There has been a great deal of misinformation regarding health insurance recently. The politicians and press have used health insurance for political reasons rather than admit that health insurance is mainly a financial tool to help people pay for high medical bills.
Let the politicians, and TV talking heads, say what they want. They are going to talk anyway. As long as the cameras continue to point in their direction they are going to try to convince others that what they think is the only option. Sadly neither the politicians or talking head are going to pay your premium for you.
You, and you alone, will have to decide what is the best use of your money in 2019. Fortunately, this year you are not faced with an ultimatum from your government for not buying the health insurance congress wants you to have.
In this post I hope to give you some information to help you decide what is the best use of your money for health insurance next year.
After being forced to pay for ACA Compliant health insurance for the last 5 years, or pay a tax penalty, I can understand why one could be tempted to avoid health insurance completely and just pay for any medical bills out of their pocket.
Please believe me when I say that if it were left up to me, and I could predict the future with accuracy, I would do that myself. However, I have never met or seen a person who could predict the future accurately.
While regular doctor office visits are low enough that one can pay those bills out of their regular cash-flow, a trip to the ER or Hospital Admission can create bills that can ruin an individual’s financial future for many years or the rest of their life.
If you are tempted to self-insure your medical risks for 2019, contact an insurance agent whom you trust and ask about a high-deductible major medical health insurance policy.
If you elect to use a policy like that, you are essentially self-insuring your more routine health care bills, but guarantee that you will get some help with high, catastrophic type of medical bills if they happen next year.
The nice thing is that since the Individual Mandate was repealed as of January 1, 2019, if you elect to use the Self-Insurance strategy, you are not subject to any tax penalties any more.
ACA Compliant/Obamacare Plans
In spite of the scare tactics that were used during the recent political campaigns, nobody’s health insurance plans have ever been at risk of being canceled on them for political reasons. The only thing that changed was that people who do not qualify for an IRS subsidy have the option to pay for health insurance they need rather than what the government wants you to pay for.
ACA plans are still available for 2019, for those who want to use them. They are ideal for the following individuals.
- Those who have had major medical treatment in the last 24 months.
- Those who can qualify for an IRS “subsidy” to help with premiums.
- Sexually active females of child bearing year.
Just be advised that all ACA compliant plans, available in Texas, are Managed Care type of plans. That means that they are either HMO or EPO type of plans.
If your primary doctor is in the plan’s HMO network, or you are very flexible with your doctor, there is no problem, as long as you learn, and apply, the rules for your Managed Care type of plan.
If you believe that an ACA Compliant plan is best for you, you may shop and apply for your plan & subsidy through this link to Blue Cross Blue Shield of Texas.
Non-ACA Compliant/Obamacare Plans
I anticipate that many Americans will exercise their option to get a Non-ACA Compliant health insurance plan for 2019. While Short Term Limited Duration Insurance (STLDI) plans are not available in all states, the State of Texas has elected to allow citizens of Texas to use STLDI plans for up to 360 days.
STLDI plans do not have the same benefits or contract types that ACA plans have. STLDI plans often do not cover maternity coverage, except for complications of pregnancy, or substance abuse. People who need that type of coverage will want to use an ACA Compliant plan as discussed above. However, STLDI plans may be the best option for males or adult females who are not able to have children.
Unlike ACA Compliant plans, STLDI are generally written on PPO type of contracts. That means that they will provide coverage as long as the insured uses a licensed physician, regardless of plan rules. Just remember that when using a PPO policy there is still a plan “network” but it works differently than an HMO.
If you use a doctor/hospital outside of the plan’s network with a HMO or EPO type of policy, you have no health insurance of any sort. However, if you have a PPO type of plan, and use a doctor/hospital that is not in the plan’s network, you will still get some help with your medical bills, just not as much as you would have gotten had you used a doctor/hospital that is in the plan’s network.
One of the most common complaints that I hear each year is that people feel that health insurance is a “rip-off” since they have to pay so much for coverage they do not use.
I can definitely understand that and in the past I had no answer that I could confidently give people. However, in recent weeks the insurance industry has given me access to a supplement that people can use that will help with that problem.
Other insurance companies may offer a Telehealth plan but the insurance company I use for STLDI for my clients is United Health One. Recently they introduced their “Healthiest You” plan. If you are interested in learning more about “Healthiest You” click on the link and read the product flyer.
Essentially, all Telehealth plans are about the same. If you are enrolled in a Telehealth plan, and need to see a doctor for a routine medical diagnosis and prescription, you can just call the number you were provided and you will speak directly with a doctor who will diagnose your issue over the phone and call a prescription in for you to your pharmacy.
Telehealth plans are ideal supplements to either ACA plans or Non-ACA Compliant plans. Telehealth plans allow people to skip the middle-man and get a prescription without the need to “get ready” and sit in a doctor’s waiting room with other sick people when you are not feeling well.
My license is only good withing Texas. Texans who want information to enroll in “Healthiest You” should email me below. I cannot help people who live in other states. If that is you, you will need to contact an insurance agent who is licensed in your state.