Healthcare.gov<\/a> or your state\u2019s exchange, the holy grail that so many people are looking for right now, does not exist.\u00a0<\/p>\nThe various options that might seem like alternatives \u2014 short-term limited-duration plans, direct primary care, health care sharing ministries, or fixed indemnities \u2014 do not offer comprehensive medical coverage, Killelea said, nor do they protect you from massive medical bills should the worst happen.\u00a0<\/p>\n
According to Lucy Culp, vice president of state government affairs at the nonprofit Blood Cancer United, people often don\u2019t realize that.\u00a0<\/p>\n
\u201cWith all of these plans, we see marketing that really is confusing,\u201d she said. \u201cThey use a lot of the same words, they use words like premiums, like deductibles, like cost sharing, co-pays, co-insurance, all of the terms that we’re used to seeing in comprehensive insurance we might get through an employer, but they really are like a completely different type of thing.\u201d<\/p>\n
Take \u201cexcepted benefit\u201d or \u201cfixed indemnity\u201d plans, which Killelea has had brokers offer up as a cheaper alternative to an ACA plan.\u00a0<\/p>\n
\u201cThese are things that were kind of originally designed to be like a supplement,\u201d Culp said. \u201cSo, if you were hospitalized, that plan would pay you to help with those out-of-pocket costs that your insurance might not cover.\u201d<\/p>\n
But if you just bought a fixed indemnity plan and didn\u2019t otherwise have insurance, it might pay you a set amount per night, maybe $100 or a few hundred dollars if you were admitted to the hospital, but it wouldn\u2019t pay your actual hospital bills \u2014 you would be on the hook for those, which could easily be many thousands of dollars.\u00a0<\/p>\n
Then there are short-term, limited duration plans, which were designed to tide you over for a few months if you were maybe between jobs. Now, in many states, you can buy them for longer periods, so they can seem, on the surface, like a cheaper, viable alternative to an ACA health plan.<\/p>\n
\u201cBut because they aren’t subject to the ACA\u2019s patient protections,\u201d Culp said, \u201cthey have pretty limited benefits, they can deny coverage for pre-existing conditions.\u201d<\/p>\n
ACA plans cannot deny coverage for pre-existing conditions. They also have to cover ten essential health benefits, including preventive screenings, maternity care, emergency room visits and prescription drugs. Short-term plans do not.<\/p>\n
Joshua Brooker, a broker in Pennsylvania, and chair of the individual markets at the National Association of Benefits and Insurance Professionals said, \u201cthe big thing I always try to explain: anything outside of the Affordable Care Act means that it unchecks something.\u201d<\/p>\n
Meaning it won\u2019t cover one, or all, of those essential health benefits we have all come to expect from insurance.\u00a0<\/p>\n
And with alternatives far outside of the insurance world, like health care sharing ministries, where you pay into a pot with lots of other people and then submit medical bills and ask the group to pay them, Brooker said there are no guarantees, and no recourse if your bills do not get paid.<\/p>\n
Amy Killelea at Georgetown understands why people are looking for cheaper options outside the marketplaces, especially now, with ACA premiums rising, but said buying anything other than a traditional health insurance plan would be taking a big risk.\u00a0<\/p>\n
\u201cThat one, your insurance product, whatever you bought, is what it says it is, that you were sold something that you understood what it was, and it is what you think it is,\u201d she said.<\/p>\n
And two, that nothing major is going to happen to you: no cancer diagnosis, no heart attack, no car accident.\u00a0<\/p>\n
\u201cThat’s an order of one too many risks for me,\u201d Killelea said. \u201cI think I would choose, still, the regulated markets.\u201d<\/p>\n
However imperfect and expensive they may be.\u00a0<\/p>\n
Related Topics<\/p>\n","protected":false},"excerpt":{"rendered":"Somehow, at some point, Amy Killelea\u2019s name must have ended up on a list \u2014 they get texts…\n","protected":false},"author":2,"featured_media":203516,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[39771,163,1541,46018,3986,521,85,46,14175],"class_list":["post-203515","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-affordable-care-act","tag-health","tag-health-care","tag-health-coverage","tag-health-insurance","tag-healthcare","tag-il","tag-israel","tag-premiums"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/203515","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=203515"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/203515\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/203516"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=203515"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=203515"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=203515"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}