Interim major medical insurance

At some point in the middle of the year we may find ourselves without medical insurance. Regular major medical insurance is normally not available until the following January 1. Insurers and federal regulators are tightening the rules for mid-year enrollments, called a special enrollment period, to make it even tougher to get coverage outside of the annual enrollment period,

Fortunately several types of alternate coverage plans are available to most people. You must pay the whole cost because government subsidies are not available for this type of coverage. An employer can pay part or all of the cost because these alternate plans are not subject to market reforms as explained in IRS Notice 2015-17.

Plans vary from state to state. I recommend the “Smart Insurance Marketplace“, an online insurance exchange run by a private insurance technology company I;ve worked with this company for many years and have sent hundreds, maybe thousands, of satisfied customers to them over more than a decade.

ID cards not issued to dependents

I received this question from a health plan member today regarding ID cards for covered dependents. The information may be worth sharing because this is a common question:

MEMBER QUESTION:  I got two I.D card both have my name, i want to ask where is my daughter’s I.D card

MY RESPONSE: I am responding as the independent adviser and not as a representative of your insurance company.

To the best of my knowledge, ID cards are always issued in the name of the policyholder. I am not aware of any legal authority which allows and insurance company to issue an ID card in the name of a covered dependent. Duplicate ID cards may be issued and these may, include the names of covered dependents. The actual content of printing on the ID card varies among plan administrators.

For more information, you may wish to contact the members services office by telephone as listed on your insurance ID card.


The point is that:

  1. ID cards are typically not issued in the names of dependents.
  2. Some, but not all, health plan administrators list the names of covered dependents of the card.
  3. ID card printing and issuance practices vary between insurers but this practice of issuing cards only to the policyholder is consistent.

Disclosure of VBA Accident ADD Insurance

This content is provided for educational purposes only and is not an offer of coverage and is not intended to represent a communication from an insurer.

This content describes Accidental Death, Disability and Dismembership insurance.

Insurance is underwritten by Federal Insurance Company, a member
insurer of Chubb Group of Insurance Companies.

The coverage described in this literature may not be available in all  jurisdictions. This is descriptive only. Actual coverage is subjective to the language of the policies as issued. Exclusions & Limitations apply. This policy provides ACCIDENT insurance only. It DOES NOT provide basic
hospital, basic medical or major medical insurance as defined by the New
York State Insurance Department. The expected benefit ratio for this policy is 85%. This ratio is the portion of future premiums which the company expects to return as benefits, when averaged over all people with this policy.

IMPORTANT NOTICE — THIS POLICY DOES NOT PROVIDE COVERAGE FOR
SICKNESS.

Chubb, Box 1615, Warren N.J. 07061-1615.

The benefit amount shown is your accidental death benefit amount. The benefit amount for accidental dismemberment is a percentage of the
accidental death amount. The benefit amount for your spouse/domestic
partner is 50% of your amount and for your dependent children is 20% of your amount. If you have no dependent children, your spouse / domestic partner’s
benefit is equal to 60% of your amount. If you have no spouse/domestic
partner your dependent children’s benefit amount is equal to 25% of your
amount.

 

Highlights of coverage of VBA accident insurance are listed here.

A summary of benefits is here.

The source of this content is the product brochure.

Will the Affordable Care Act be repealed in 2017?

At this time it appears that Democrats have the political power to block any attempt to repeal of the Affordable Care Act in the US Senate and are expected to do so, according to policy experts who advise the health insurance industry. However, Republicans do have enough votes for a budget-related bill to remove funding for the cost-sharing federal subsidies and the expansion of Medicaid.

So it appears that coverage for the lowest income individuals is threatened but other parts of the law remain safe for 2017.

Mini-med insurance plans OK per court

This week the Court of Appeals for District of Columbia affirmed a lower court’s earlier decision on litigation affecting the fixed indemnity health insurance. The ruling reaffirms that  the Department of Health and Human Services (HHS) may not require consumers purchasing fixed indemnity health insurance policies to certify that they have other health insurance coverage that qualifies as under the provisions of the Affordable Care Act. The common term for these policies is “mini-med insurance”. While many, like this Consumer Reports writer, predicted the death of this type of insurance, the opposite actually happened. This type of coverage has become more popular since passage of the Affordable Care Act.

While these plans do not help an individual or company avoid penalties for non-compliance with Affordable Care Act, they may be a more attractive option to the millions who are exempt from the health care law’s requirements.

Earlier HHS had proposed that only individuals who have qualified plans (aka “Obamacare”) could buy these policies. The court seems to uphold the rights of individuals who avoid  Obamacare for any reason and want to maintain their non-compliant health plan.

The courts seem to say that consumers can purchase any insurance they want and deal with the consequences later.

Insurance is the business of mirage

“Insurance is the business of mirage” -a theme of my law professor many years ago. Life experience has proven him correct time and again. 

I suppose that most of us involved in the field of advising formerly affluent clients in financial distress have seen more collapses due to not having insurance coverage they thought they had than all other causes combined.

Identity protection now included in selected medical insurance plans

Freedom Benefits is pleased to announce that all Value Med insurance plans now include Identity Restoration protection plan through ID Recovery Pros. Identity protection is a growing concern among consumers who need assistance in dealing with credit and related issues that accompany an identity theft.

ID Recovery Pros provides immediate and complete assistance in resolving ALL threats if your identification has been compromised. ID Restoration service includes:

  • Three Generation Family Coverage
  • Includes member’s, parents and children under the age of 25 living in the same household
  • Personal Advocate assigned to you after a compromise
  • Personalized recovery plan
  • Post-recovery follow-up for 12 months after resolution
  • Unlimited Discovery Period
  • Online access to case status 24/7

Read more at http://freedombenefits.net/affordable-health-insurance/Value-Med-Insurance.html.

Low cost telephone-based medical services are expanding

We are please to see more low cost telephone-based medical service options (often called “tele-med”) being added to popular health insurance policies. While each health plan is different, this example below was part of a recent advertisement for tele-med services in Value Benefits plans available through Freedom Benefits:

 

MDhotline
  • UNLIMITED NO Cost Consultations
  • Only $19.95 / month for Individuals or Families
  • 70% of ALL Emergency Room Visits can be treated with MDhotline
  • NO Waiting Rooms! The average consultation time is approximately 12 minutes.
  • NO Hassle! MDhotline physicians are board certified and available 24 hours per day, 7 days a week.
  • NO Co-Pays or Deductibles