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What Are My Health Insurance Options?



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Over the last few years, the health insurance market has been on a rollercoaster ride of changes.  Health plan premiums have continued to spiral upwards.  Participating physicians and hospital networks have continued to shrink.  There is intractable political gridlock in Washington.  One of the casualties of such gridlock is the passing of meaningful health insurance legislation that could resolve some of these exasperating issues.  As things stand now, there is no indication that America's health insurance rollercoaster ride will end anytime soon.

Consequently, finding viable health plan options that fall outside of traditional health insurance (ACA insurance plans), has become increasingly important to consumers.  Following, are a couple of intriguing options that you may not be aware of.


Good to know:  Do the math.  When shopping for health insurance, most people focus on the monthly premiums, but you also need to take a close look at deductibles.  For example, if you have a choice between a lower silver plan premium of $345 a month for a plan with a $5,500 deductible, and a higher gold plan premium at $465 a month with a $1,750 deductible, you may be better off with the second plan if you anticipate needing more than $1,500 in medical care.  With the second plan, your total annual cost for the premium and deductible comes to $7,330, a $2,310 savings over the lower premium plan.

What's New.

The New Short-Term Health Insurance Plans.

Recent rule changes enacted by the Trump administration have made short-term health insurance plans an increasingly viable option for those seeking an escape from the sky-high Affordable Care Act (ACA) premiums.  One significant change was instituted last August.  The Trump administration repealed Obama-era measures that placed limits on short-term health insurance availability.  Due to this change, short-term health insurance is not so "short" anymore.  Depending upon the state, it is now possible to purchase a short-term health insurance plan with the option to renew ongoing coverage for up to three years.  In addition, there are new short-term plans that feature benefits that are markedly superior to the short-term policies of just a year ago.  While benefits and protections still have a long way to go in order to be comparable to an ACA approved health insurance plan, these new short-term plan benefits are getting closer.  They are now considered a viable option for providing health coverage for an individual or family for the long term.

Consumers appear to have taken notice.  According to research, the number of businesses that plan on offering short-term health insurance plans in 2019 nearly doubled after changes to existing law by the Trump administration took effect.


Good to know:  When making an appointment, always double-check that the doctor is still in your insurance plan's network.  Ask to see in-network providers when you go to the hospital or an urgent care center.  Just because a facility participates in your plan doesn't mean every professional (the nurse-practitioner or radiologist, for instance) does.  Also, if you need to see a doctor when you're out of town, call your insurance provider's toll-free phone number to find out the best way to get services that will be covered.
courtesy of Parents.com
What's Different.

Healthcare Sharing Plans

Healthcare sharing plans (also known as faith-based health plans), are one of the fastest-growing healthcare options in the nation.  Even so, there is a fair chance that you have never heard of them.

Healthcare sharing plans can provide applicants with effective and affordable health coverage.  These plans operate within a framework that is similar to insurance.  However, from a legal standpoint, a healthcare sharing plan is not insurance.  This distinction affords such plans the ability to function in ways that a traditional insurance plan cannot.  Because Healthcare sharing plans operate within different guidelines than traditional health insurance, what is covered, as well as what manner it is covered, can be quite different.  In many cases, this flexibility can lead to a lower premium amount when compared to a traditional insurance plan featuring similar benefits.  Applicants who meet a healthcare sharing entity's requirements, join a network of other individuals who all pay a monthly fee into the plan.  These funds are distributed to members with medical needs according to the guidelines set out in the plan.  So, a health plan that is not legally insurance, actually behaves very much similar to typical health insurance.  Healthcare sharing entities are less constrained by the bloated administrative costs and inherent industry obligations that traditional health insurance policies are straddled with.  This often translates into a lower premium for a healthcare sharing plan when compared to health insurance plan featuring similar benefits.

Healthcare sharing plans may not be a perfect solution for everyone.  Healthcare sharing plans usually lack several benefits that are required to be covered by Affordable Care Act health insurance plans.  Make certain you understand exactly how your plan works, and what exactly is covered, before you join a Healthcare sharing network.


Good to know:  Many plans don't provide drug benefits, or discounts, even on generics, until you reach your deductible, which is often in the thousands of dollars.  Instead of just accepting your insurance plan's lousy prescription drug benefit, try using websites such as Blinkhealth.com or Goodrx.com to shop around for the best price for your medication in your area.
The Traditional.

Affordable Care Act Plans

Affordable Care Act coverage refers to major medical health insurance policy that conforms to the regulations set forth in the Affordable Care Act (Obamacare).  These plans are sold on or off the exchange.  All ACA plans must include coverage for the ten essential benefits with no lifetime or annual benefit maximums.  ACA plans offer the most complete coverage.  The only downside is, if you do not qualify for a subsidy, ACA plans may also be the most expensive option.



Other articles:  Is Short-Term Health Insurance Right For You?
Finding Short-Term Health Insurance.
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