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Health Insurance Resources

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Most insurance companies are highly ethical and will tell you exactly what your plan covers.

But you have to watch out!  There has recently been a rise in deceptive marketing of mediocre and bad health insurance plans.

Answers to Your Questions

What is Health Sharing?

Health care sharing ministries are organizations in the United States in which health care costs are shared among members who have common ethical or religious beliefs. A health care sharing ministry does not use actuaries, does not accept risk or make guarantees, and does not purchase reinsurance policies on behalf of its members. 

Members of health care sharing ministries are exempt from the individual mandate requirement of the U.S. Patient Protection and Affordable Care Act,

often referred to as Obamacare (the individual shared responsibility provision was repealed in December 2017, effective in 2019). This means members of health care sharing ministries are not required to have insurance as outlined in the individual mandate.

Approximately 30 states have safe harbor laws that distinguish healthcare ministries from health insurance organizations.

Some of the larger health care sharing ministries include Christian Healthcare Ministries (established around 1981),  Medi-Share, a program of Christian Care Ministry (1993),  Samaritan Ministries (1994),  Liberty HealthShare (1998), United Refuah HealthShare, MCS Medical Cost Sharing and Altrua HealthShare 

 

What Are Assocation Plans?

Association Health Plan 

In the late 1990s federal legislation had been proposed to “create federally-recognized Association Health Plans which was then “referred to in some bills as ‘Small Business Health Plans. The National Association of Insurance Commissioners (NAIC), which is the “standard-setting and regulatory of chief insurance regulators from all states, the District of Columbia and territories, cautioned against implementing AHPs citing “plan failures like we saw The Multiple Employer Welfare Arrangements (MEWAs) in the 1990s. 

Small businesses in California such as dairy farmers, car dealers, and accountants created AHPs “to buy health insurance on the premise that a bigger pool of enrollees would get them a better deal. A November 2017 article in the Los Angeles Times described how there were only 4 remaining AHPs in California. Many of the AHPs filed for bankruptcy, “sometimes in the wake of fraud.” State legislators were forced to pass “sweeping changes in the 1990s” that almost made AHPs extinct. 

According to a 2000 Congressional Budget Office (CBO) report, Congress passed legislation creating “two new vehicles Association Health Plans (AHPs) and HealthMarts, to facilitate the sale of health insurance coverage to employees of small firms” in response to concerns about the “large and growing number of uninsured people in the United States.

In March 2017, the U.S. House of Representatives passed The Small Business Health Fairness Act (H.R. 1101), which established “requirements for creating a federally-certified AHP, including for certification itself, sponsors and boards of trustees, participation and coverage, nondiscrimination, contribution rates, and voluntary termination.

AHPs would be “exempt from most state regulation and oversight, subject only to Employee Retirement Income Security Act (ERISA) and oversight by the U.S. Department of Labor, and most proposals would also allow for interstate plans.

What is Term Life Insurance?

Term life insurance or term assurance is life insurance that provides coverage for some sum of money during a given period of time. After the term stated in original contract expires, the sum of money paid to insurance company will need to be renegotiated and will often increase. Term insurance is the cheapest way of buying live insurance.

Term life insurance is the original form of life insurance and is different to permanent insurance because its rates will not go up, and there is a fixed term contract, which will end in the future. Permanent life insurance contracts can last until the death of insured person, but the rates will slowly increase over time.

Because term life insurance is only death insurance, it is used to cover mortgages (guarantee that the bank will receive their money), payment to the families (upon death of insured person his family will usually receive repayment for funeral costs and in some cases will get some money), repayment of debts.[1]

The simplest form of term life insurance is a one-year contract. The death benefit will be paid if the insured dies. If he does not die during this the coverage period no claims are paid, and a new contract must be written.

Term life insurance is the most affordable type of life insurance because it is temporary and builds no cash value inside the policy over time. Term life is “pure protection”, not an investment.

Level term life insurance is a type of term life insurance plan that has guaranteed level rates and amounts of coverage for the entire term of the policy.

Level term life plans may offer coverage with level rates for a period of 10, 15, 20 or 30 years. Some term life insurance plans provide life insurance to age 65 or 70, but your rate will increase after the “level term” period.

What Is Short Term Health Insurance?

In the United States, short-term health insurance or “Short-term, limited-duration insurance” (STLDI refers to health insurance plans with a limited duration, typically several months to a year. These plans are geared toward people who need temporary medical insurance to bridge the gap between longer term plans. For instance, people who are switching employers, starting graduate school, or young adults who have become ineligible for coverage under their parents’ plans and are searching for their own insurance might use a short-term insurance plan until obtaining a more permanent solution.

Short-term health insurance plans are typically less expensive than traditional plans, but do not cover pre-existing conditions. This can cause problems for people who acquire a longer term illness, since the short-term plan is completely terminated at the end of the coverage period. Short-term plans are not considered “adequate coverage” under the Affordable Care Act so customers would also be subject to the tax penalties of being uninsured in 2010-2018.The tax penalty was eliminated under the Congressional Tax Cuts and Jobs Act starting in 2019. 

The length of short term plans was extended to up to 365 days in most states, lifting a prior 3-month term limit. 

In 2018 the Congressional Budget Office broadened its definition of health insurance to include short-term health insurance 

Starting in 2019 consumers will be able to purchase short-term plans which are renewable for up to 3 years in some states. 

Short-term, limited-duration health care plans are not available for purchase on HealthCare.gov or state operated health insurance marketplaces. They are not required to cover everything that Marketplace plans require, preventative treatments, or pre-existing conditions. They are not eligible for federal financial aid but the monthly healthcare premiums may be less expensive. 

What is Medicare?

Medicare is a national health insurance program in the United States, begun in 1966 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS). It provides health insurance for Americans aged 65 and older, younger people with some disability status as determined by the Social Security Administration, as well as people with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease).

In 2018, Medicare provided health insurance for over 59.9 million individuals—more than 52 million people aged 65 and older and about 8 million younger people.[1] On average, Medicare covers about half of healthcare expenses of those enrolled. Medicare is funded by a combination of a payroll tax, beneficiary premiums and surtaxes from beneficiaries, co-pays and deductibles, and general U.S. Treasury revenue.

According to annual Medicare Trustees reports and research by the government’s MedPAC group, enrollees almost always cover remaining out-of-pocket costs with additional private insurance, by joining a public Medicare health plan, or both.

Medicare is divided into four Parts. 

Medicare Part A covers hospital (inpatient, formally admitted only), skilled nursing (only after being formally admitted to a hospital for three days and not for custodial care), and hospice services. 
Part B covers outpatient services including some providers’ services while inpatient at a hospital, outpatient hospital charges, most provider office visits even if the office is “in a hospital”, and most professionally administered prescription drugs. 
Part D covers mostly self-administered prescription drugs. 
Part C is an alternative called Managed Medicare which allows patients to choose health plans with at least the same service coverage as Parts A and B (and most often more), often the benefits of Part D, and always an annual out-of-pocket spend limit which A and B lack. 
A beneficiary must enroll in Parts A and B first before signing up for Part C

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