Dawn and I (Dave Cook) found a cheaper and better solution for ourselves. Granted neither of us have any pre-existing conditions and we are okay with self-insuring our healthcare up to a certain dollar amount annually to save on those higher monthly premiums
You must realize that the only option that still covers pre-existing conditions for the first 12-24 months is a “Qualified Health Plan” (QHP) offered through the marketplace (Obamacare). All other terms of insurance usually have a 12 month and, in some cases, up to a 5-year pre-existing look back period.
For us, the cheapest Obamacare plan we could find in our area was an HMO for $1,063.25 per month with a individual deductible of $7,900 with a combined Max Out Of Pocket (MOOP) of $15,800.00. A lot of people never heard of this carrier and a lot of doctors and hospitals do not even accept this carrier in our area. Remember that the only benefit for us is that these plans do cover pre-exiting conditions and preventative services such as pap-smears, colonoscopies and other things, but doesn’t cover doctor visits and other things until we reach the $7,900 deductible per person.
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