Medical Sharing Plans: A risky alternative to Health Insurance
Whether you are in Cincinnati, Columbus or Cleveland, many Ohioans share negative feelings toward health insurance carriers. After all, the carriers do accept and decline individuals at will, raise premiums consistently and remain profitable–regardless of the economic climate. Over the last decade many have sought out alternative health care options. One alternative, which has become increasingly popular, is the concept of the medical sharing plan.
A medical sharing plan is not to be confused as a form of health insurance. Medical sharing plans offer flat monthly rates for individuals and families to share in the cost of health care among a large group of people. In other words, you pay premiums to help others meet their health care expenses (i.e. office visits, hospitalization, prescriptions, etc.) and vice versa. While this might be a noble idea, the concept has its flaws.
For one, medical sharing plans, such as Samaritan Ministries International, provide health care assistance based on the cost of the service. For example, if you have an expense under $300, you are responsible for paying that out of pocket. As well, if you have an expense that exceeds $250,000, you are responsible for paying the balance. Under typical health insurance plans, you are offered copays or discounts, which helps alleviate the burden of expensive office visits and prescriptions. Also, standard health insurance policies usually have lifetime maximums that far exceed the $250,000 offered by medical sharing plans. And, as a result of President Obama’s recent health care reform bill, lifetime maximums will eventually be a limitation of the past.
Medical sharing plans require others to pay for your medical expenses and there’s no guarantee you will receive the money to cover those expenses. Samaritan Ministries International requires that you submit a petition for needs over $300, which is posted in their newsletter, stating your condition and the amount of assistance you are needing. Essentially, this system relies on others to meet medical expenses with absolutely no assurance that the amount of need will be met. Under a typical health insurance plan, on the other hand, you would not have to face such uncertainty with regard to covering claims.
If you would like to read more about medical sharing plans check out the following site: http://www.samaritanministries.org/. For questions regarding health insurance plans available to individuals, families and self employed persons, feel free to contact a licensed health insurance agent of Chaser Insurance Group at 1-877-775-4321.
Medical Mutual of Ohio to Operate Temporary High Risk Pool
As stated in the Patient Protection and Affordable Care Act, states must provide a temporary high risk pool to those individuals who are unable to purchase health insurance due to pre-existing conditions. As of last week, Mary Jo Hudson, the Director of the Ohio Department of Insurance announced that Medical Mutual of Ohio will be the non-profit entity responsible for operating the State of Ohio’s temporary high risk pool program.
“We are pleased to have selected an Ohio company to operate the temporary high risk pool program in Ohio,” declared Hudson. “With approximately $152 million coming to Ohio through the Patient Protection and Affordable Care Act to operate this program, this is an opportunity for an Ohio based non-profit company to be involved in providing health insurance benefits to the many Ohioans who need coverage because of pre-existing health conditions.”
Hudson continued: “We selected Medical Mutual to operate the temporary high risk pool program in Ohio after a competitive process because they can begin to cover Ohioans by August and will do so at a low cost. We look forward to working with them throughout this process to ensure eligible Ohioans can obtain quality coverage through this new program.”
The temporary high risk pool is a health insurance plan that is federally subsidized and intended for those individuals who cannot secure coverage in the private market due to pre-existing conditions. According to the Patient Protection and Affordable Care Act, in order to be eligible for the temporary high risk pool one must be uninsured for at least six months.
In submitting their proposal to the state, Medical Mutual estimated they would be able to cover over 5,000 Ohioans with the funding available. Insured persons would be responsible for paying a base rate for their coverage. Aside from the funding provided by the Patient Protection and Affordable Care Act, no other federal or state funds will be used toward this program.
“Becoming involved in the high risk pool is consistent with who we are as a mutual insurance company, as well as an Ohio company, that has been serving the healthcare needs of Ohioans for 76 years,” said Rick Chiricosta, President and CEO of Medical Mutual of Ohio.
Maternity Benefits: No longer a common offering
As the landscape of our nation’s health care system continues to change, products and benefits offered by the many carriers change as well. While the health care reform will eventually force the carriers to shoulder higher risk individuals, who would have been declined coverage prior to the legislation, the carriers are scrambling to find ways to manage this risk while remaining profitable. One way to accomplish this task is through minimizing benefits.
A necessary benefit to many newlyweds and young families is maternity coverage. Such coverage, which has commonly been included on individual and family policies, is quickly becoming a benefit of the past. Carriers, such as Aetna, Humana and United Health Care, to name a few, have dropped all coverage relating to maternity with the hope of providing internal savings on claims. While this may provide savings to the carriers, it will certainly require policy holders to pay largely out of pocket toward the cost of pregnancies.
Although maternity benefits are certainly facing extinction from the majority, there are still a couple of well known carriers that remain loyal to the coverage. Anthem Blue Cross and Blue Shield continues to offer maternity coverage for individuals and families. There are, however, stipulations to purchasing maternity coverage: 1) Maternity is only available to Blue Access - Plan 2, Lumenos HSA and Premier plans; 2) With Lumenos and Premier plans, the deductible must be $2,500 or greater. As well, policy holders must complete a nine month waiting period (270 days) prior to receiving any benefits. Members can also expect to see a 35-45% increase in premiums as a result of purchasing a maternity rider.
Another carrier that continues to offer maternity coverage is Medical Mutual of Ohio. With a strong network in Ohio, and an aggressive campaign to write policies on the individual and family level, Medical Mutual is a carrier that should not be overlooked. Much like Anthem, maternity coverage comes with exceptions. For example, maternity is only available on SuperMed One Elite and Premium plans and, unlike Anthem, it’s not available with their HSA product (Wellness HSA). The cost associated with this coverage is not cheap, with premiums exceeding $400 per month just for the rider alone and there is a nine month waiting period as well. However, the rider affords the policy holder the peace of mind in knowing should any problems arise throughout the pregnancy, they are covered and their exposure to risk is limited.
Going forward, maternity coverage may very well be eliminated from all carrier offerings. Yet, for the time being, there are still options available to people who want to manage the costs of a pregnancy. If you would like to know more about maternity benefits, feel free to contact an agent of Chaser Insurance Group at (877)775-4321.
COBRA Subsidy Expires… Alternatives Available
Effective June 1, 2010, the federal COBRA subsidy expired. The program was enacted in March of 2009 and allowed COBRA participants to receive a 65% federal subsidy as a part of the Obama Administration’s $787 billion stimulus program.
House Democrats at the end of May elected not to extend the subsidy through the remainder of 2010, as an extension would have cost taxpayers nearly $8 billion. Although this move will ultimately save the taxpayers, it’s the unemployed who are truly feeling the pinch. According to Families USA, a consumer advocacy group, COBRA premiums consume as much as 84% of a person’s unemployment check (Tami Luhby, June 7, 2010, CNNMoney.com). To offer an example of the savings provided by the COBRA subsidy, with the average annual cost of COBRA around $13,500 for a family, the subsidy reduced this amount to roughly $4,725.
Although many COBRA participants feel as though their current policy is their only option, this is often times not the case. By purchasing an individual or family policy, most people can cut their monthly premiums in half. Many individuals will purchase a policy while out of work and then possibly move to a group plan when they find another job. This strategy allows for considerable savings and allows individuals and families to have substantial coverage should health problems arise.
As an aid to find individual and family coverage, many people are turning to the internet. Websites, such as InsuranceChaser.com, offer individuals and families of Ohio, Kentucky and Indiana the ability to compare rates of some of the largest carriers in the country (Aetna, Anthem, Humana, Medical Mutual of Ohio and United Health Care).
If you are interested in seeing quotes from the major health insurance carriers, feel free to contact an agent at Chaser Insurance Group at (877)775-4321 or compare rates for yourself at www.InsuranceChaser.com.
Read Tami Luhby’s article for yourself! (http://money.cnn.com/2010/06/06/news/economy/COBRA_subsidy_health_insurance/index.htm)
In Search of Support, Obama Takes Aim at Seniors
As the oil spill in the Gulf continues to dominate national news, President Obama appears to have refocused his energy toward the defense of the recent healthcare reform bill. Although his quest to drum up support may not surprise most, considering midterm elections are on the horizon, it’s Obama’s target audience that has raised eyebrows.
With the elderly population being one of the most represented demographics in recent elections, Obama is hoping he can help seniors better understand the recent legislation that’s been dubbed far too complicated by the average American. As mentioned in The Washington Post this week (6/8, Perry Bacon, Jr. and Michael D. Shear), the Obama administration “is determined to take note of the more popular outcomes of its health-care overhaul, in part to remind voters… of the reasons that the president pushed so hard to pass it.”
In a televised town hall meeting on Tuesday, which was broadcast live on C-SPAN, Obama addressed the $250 rebate check that is intended to soften the impact of the “donut hole” that affects many Medicare eligible seniors. Obama also addressed scams that are typically directed at seniors. Speaking of the perpetrators, Obama said “We will find you. We will prosecute you. And we will ultimately prevent those crimes from happening ever again.”
While the president’s message to seniors may turn some skeptics into believers, it’s being lost on others. If Obama intends to extend his presidency beyond 2012, he and his administration must do a better job of explaining to the masses the far reaching impact of the recent legislation. Expect to see similar town hall meetings, and possibly even commercials and mainstream literature, come about as midterm elections draw closer. Until the average American can truly understand the reform bill, and find the benefits to be applicable, it would be safe to say that discord between political personalities and their constituents will only continue.
Read Bacon & Shear’s article for yourself! http://www.washingtonpost.com/wp-dyn/content/article/2010/06/08/AR2010060800872.html?hpid=topnews