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While eating lunch after church Sunday I was asked the following question by my luncheon companion;
“People at work have children but the group health insurance plan the company offers is a plan with a high deductible but no co-pay. It is fine for older employees but there are parents with children. Is there an option available for them?”
Fortunately, the answer is yes. There are a couple of different options available. Today, I want to discuss options for the individual employees. Tomorrow I will share some options for the employer to tweak the benefit plan.
There are some plans, available to individuals, that can act as a supplement. They are similar to the plans that received so much bad press last year called, mini-meds.
Since most employers pay a portion of the employee’s premium, which can add up to a significant expense, many small businesses have elected to switch to higher deductible plans and cut some of the more popular benefits in order to save money.
In many cases, rather than griping about what their new plan does not have employees should be thankful that their employer even offers health insurance at all. Group health insurance is very, very expensive and employers are not legally required to offer coverage to start with.
“Mini-med” plans are excellent options that you can get on an individual basis to supplement what your group plan does not pay. When used correctly, they are not near as bad as the ultra left paints them.
When used as a group plan, mini-meds tend to provide excellent insurance protection for relatively minor issues. Employees with influenza or hay fever can see a doctor, get a prescription and get back to work. They are also fine for minor lacerations and sprains that require an Emergency Room visit.
Because mini-meds often have a cap on the amount of insurance benefit they provide they tend to be very in-expensive, which is good for the employer but not necessarily good for the employee.
If the employee is seriously injured in an accident away from work or is diagnosed with a disease they will blow right through the insurance limit and be personally responsible.
Allegedly, the PPACA eliminated policy limits last year but the Secretary of Health and Human Services has granted enough waivers, especially to union members that the possibility of someone filing bankruptcy for medical bills, even though they had “insurance” still exists.
In fact I saw today that over 1,500,000 American employees, 1/3 of them members of unions, still have limited “mini-med” plans at work. In other words, if you have any doubt, read your group insurance policy to see if it is a Limited Benefit type of policy.
If you find that your health insurance is a “mini-med” plan and that is unacceptable to you, don’t panic. There are things you can do to correct the short fall. In and of itself, a “mini-med” plan is not bad. The problem is in how it is used. Call me at (832) 767-8059 and we can talk about options for you.
“Mini-meds” work great as a supplement to plans like my lunch companion talked about. Often, if they are used correctly, they can provide co-pay benefits for minor medical care when a group plan does not have that benefit. Major things, like a surgery, will be taken care of by the group plan.
For example, an employee with a group plan with a $ 2000 deductible and no doctor office co-pay may wish to get an individual “mini-med” with doctor office co-pays and a limited benefit.
If the employee needs to see the doctor because of a routine ailment, they could use the “mini-meds” co-pay benefit but if they suffered a more costly injury or disease, they would have unlimited health insurance benefits under the terms of their group health insurance.
Also, keep in mind that the PPACA mandates that all group health insurance plans provide some preventive visits at no cost to the insured, regardless of if the plan offers co-pay benefits or not.
Because they tend to be so inexpensive, the temptation is present for people who do not have group health insurance benefits through work to rely on them for all their medical needs. That is fine if nothing major occurs but if it does, they are at best, disappointed.
As a result, I do not offer “mini-med” plans through either this blog or my web site. If you think you are a candidate for this type of strategy, contact me by email, info@theinsurancebarn.com or call (832) 767-8059.
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- Mini-Med Health Insurance (theinsurancebarn.wordpress.com)
- A Strategy To Hold Health Insurance Premiums Down (theinsurancebarn.wordpress.com)
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