Which Healthcare Insurance Plan is Best for YOU?

“Do I need to be on an Obamacare plan (Affordable Care Act),” this is a comment I hear about 50% all the time when I first speak to a new client. The fact is if you have NO major pre-existing conditions, you do not have to be on an Obamacare plan. Also, the good news is that the IRS Individual Mandate is now history.

The IRS announced early Tuesday, February 14, 2017 that it will no longer require tax filers to indicate whether they had health insurance during the previous year.

So which plan is right for you? Obamacare or Non-Obamacare?

Non-Obamacare Plans were created for people who have no major pre-existing conditions. Major pre-existing conditions are heart disease/stroke, cancer, chronic obstructive pulmonary disease (COPD), diabetes, human immunodeficiency virus (HIV), and substance abuse. What are the benefits of these plans?

  • Nationwide PPO (excellent coverage for doctors, office visits, hospital stays, surgeries, and prescription drugs)
  • Lower deductible and out of pocket costs
  • Fully customizable (you choose how much you want to pay for your monthly premium, deductible, etc.)
  • ½ the cost of an Obamacare plan
  • Sign up anytime and cancel anytime during the year
  • Multiple carriers who offer Non-Obamacare

Obamacare Plans were created for people with major pre-existing conditions (heart disease/stroke, cancer, chronic obstructive pulmonary disease (COPD), diabetes, human immunodeficiency virus (HIV), substance abuse or for people who need maternity care or invitro fertilization. What are the advantages of Obamacare plans?

  • Every legal US resident is eligible for an Obamacare plan
  • There are no medical questions in order to qualify
  • Depending on how a family income compares to the Federal Poverty level, family size, and how much healthcare insurance costs where you live, individuals and families can qualify for a subsidy

 

The disadvantages of Non-Obamacare Plans are:

  • Doesn’t cover major pre-existing conditions; however, if you do get sick while on Non-Obamcare, you can switch to an Obamacare Plan during open enrollment
  • There are a few medical questions that a new client needs to answer
  • The plan is only available to healthy individuals who have no major pre-existing conditions

 

There ARE a few disadvantages of having an Obamacare plan as well.

There is only one carrier that offers an Obamacare (which does increase your premium somewhat due to no carrier competition)

  • The networks are limited to only counties and cities
  • If you get sick or hurt out of state, your plan will not cover 100% of your bills
  • These plans are mostly HMOs which means these plans are not portable
  • Because everyone qualifies for an Obamacare plan, the premiums are very costly due to the many sick individuals on these plans. There is a shared cost to help people with surgeries, medications, and more
  • You do not get to customize your plan meaning you do not get to choose your monthly premium, deductible, etc.
  • Open enrollment is only once a year between November through December

After comparing the Non-Obamacare plan to an Obamacare plan, you can see that individuals with MAJOR pre-existing conditions only have ONE choice and that’s to get Obamacare. Healthy individuals with NO major pre-existing conditions have a choice between an Obamacare plan and a Non-Obamacare plans. This is not a knock against Obamacare plans, but they are very expensive, very limited networks, one provider in most states, and high out of pockets. In addition, without what is called a qualifying life event, you cannot get an Obamacare plan until Nov. 1st 2017. Which plan works best for you?

Best TOP 10 Reasons to have a Health Insurance Broker

1. Healthcare insurance agents represent many carriers so agents can shop around for you and compare plans.

2. Healthcare insurance agents are able to check to see if your doctor(s) and hospital(s) are in network.

3. Healthcare insurance agents’ services are FREE!

4. Agents are able to look up your prescriptions and find out how much they will cost and where you can get discounts.

5. If you choose a Non-Obamacare Plan, agents are able to help you customize your plan. You choose your monthly premium, deductible, etc.

6. Agents are able to put members in a family on different plans. If all family members do not have major pre-existing conditions, then the agent can put the healthy family members on Non-Obamacare plans and others on Obamacare.

7. Agents will continue to answer any questions while you are still on a plan they signed you up for. Agents don’t disappear like online insurance!

8. If you need to switch a plan anytime, your agent will be able to help you.

9. Agents are able to help find new doctors or hospitals if you are new to an area.

10. Healthcare insurance agents are up to date about new laws and changes.

Top 10 Reasons Why Healthy People Should Choose a Non-ACA Plan (Non-Obamacare Plan)

Group of people at the gym in an aerobics class
Non-Obamacare Plans were created for people who have no major pre-existing conditions. Major pre-existing conditions are heart disease/stroke, cancer, chronic obstructive pulmonary disease (COPD), diabetes, human immunodeficiency virus (HIV), and substance abuse. What are the benefits of these plans? Here are the top 10 reasons why healthy people should choose a Non-ACA Plan:

1.) Nationwide PPO Plans (excellent coverage for doctors, office visits, hospital stays, surgeries, and prescription drugs)

2.) Lower deductible and out of pocket costs

3.) Many Non-ACA plans qualify as minimum essential coverage

4.) Fully customizable (you choose how much you want to pay for your monthly premium, deductible, etc.)

5.) Lower monthly premiums; ½ the cost of ACA plans

6.) Sign up anytime and cancel anytime during the year

7.) Multiple carriers who offer Non-ACA Plans

8.) Some Non-ACA plans cover maternity costs

9.) Non-ACA plans protect you if you have a catastrophic event

10.) Non-ACA plans can be short term (1 month) or long term; better alternative instead of a COBRA plan