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Obamacare Alternatives In Florida
Affordable Care Act plans, otherwise known as Obamacare plans, have been available to consumers since 2011. The features and benefits of ObamaCare health plans are quite comprehensive. However, for a growing number of consumers, Obamacare is simply not affordable.
According to the Congressional Budget Office (CBO), premiums for benchmark plans - i.e., the second-lowest-cost silver plan listed on ACA exchanges - are expected to rise by 15% in 2019, and then average a 7% increase in 2020 and every year thereafter, through 2028.
Many experts believe these estimates to be conservative. Being unable to repeal and replace the Affordable Care Act outright, The Trump administration has been chipping away at many of the ACA premium containment components. The result of these actions will almost certainly lead to runaway increases in health insurance premiums for all ACA plans.
You may believe Affordable Care Act plans are the only option by which you can protect your family from devastating financial loss due to unexpected medical costs. There are actually more quality choices than you may realize.
Increasingly, families across the nation are making the switch to a lesser-known healthcare option: healthcare sharing plans. Healthcare sharing plans, (also known as faith-based health plans, faith-based health insurance, or healthcare sharing ministries), are one of the fastest-growing healthcare options in the nation, however, chances are, you've never heard of them. Below, we'll walk you through some of the important information you need to know about this fast-growing healthcare option.
Good to know: If you have outstanding medical bills, sometimes, phone calls just don't cut it. In those times, you may have to take a trip to meet with members of your healthcare facility's billing department one-on-one. Often, you will be able to work out a deal by meeting in person that you may not have achieved over the phone. When you go to your meeting, make sure that you give your hospital detailed information of your finances and current medical situation. Often, healthcare providers are willing to work with you to iron out an affordable alternative to traditional payment options. In some cases, you may even be eligible to discounts and other benefits to which you would otherwise not have been given access.
The Advent of Healthcare Sharing Plan.Healthcare sharing plans (faith based plans), have grown exponentially beyond what anyone could have possibly imagined, when such plans were exempted from the Affordable Care Act health plan requirements. At the time, the exemption was a way to sooth objections from conservative leaning congressmen who had reservations on the passage of the ACA. This exempted niche, is now a fast-growing segment of the health plan industry. From all appearances, this trend will continue well into the foreseeable future. What was once a fringe idea, limited to devout Evangelicals and rural churches has found acceptance with a wide swath of the American populous.
How do these faith-based plans work?
To put it simply, healthcare sharing is about like-minded people voluntarily coming together to share the burden of medical expenses. Healthcare sharing plans are typically faith-based, meaning the core concepts are based upon religious beliefs. However, in most cases, consumers do not need to be affiliated with any religious group, or be religious at all, in order to purchase a faith-based health plan. Faith-based health plans are not considered insurance and are not regulated by the Florida department of insurance.
These plans are designed to accomplish the same fundamental goals as traditional health insurance:
- Help people maintain good health by offsetting the costs of health care access.
- Assist people with the cost of medical bills.
- Protect people from catastrophic financial loss due to major medical expenses.
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
courtesy of Parents.com
The Mechanics.
The workings of faith-based health plans offered by various entities are quite similar. Each month all the members pay a set contribution or "share" amount. This contribution is based on the health plan style they have purchased. Other factors that may contribute to what the contribution will be are age, gender, and health history. Contributions are placed into a pool and managed by the healthcare sharing company. The funds are "shared" with members who have immediate medical bills, according to their chosen plan and company guidelines.
Usually, funds to pay medical bills are dispersed within the same community that the members reside. in other words, membership dues collected from plan members living in Florida, will be used to pay for medical costs that arise within Florida.
Advantages of Faith-Based Healthcare Sharing Plans.
Because Faith-based health plans do not fall under Affordable Care Act regulations, there is enormous flexibility in plan structure. This is one of the factors that contribute to a lower monthly premium when faith-based health plans are compared with traditional health insurance plans with similar benefits. Another contributing factor to lower premiums is the comparative lack of bureaucracy within entities that offer faith-based health plans. Insurance companies in the U.S. have had over a century to build up a virtual mountain of bureaucracy. The stifling bureaucratic excess is invariably passed on to the consumer, in the form of high plan premiums. Also, in many cases, the lack of bureaucracy, translates into your physician, medical facility, or hospital being paid much more quickly for services provided. Consequently, medical providers generally like health care sharing plans.
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Good to know: Ask whether tests, prescriptions or procedures are really necessary. The latest drugs aren't always better than older, cheaper drugs - just more expensive. If you tell the doctor you're paying cash, he/she may suggest you wait to see if the condition resolves before ordering an expensive test. Instead of paying for 20 sessions of physical therapy, pay for one and learn exercises to do at home.
DisadvantagesOne big advantage of an ACA backed plan is you cannot be declined coverage due to health issues. Healthcare sharing companies can choose to decline coverage to any individual due to medical issues or history. Also, certain ACA plan benefits and protections are mandated by law. Some benefits, like maternity, for example, may be very important to you. Your faith-based plan may not offer it.
There are also lifetime maximum benefit limitations with most any faith-based health plan. ACA plans have no such limitation.
For these reasons, faith-based healthcare sharing plans are not the perfect alternative healthcare plan solution for everyone. Whether or not a faith-based plan makes good sense, depends upon your medical and financial circumstance. Be certain to understand benefits and limitations thoroughly, before purchasing any faith-based plan, or traditional health insurance plan.
For more information on Faith-Based / health care sharing ministries, please contact us directly.
Short Term Health Insurance
So, what is short term health insurance?
The first thing to do is define short term health insurance. There are two parts to this: What short term insurance was, and what short term insurance is today.
Initially, short term health insurance was designed just for short term situations. As the name implies, it was a health insurance plan with a short term duration, which ranged from several months to a year. This type of insurance was for individuals who needed temporary medical insurance or could not afford traditional health insurance. It was used mostly by employees who frequently changed jobs, employees waiting for their group health insurance plan to kick in, students going out of state to college, or young adults searching for their own insurance because they were no longer covered under their parent's plan.
Insurance coverage was strictly for hospitalization. Doctor visit benefits, preventative services, or prescription drug benefits, were unheard of.
Good to know: It's never too late to negotiate a bill. Many patients think once a bill has gone to collections it's game over, but that's not true. Call the healthcare provider first, not the collection agency, to see if you can negotiate directly with them. They have much more of an interest to negotiate the debt down than the collection agency.
Things have changed. In Florida, there are short term health insurance plans that now offer doctor visit copay benefits, preventative services, prescription drug benefits, and more. Some of these plans
can provide coverage for up to 3 years or more before a new application is needed. For these reasons and more, short-term health insurance is becoming an ideal health insurance solution for a growing number of Florida families.Short term health insurance plans are affordable, and the plan benefits have vastly improved from what was offered in the past. However, short term health insurance is not for every circumstance. It lacks several of the guaranteed benefits that are part of the Affordable Care Act portfolio of plans.
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Other articles:
Explaining the Growth of HealthCare Sharing Plans.
5 Strategies For Reducing Medical Bills.
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