Never too Early to Prepare for Next Year

If you are responsible for providing your own health insurance and you are currently covered on a plan that is offered through the health insurance marketplaces, the time to prepare for 2017 is now. Early reports from around the country on marketplace offerings for next year are not looking good. Carrier exits, smaller networks, higher premiums, and higher out-of-pocket costs are all forecast or already announced.

For example:

• In Illinois, one of a handful of health insurance cooperatives that were still left from the 23 that were originally created after passage of the Affordable Care Act, recently failed. It does not even have the monetary reserves to insure its members through 2016.
• In Arizona, BlueCross BlueShield of Arizona will not be offering plans in the Phoenix area, by far the state’s largest population center.
• In Texas BlueCross BlueShield of Texas has requested a 53.7% rate increase for 2017.
• UnitedHealthcare announced early in the year that they do not intend to offer plans in nearly any jurisdictions in 2017. Aetna and Humana are reconsidering their marketplace involvement as well.

This article is the first in a series that will explain alternatives to the Affordable Care Act (ACA), also known as Obamacare, and to the health insurance plans that are offered by the public marketplaces.

Today’s article is devoted to Health Care Sharing Ministries, one of the primary alternatives to the ACA. Health care sharing ministries are organizations, some of which were formed as early as the 1980’s, that are comprised of like-minded religious individuals who share in each other’s medical expenses. Members must adhere to common ethical or religious beliefs. The guidelines of the ministries restrict benefits for services such as pregnancy out of wedlock, contraception, and other medical practices that may violate religious doctrine.

Members of these ministries are encouraged to lead healthy lifestyles and form good health habits. Consequently, the costs of “sharing contributions” are often significantly lower than comparable health insurance premiums because members incur fewer and less severe claims.

Under the Affordable Care Act members of health care sharing ministries are exempt from the “fines” otherwise known as Individual Shared Responsibility Payments for persons without health insurance for more than two months of the year.

For information about the federal exemption for members of a health care sharing ministry click this link.

 Health care sharing ministries are not for everyone because of the obvious religious requirements, but there are other things to consider as well before switching to this form of health care. Some, but not all, of these limitations are:

• Coverage is not guaranteed. Applicants must complete a medical questionnaire and be approved in order to qualify.
• Pre-existing conditions often have limited, or gradually increasing coverage during the first few years of membership.
• Most of these plans limit the dollar amount of coverage per medical condition.
• There are usually limited benefits for routine preventive care.

One possible way of offsetting some of these limitations is to add supplemental coverage in the form of accident plans, critical illness plans, telemedicine services, and medical indemnity plans, some of which can add up to $5,000,000 of additional coverage. More about these plans will be the subject of future messages. Since health care sharing ministry plans are often 25% to 65% lower in cost than Obamacare plans there is often room in the health care budget for one or two of the low-cost supplemental plans.

In light of the exploding rates and shrinking networks for Obamacare plans, a health care sharing ministry may just be an affordable and sensible solution for your health care needs in 2017 and beyond. For more information contact us at info@wwins.com

Thanks for reading.

Alan Leafman, President/Blogger
Toll Free: 800-955-0418
E-Mail Info@h-ie.com or info@wwins.com