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What is the Best Health Plan For You If You Don't Qualify For Obamacare Coverage?

What is the Best Health Plan For You If You Don't Qualify For Obamacare Coverage?

Posted Jul 26, 2016 by Jenifer Dorsey

How to Choose Temporary Insurance Coverage

Maybe you forgot to enroll for an Obamacare plan, or maybe your Obamacare plan (i.e., ACA-compliant major medical insurance) got cancelled because you didn’t make payments. One way or another, you’re probably reading this because you’ve found yourself uninsured outside of the annual open enrollment period for individual health insurance plans.

The next Obamacare open enrollment period begins Nov. 1, 2016—and then, the earliest you can start your coverage is Jan. 1, 2017.[1] So, what exactly happens if you lose your health insurance between Obamacare open enrollment periods? You could face a tax penalty. You could wind up paying all of your medical bills out of pocket.

If you don’t qualify for a special enrollment period, are not eligible for Medicaid, or will not have access to job-based health insurance, you may need another coverage option until the new year. That option may be short term health insurance—temporary benefits to help you pay for unexpected healthcare expenses when you are in between Obamacare or employer-sponsored health plans. You can buy short term coverage anytime of year, and you can begin benefits as early as the day after you enroll.

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How do you pick the right temporary coverage? As with your Obamacare plan, not all short term plans are the same. Shop around a bit to familiarize yourself with the options available, and work with a licensed health insurance producer who can assist you in selecting coverage that best meets your healthcare needs and budget.

Ready to speak with someone now? Call the number at the top of your screen and get connected with a licensed health insurance producer.

Things to consider as you shop for a short term health plan

1. How long do you need health insurance?

Short term plans are available for as few as 30 days—plan length maximums vary by state.

Keep in mind that short term health insurance plans are not considered minimum essential coverage under the Affordable Care Act. The ACA allows those who are not exempt from the individual shared responsibility provision (i.e., individual mandate) to be without minimum essential coverage for a single period of up to three months each year. If you need coverage longer than that, investigate your eligibility for special enrollment or Medicaid. Call the number at the top of your screen to discuss your situation with a licensed health insurance producer.

2. What kind of benefits will you need?

Will you or your family need preventive care while you are temporarily insured? Or, are you simply looking for something to help with the bills if you become injured or ill? Some short term plans may include a few preventive care benefits, while others do not. Read plan details carefully so that you understand what the policy will and will not cover—contact the insurance company with questions before you buy.

Because short term insurance is not ACA-compliant and is not intended to serve as a long-term health insurance solution, it does not include the essential health benefits or preventive services that are covered by all Obamacare plans. Furthermore, you may be denied short term coverage based on your health history

Again, if you need more robust care than temporary coverage offers or do not qualify, investigate your eligibility for special enrollment or Medicaid.

 

 

3. What can you afford to pay in premium and out of pocket for healthcare?

What will you pay for short term coverage? Do you have the option to pay a monthly premium or pay the premium all at once? Are you able to choose coinsurance, copays and deductible amounts?

In general, a lower premium will result in higher out-of-pocket costs for the policyholder, and a higher premium will result in lower out-of-pocket costs for the policyholder.

In addition to selecting a plan with a premium you find affordable, also consider whether or not you have the financial resources to pay your deductible, copay and coinsurance if you become ill or injured.

4. Can you continue using your preferred healthcare providers?

If you need medical care, will you be able to choose your own doctors, hospitals and other providers? If there is a network, are your preferred healthcare providers accessible to you? Where will you have access to after hours and emergency care?

Short term policyholders can often choose their own doctor and hospital without restrictions, although there may be financial incentives for using network providers. However, there are also short term plans utilize a preferred provider organization (PPO) network, with in- and out-of-network levels of cost-sharing. If you cannot find this information in the plan details, visit the insurance company’s website or call its customer service number.

 

 

5. What are plan limitations and exclusions?

Are certain illnesses and injuries excluded? Are there benefits for pregnancy?

Temporary health insurance plans usually cover a range of physician services, surgery, outpatient and inpatient care. Plans typically will not cover routine office visits, preventative care or preexisting conditions, so be sure to check the policy's list of exclusions. If you cannot find it, contact the company selling the plan.

Where to buy short term plans

Temporary health insurance is not available through state-based and federally facilitated health insurance exchanges. Plans may be purchased from a licensed health insurance producer, carrier-specific website, or multi-carrier website such as healthedeals.com. 

You want to find coverage you can trust and afford. Research your health plan options and discuss them with a licensed health insurance producer in order to make an informed decision. These individuals may also recommend other products such as dental insurance or critical illness coverage to help lessen your out-of-pocket healthcare costs while you are in between Obamacare plans—and after you have enrolled in one.

Call the number at the top of your screen. We’re here to help!

Get a quote and apply within minutes!

 



[1] Healthcare.gov. “Dates & Deadlines for 2016 Health Insurance.” Accessed July 25, 2016. https://www.healthcare.gov/quick-guide/dates-and-deadlines/

SHORT-TERM MEDICAL EXPENSE (STM)
THIS IS A SHORT TERM HEALTH BENEFIT PLAN THAT IS NOT INTENDED TO QUALIFY AS THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA). UNLESS YOU PURCHASE A PLAN THAT PROVIDES MINIMUM ESSENTIAL COVERAGE IN ACCORDANCE WITH THE ACA, YOU MAY BE SUBJECT TO A FEDERAL TAX PENALTY. ALSO, THE TERMINATION OR LOSS OF THIS POLICY DOES NOT ENTITLE YOU TO A SPECIAL ENROLLMENT PERIOD TO PURCHASE A HEALTH BENEFIT PLAN THAT QUALIFIES AS MINIMUM ESSENTIAL COVERAGE OUTSIDE OF AN OPEN ENROLLMENT PERIOD. THIS POLICY INCLUDES A PRE-EXISTING CONDITION EXCLUSION PROVISION.

About The IHC Group
Independence Holding Company (NYSE: IHC) is a holding company that is principally engaged in underwriting, administering and/or distributing group and individual disability, specialty and supplemental health, pet, and life insurance through its subsidiaries since 1980. The IHC Group (including through its 92% ownership of American Independence Corp. (NASDAQ: AMIC)) owns three insurance companies (Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company), a majority of Ebix Health Administration Exchange, Inc., a fully insured third party administrator, and IHC Specialty Benefits, Inc., which is a technology-driven insurance sales and marketing company that creates value for insurance producers, carriers and consumers (both individuals and small businesses) through a suite of proprietary tools and products (including ACA plans and small group medical stop-loss). All products are placed with highly rated carriers.

About IHC Specialty Benefits, Inc.
IHC Specialty Benefits, Inc., doing business as Health eDeals Insurance Solutions is a full-service marketing and distribution company that focuses on small employer, individual and consumer products. Health eDeals markets products via general agents online, telebrokerage, advisor centers, private label and directly to consumers. For more information about Health eDeals visit http://www.HealtheDeals.com.