All insurance comes down to what “Risk” are you willing to accept. At a monthly premium $1,063.25 ($12,782.76 annually) plus a combined MOOP of $15,800.00, our Risk with the above plan would be $28,582.76 per year. Since we are both healthy with no pre-existing conditions, this annual risk is just too high!

Based on our health insurance needs, we opted for what is called a Short-term Medical (STM) plan that is a PPO and uses the Aetna network. In the past, STM could only run for 3-month periods and you were exposed to the government health insurance mandate (government tax penalty) for not having an Obamacare plan. With the NEW law, STM plans in Florida can offer 364 days of coverage and the insurance mandate is no longer an issue for being penalized.

Now if someone is getting a tax credit (a subsidy based on family makeup and income) to offset their monthly premium or they have health issues, then maybe an Obamacare plan is a good option to lower their overall risk.

Based on our situation, the Short-term Medical Aetna PPO option is better for us with a monthly premium of only $708.17 ($8,498.04 annually) and a deductible of $5,000.00 with a combined Max Out Of Pocket of $10,000.00. With this our overall risk is $18,489.04 vs. the Obamacare HMO alternative of $28,582.76 per year.

Even though we do not get the preventative screenings offered under a QHP, we are potentially saving over $10,000.00 per year and we receive discounts using a much larger PPO network of doctors and hospitals.

NOTE: You can drop your Obamacare plan throughout the year, but you can only enroll in those plans during Open Enrollment. If Short-term Medical isn’t a good fit, there are other options available as well that may better suit your needs and you can enroll at any time during the year such as; Minimal Essential Coverage (MEC) plans, Healthshare Ministry plans, Hospital Indemnity plans and more…

Contact us today to find the right plan for you and your family. 

Short Term Medical | Obamacare Alternative | Bradenton FL | Sarasota FL 

Insurance is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss. Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for payment. An insurer, or insurance carrier, is a company selling the insurance; the insured, or policyholder, is the person or entity buying the insurance policy. The amount to be charged for a certain amount of insurance coverage is called the premium. Risk management, the practice of appraising and controlling risk, has evolved as a discrete field of study and practice.

The transaction involves the insured assuming a guaranteed and known relatively small loss in the form of payment to the insurer in exchange for the insurer’s promise to compensate (indemnify) the insured in the case of a financial (personal) loss. The insured receives a contract, called the insurance policy, which details the conditions and circumstances under which the insured will be financially compensated.

Insurance involves pooling funds from many insured entities (known as exposures) to pay for the losses that some may incur. The insured entities are therefore protected from risk for a fee, with the fee being dependent upon the frequency and severity of the event occurring. In order to be insurable, the risk insured against must meet certain characteristics in order to be an insurable risk. Insurance is a commercial enterprise and a major part of the financial services industry, but individual entities can also self-insure through saving money for possible future losses.

• Accidental loss: The event that constitutes the trigger of a claim should be fortuitous, or at least outside the control of the beneficiary of the insurance. The loss should be pure, in the sense that it results from an event for which there is only the opportunity for cost. Events that contain speculative elements, such as ordinary business risks or even purchasing a lottery ticket, are generally not considered insurable.
• Large loss: The size of the loss must be meaningful from the perspective of the insured. Insurance premiums need to cover both the expected cost of losses, plus the cost of issuing and administering the policy, adjusting losses, and supplying the capital needed to reasonably assure that the insurer will be able to pay claims. For small losses these latter costs may be several times the size of the expected cost of losses. There is hardly any point in paying such costs unless the protection offered has real value to a buyer.
• Affordable premium: If the likelihood of an insured event is so high, or the cost of the event so large, that the resulting premium is large relative to the amount of protection offered, it is not likely that the insurance will be purchased, even if on offer. Further, as the accounting profession formally recognizes in financial accounting standards, the premium cannot be so large that there is not a reasonable chance of a significant loss to the insurer. If there is no such chance of loss, the transaction may have the form of insurance, but not the substance. (See the US Financial Accounting Standards Board standard number 113)
• Calculable loss: There are two elements that must be at least estimable, if not formally calculable: the probability of loss, and the attendant cost. Probability of loss is generally an empirical exercise, while cost has more to do with the ability of a reasonable person in possession of a copy of the insurance policy and a proof of loss associated with a claim presented under that policy to make a reasonably definite and objective evaluation of the amount of the loss recoverable as a result of the claim.
• Limited risk of catastrophically large losses: Insurable losses are ideally independent and non-catastrophic, meaning that the losses do not happen all at once and individual losses are not severe enough to bankrupt the insurer; insurers may prefer to limit their exposure to a loss from a single event to some small portion of their capital base. Capital constrains insurers’ ability to sell earthquake insurance as well as wind insurance in hurricane zones. In the US, flood risk is insured by the federal government. In commercial fire insurance it is possible to find single properties whose total exposed value is well in excess of any individual insurer’s capital constraint. Such properties are generally shared among several insurers, or are insured by a single insurer who syndicates the risk into the reinsurance market.

    involved and the nature of the property ownership or relationship between the persons. The requirement of an insurable interest is what distinguishes insurance        from gambling.

• Contribution – insurers which have similar obligations to the insured contribute in the indemnification, according to some method.
• Subrogation – the insurance company acquires legal rights to pursue recoveries on behalf of the insured; for example, the insurer may sue those liable for insured’s loss.
• Causa proxima, or proximate cause – the cause of loss (the peril) must be covered under the insuring agreement of the policy, and the dominant cause must not be excluded.
• Mitigation – In case of any loss or casualty, the asset owner must attempt to keep loss to a minimum, as if the asset was not insured.

Bradenton Life Insurance | Ellenton Health Insurance | Dave Cook Safeguard