on a daily basis or in an appropriate center.

The gastroscopy only takes a few minutes; the doctor can not only check the condition of the esophagus and stomach up to the duodenum, but can also test whether Helicobacter is present and possibly take additional tissue samples.

Usually no tumor is discovered, but rather the stomach germ or an enlargement or relocation of the area between the stomach and esophagus (hernia), which can cause reflux. A change in diet can help here or medication may be necessary. Sometimes, however, the doctor finds stomach cancer, “and more and more often in the transition area to the esophagus,” reports the expert from the practice.

The reason for this is that there are more and more people who are very overweight. “Being overweight puts pressure on the abdominal cavity, which is why bile acids and stomach acids flow back into the transition area to the esophagus, which is not designed for frequent contact with these acids and is therefore damaged,” says Michael Stahl, summarizing the chain of reactions.

How stomach cancer spreads

The treatment depends on the severity of the disease (grading):

  • Whether the carcinoma is limited to the mucous membrane,
  • already affects the underlying muscle
  • in addition, the outer connective tissue of the stomach
  • surrounding organs
  • Lymph nodes
  • Has metastasized.

In Asian countries, where the risk of stomach cancer is very high and gastric cancer screening is therefore carried out regularly, the cancer can often be detected early. If the diagnosis “stomach cancer” is made in the early stages, i.e. only the mucous membrane is affected, there is a high chance of recovery.

Unfortunately, this is extremely rare in Germany, explains the oncologist. In this country, stomach cancer is usually only discovered when it has worked its way deeper into the tissue or has already broken through the stomach. This is also the reason why the prognosis for stomach cancer in Germany is so unfavorable – the cancer is recognized very late.

Stomach cancer does not depend on age

How long the time span between gastric cancer in its initial stage and the appearance of metastases cannot be answered. However, Michael Stahl points out in this context that it is a cancer myth that the tumor only grows slowly in the elderly. “We also have elderly patients with rapidly growing stomach cancer, and young ones,” he warns. Young people should also take stomach problems seriously and not dismiss them: “I’m only 35, it can’t be something bad, like cancer.”

Treatments for stomach cancer – chemotherapy plus surgery

Only in the early stages, i.e. when stomach cancer is limited to the mucous membrane, surgery alone is the method of choice. Then it is the only way to cure the patient.

Most patients, however, need more than the operation, the scientist reports. For locally advanced tumors (without metastasis), treatment consists of chemotherapy, surgery and renewed chemotherapy. Chemotherapy before the operation is intended to shrink the tumor and combat (invisible) metastases at an early stage.

Antibody therapy for HER2-positive gastric cancer

In addition, chemotherapy plus antibody therapy with so-called HER2 antibodies is used for certain forms of metastatic gastric cancer. In around 20 percent of gastric cancer patients, HER2 receptors (HER2-positive gastric cancer) are found in particularly large numbers on the cancer cells. They are docking points for growth factors. Occupied by the special antibodies, tumor growth can slow down significantly.

By the way, HER2 receptors are also found on breast cancer cells, keyword HER2-positive breast cancer. This is where this antibody therapy, which incidentally does not count among the immunotherapies, was first used.

In addition, attempts are being made in Germany, the scientist reports, to treat HER2-positive gastric cancer with HER2 antibodies plus immunotherapy. Scientists hope that this will enable them to offer equivalent treatment without chemotherapy in the future. However, the effect of this combination of therapies has not yet been proven.

Immunotherapies for gastric cancer do not (yet) meet expectations

In some forms of cancer such as melanoma or lung cancer, immunotherapies, for example with checkpoint inhibitors, are considered particularly successful today. These drugs are also currently being tested in studies for gastric cancer .

“Unfortunately, the first results are sobering,” reports the scientist. He and his colleagues had hoped that immunotherapy could improve the effect of chemo, but this was not confirmed. “If, however, all therapy options have already been exhausted in a patient, more can be achieved with immunotherapy than without further tumor-specific treatment,” reports Michael Stahl about the studies.

The problem with this is that it is currently difficult to predict in which patients the immunotherapy will work and which will not. Only in the few patients (less than ten percent of all patients with gastric cancer) whose tumors show what is known as high microsatellite instability (MSI-H) can one predict that immunotherapy has a high chance of effectiveness. Overall, the risk of severe side effects under immunotherapy is significantly lower than under chemotherapy, namely 20 percent instead of 60 percent.

The prognosis for gastric cancer is poor because the patients are late

How successful are the therapies at a glance? “The chances of a cure for stomach cancer are on average 25 to 30 percent; if stomach cancer is metastatic, the average life expectancy is one year,” reports Michael Stahl. The prognosis is only very good at a very early stage. However, patients with gastric cancer in this easily curable stage would be the exception in practice because many go to the doctor too late.

Prevention of stomach cancer – three measures

This makes provision and prevention all the more important. This includes, on the one hand, having longer stomach complaints clarified by a gastroscopy – and it does not matter how old the person affected is.

On the other hand, everyone should pay attention to the following three factors. Because little is known about the development of stomach cancer, so few are:

  1. Pay attention to food hygiene, do not eat spoiled food, nothing that is moldy
  2. Do not smoke
  3. Avoid being overweight

This can not only protect the stomach, but is known to promote general health – not smoking and maintaining a normal weight are among the most important preventive measures against cardiovascular diseases such as high blood pressure, heart attack and stroke, but also against cancer.

What is the Best Treatment For Peyronie’s Disease?What is the Best Treatment For Peyronie’s Disease?

What is Peyronie? What are the symptoms of Peyronie? What is the cure for Peyronie? Who is at risk if I’m infected with Peyronie? These and many more questions may pop into your head if you are suffering from this disease. What if I do not treat my disease? This is a common question many people ask – is it safe to buy and use peyronie’s device amazon. Unfortunately, there is nothing we can do about our genes or family history that will make it “rain” down from us.

There are several treatment options available. What are the most common treatments? Which ones have the highest success rates? What is the risk for treatment failure? Which treatments relieve symptoms better than others? When the infection first appears what are the best treatment options? What is the most effective cure? If you are suffering from Peyronie what are your treatment options? What are the side effects of each treatment option? Where do I start? These are just some of the common questions faced by most people. Unfortunately, the answer is not simple. But to help you decide, here are some of the treatments available.

Oral antibiotics are the most commonly prescribed treatment for early-stage infection. It is taken orally in either a pill form or tablets. If it is taken as a pill it is usually taken once per day with your meal. The pill form of Vitamin C needs to be taken on an empty stomach to maximize the absorption rate and speed up the action of the medication. Oral antibiotics like penicillin are available at most drug stores and supermarkets.

Topical corticosteroids are usually applied topically to the affected area or joints. They work by reducing inflammation and redness within hours of being applied. These treatments can be found at most drug stores and supermarkets as well as vitamin stores. The most common brand is prednisone, which is usually prescribed for short periods only.

Most conventional therapies start off with topical steroid creams or gels. These treatment options are usually only recommended for mild or moderate cases of the disease. However, for more severe cases oral steroids may be required. Also, for the acute phase, these treatments are usually only recommended.

For the acute phase of the disease, many doctors will recommend surgery. Depending on how advanced the disease is surgery might be required as part of the treatment plan. Surgical options will always be under serious consultation with your physician. However, with advanced and aggressive disease, you will probably be able to choose a different course of treatment such as hormonal therapy or microsurgery.

As mentioned before, some patients will need more than one type of treatment. So it is important to find out what sort of treatments are already available for your condition. In most cases, surgery or hormonal therapy is usually the first recommendation. However, in some situations such as those that occur during menopause women will require liposuction. And last but not least, it is important to follow your doctor’s advice and start treatment as soon as possible.

It is very important to keep in mind that every case of the disease is different. Some patients will respond to treatments quicker than others. For this reason, you must discuss with your doctor which treatment will be best for you. Remember, that at any stage of the disease you should always see your doctor. Your doctor will be able to advise you on the best treatment for Peyronie’ disease based on your unique circumstances and the severity of the disease.

One of the most common treatments for Peyronie’s disease is a nonsurgical treatment using a penile traction device. The traction device has been shown to be very effective in helping to reduce the pain associated with the condition. This nonsurgical treatment can usually be worn under clothing. If your doctor recommends a penile traction device then it is strongly recommended that you wear it only during the day. Penile traction devices have been known to cause some discomfort, so you should take care not to aggravate the discomfort by exercising or performing other activity during the day.

Other nonsurgical treatment options that your doctor may recommend include steroid tablets, which can help relieve inflammation and reduce pain associated with the condition. Also part of what is the best treatment for Peyronie’s disease is to use prescribed oral pain medication. In most cases your doctor will consider anti inflammatory medication as an option, but there are also several oral pain medications that are considered safe if taken as directed. One important thing to remember is that when taking any kind of medication to relieve your condition, you should always consult your doctor and follow his or her dosage recommendations.

Finally, the best treatment for Peyronie’s disease is to commence treatment as early as possible, i.e the earlier you start your treatment the sooner you can get back to your daily activities. For example, if you begin treatment for your Peyronie’s disease the sooner you can get back to work and resume sporting activities. In addition, the earlier you begin your treatment the earlier you can get back to your social and emotional life. Therefore, if you have been suffering from this condition for some time it is highly recommended that you look into the available treatment options that are available to you.