If you are not yet on Medicare, and you are responsible for
providing your own health insurance in 2017, the news continues to worsen. Last
week Aetna announced that they will not participate in public markets in 46
different states, including the most populous ones. There is speculation that
Aetna made this move in retaliation for the federal government’s pushback on Aetna’s
proposed takeover of Humana but, regardless of the motivation, consumers will
have one less major carrier from which to choose coverage next year.
This series is devoted to preparing you for next year and
arming you with as many alternatives to Obamacare as possible. I have already
identified alternatives in two previous articles, both of which may result in
better coverage, greater choice of doctors and hospitals, lower monthly costs,
lower out-of-pocket costs when you use your plan, and potential net savings of
thousands of dollars, even for those who will pay a fine for not having an
Affordable Care Act-compliant plan. Specifically we discussed short-term health
insurance plans and health care sharing ministries.
No health care plans are perfect, and even the very best
plans are designed to assure that everyone in the “chain of care” gets
compensated…doctors, hospitals, clinics, pharmacies, therapists, and other care
givers. No health care plans, however, are designed to potentially provide
extra cash for patients. Think about it. When you are sick or injured there are
many forms of economic losses to you in addition to the cost of medical care.
Here are several:
·
Lost pay from time off
·
Lost pay for your spouse or partner if they are
required to care for you while you recuperate
·
Travel and parking expenses
·
Deductibles, co-payments, or other unshared amounts
·
Substitute child care, parent care, or pet care
·
Experimental treatments and medications not covered by
your health care plan
·
Modifications to your home should you have special
needs as a result of your medical condition
Fortunately,
there are a number of supplemental products, with more being introduced all the
time, that provide direct cash payments to you to help replace most, if
not all, of the expenses mentioned above. These products may be purchased
individually, and, if properly combined, they can build a wall around your hard
earned resources so that a medical crisis doesn’t also turn into a financial
crisis. Here are some brief descriptions of these affordable plans:
·
Hospital
Indemnity Plans – the best versions of these plans pay:
o Up to
$6,000 per day of hospital confinement
o Up to
$6,750 per day of intensive care confinement
o Up to $600
per day for confinement for mental illness, alcohol, or substance abuse
o Up to
$2,250 per day for a rehabilitation or skilled nursing facility
o Up to
$2,250 per day for outpatient radiation or chemotherapy
o Up to
$4,500 per day for outpatient hospital or ambulatory surgical center
o Additional
cash benefits for surgeries (amounts depend on type of procedure), including
benefits for assistant surgeons and anesthesiologists
o Additional
cash benefits for pathology and radiology services
o Up to $80
per day for outpatient physician visits
o Up to $525
per day for diagnostic, lab, and imaging services
o Up to $15
per day for generic prescriptions
o Up to $400
per year for emergency room services
o Up to $100
per year for urgent care center services
o Up to $125
per year for preventive care services
o Up to
$1,500 for emergency ambulance services
·
Critical
Illness Insurance Plans – a sudden illness can have a devastating effect on your
finances – these plans pay lump sum,
tax-free benefits of up to $250,000
directly to you to use as you see fit – plans cover:
o Heart
attack
o Cancer
o Stroke
o Kidney
failure
o Organ
transplants
o Coronary
artery bypass surgery
o Angioplasty
·
Accident
Insurance Plans – the best among these plans provide up to $100,000
in benefits for:
o Household
accidents
o Job-related
accidents
o Sports or
recreational accidents
o Automotive
or boating accidents
o and more
Most
importantly these plans’ benefits are paid directly to you to use any way you
choose. Too often you have no control over the way that benefits are paid, and
to whom they are paid, on a traditional health care or Obamacare plan. These
supplemental plans give you the tools that let you choose a low-cost,
catastrophic health care plan and use your supplemental benefits to take care
of smaller medical bills and, most importantly, to take care of you, your family,
and your finances.
For 2017 the maximum out-of-pocket costs for Obamacare plans
is increasing to $7,150 for individuals and $14,300 for families. Now is the
time to prepare your strategy for next year.
Thanks
for reading.
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