ACA PPO plans are still hard to find and even if you do find one it does not necessarily make it a good choice for nationwide coverage, given the fact that their provider networks may be regional only (Like Avera Health in SD). So, once again we are offering alternative options for those that once something outside of the ACA offerings. The two biggest changes to our offerings in 2019 are 1) Short Term Medical can be written for up to 364 days (and renewed for up to 3 years) and, 2) Premier Plans (Elite Series) are back for self-employed individuals.
There are also some states where insurers that are expanding their existing coverage areas, including Kentucky and Colorado. But that’s not the case everywhere. Some insurers in Washington, for example, are reducing their coverage areas. And in Georgia, Anthem is simultaneously reducing the number of counties where they’ll offer plans, but increasing the number of people who will be eligible for their plans (by exiting numerous rural counties and rejoining almost as many populous counties)
This is our preferred HCSM plan from Aliera Healthcare that combines the 63 Minimum Essential Coverage preventive care benefits plan with a HCSM for hospitalization. It is an ACA exempt plan because it covers preventive care (after a 9 month waiting period) at 100% with no out of pocket expense to the member and includes an ACA-exempt HCSM hospitalization plan. It is not two separate bundled plans but is one plan through Aliera. Rates look good, benefits are nationwide, and the application is simple. The Statement of Beliefs is non-evangelical personal rights/liberty oriented, making it appealing to a broader audience than some of the other HCSMs.
You need to be relatively healthy to qualify for these plans. Any surgery in the past 6 months or scheduled in the next 12 months will likely disqualify you. If you are taking expensive medications at the time of application you will likely not qualify. Type I diabetes, high cholesterol, hypertension are okay if there aren’t other additional pre-existing conditions. Email Kyle if you are unsure if you qualify.
You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call: 1-800-MEDICARE (800-633-4227). TTY or TDD users should call 877-486-2048, 24 hours a day/7 days a week; The Social Security Office at 800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY or TDD users should call, 800-325-0778; or Your State Medical Assistance (Medicaid) Office.
Medicare insurance plans include coverage for hospital, medical, and some prescription drugs. Medicare supplemental insurance plans, also called Medigap, can help pay for your copays and deductibles. You can also explore Medicare Part D plans, which are a standalone prescription drug program offering coverage for medication costs. eHealth makes it easy to browse insurance plans in your area while advocating for you throughout the process. Guidance is available at no cost from more than 200 licensed insurance agents.
This year’s enrollment period offers good news to many Americans. After two years of carriers leaving markets and steep rate increases, states are seeing carriers re-enter exchanges for 2019 – and average rate increases are smaller than they were in 2017 and 2018. And, although premium subsidies will be slightly decreased in 2019 (though not in all states), those eligible for cost-sharing reductions will continue to receive them.