Saturday, November 12, 2016

Temporary ShortTerm Coverage ... NOT for those with pre-existing medical conditions!



Temporary ShortTerm Plans do NOT:
- Cover pre-existing medical conditions
- Cover most preventive care (...like wellness check-ups...when you're not sick)
- Cover maternity claims (having a baby)
- Avoid the ACA (Obamacare) Tax Penalty
......The penalty MAY be waived in the future ...based on directives from Pres Trump (dated 1/20/17).

Please see more info about these subjects (below).


Temporary ShortTerm coverage is not Obamacare (ACA) coverage!!!


Read the company literature carefully before buying a Temp Policy for 2018!!!

The old 11-month policies (allowed by law in 2017) are no longer legal to buy (after Obama changed the law in late 2016....to be effective ON April 1, 2017).

You could (can) KEEP your old 11-month policy until it ended (ends)...legally.
Most of them are ending at midnight on December 31st.

But, in 2018, Obama's new law applies...
...until Trump can get congress to abolish it.

The new (current) law will only allow for 3-months of ShortTerm coverage at a time.  
See more details below.
Just look for the RED notes.




Updated:  November 5, 2017



For 2018 - The BEST Temp Plan available on the market!


Lloyd's of London Policy:


Simple benefits!
Lowest prices in Texas for comprehensive coverage!

Use any doctor or hospital.
Access to a huge PPO network for discounted medical fees...if you want.

Simple online enrollment!
Enroll in 2-3 minutes.

Instant approval-of-coverage!
Coverage can be effective as soon as "midnight" tonight.

No medical questions!
But, you must certify that you are in good health & ordinarily have no health/medical problems.


The Lloyd's policy offers the longest term (length-of-coverage) available by Federal Law!
Maximum term length is 3 months  (since Obama changed the law in late 2016...to be effective ON 4/1/17).
But, the Lloyd's policy can be renewed .... every 3 months!
You'll get an email to renew (re-apply) every 3 months. ***

Yes, Trump tried to get this very-complicated 2016 law abolished.
But, congress has not acted on his Executive Order....yet.



*** You must re-apply every 3 months (when you get your email).
You'll get a new 3-month policy...
...that allows you to receive follow-up treatment for covered accidents & illnesses that occurred in your prior Lloyd's policy.

...
You can have this protection for up-to 11 months.
If you purchase more-than 11 months of coverage:
- A new pre-existing condition exclusion will apply!
.................See page 2 of the brochure (below)

Don't buy a Temp Policy if this concerns you!!!
This leaves you vulnerable in December 2018!
You can't own an ACA policy (again) until Jan 1st, 2019...
...unless the laws change.

...
This could change (improve) if congress changes the law!
Trump knows that this law needs to be abolished....now!
But, your congressmen are obstructing.
Carefully consider the above info before buying!


The Lloyd's policy covers more than any of the other Temp policies.
It has less exclusions & limitations than any of the others.


Strong financial ratings!
...as you'll see on page 4 of the Lloyd's-of-London brochure (below).


Lloyd's of London is the oldest & largest insurance market in the world.
If you're not safe with Lloyd's, then the entire market is not safe.


All of the other Temp Policies available on the Texas market:
- Are complicated
- Are full of limits!
- Have a long list of exclusions!


Lloyd's of London is not an "authorized" USA insurer (by the Feds).
But, they are legal.
They are classified by the USA as Surplus Lines Insurance.
They pay Surplus Lines Taxes to the State of Texas.


Because they are classified by the USA as "Surplus Lines Insurance":
- You must look at Domestic Carrier coverage before you buy from Lloyd's.
......See links below to Domestic USA policies.
..........I've looked at all of them.  
............They are much more complicated & limited than the Lloyd's policy.
................I would not buy one of them for my own family!


Since I'm now over 65 (and on MediCare), I don't have a choice any longer.
But, I've owned Temp policies before...many times.

When I was a young, struggling single Mom, I bought them for myself and my young children!
Back then, in the 1970's, all that we could legally buy was a 6-month Temp policy.

Since we were normally in excellent health, I was comfortable with a policy that would end.
If you have accident-prone children, this is not for you!!!
Consider your own situation carefully!!!




Temp Plans are "free market" policies.
They are not restricted by the ACA/Obamacare Law.
....  (They existed before Obamacare...and are still legal to buy.)
That's why they are so much cheaper.
The free market still lets them compete.
BUT:
- They are free to add limits to their policies!


The Lloyd's policy is not full of limits (like all of the others)!
You'll see the Lloyd's policy Limitations & Exclusions on page 6 of their brochure.
Their list of "Exclusions" is less-than-half the size of their nearest competition...
....if we could even call the others "competition".





Lloyd's of London Temp Policy:



Brochure:            Click HERE

Page 2 - Benefits - 100% after deductible...to $1 million EACH person
Page 3 - PPO Network...not required  (Use it for reduced medical prices)
Page 4 - Monthly Premiums ...for ANY zip code in Texas

Enrollments, Billing, Admin & Claims are processed by:
Petersen International Underwriters
Valencia, California
...Serving the market since the 1970s



Quick Online Application here:
   https://zone.piu.org/short_term_medical/start?producer=05E6E4


Specimen Policy:
                                 Click HERE


Remember that these policies do not cover pre-existing medical conditions!
They cover future (unknown) illnesses or injuries...
...things that might happen during your term of coverage
....including major things that could wipe us out !!!
This is why we should be buying insurance!


We don't buy auto insurance to cover the oil changes & tune ups!
We buy it to pay for a catastrophic event!

If you don't take care of your car, you'll pay to get it fixed. 
It's not covered by auto insurance.
That's why auto insurance is still affordable.
And.....that's (one reason) why Obamacare is not !!!


Do not buy temporary coverage if you have pre-existing conditions that need to be covered by your insurance policy!

If you have an existing lump on your neck, it's pre-existing.
If you had a condition that was never diagnosed, it's still pre-existing.
If you have controlled high blood pressure or high cholesterol, that's pre-existing.


Those who need coverage for pre-existing medical conditions should buy an ACA policy during Annual Open Enrollment (or during Special Enrollment exceptions).

If you have minor conditions like "seasonal allergies", that's ok.
But, why pay twice-the-price (for ACA coverage) if that's all you have?
Your savings in monthly premiums will more-than-pay for your allergy needs.




Temporary policies will NOT cover things that EXIST ON your Policy Effective Date!

Your claims will be denied if your medical records indicate that your treatment is for a pre-x condition.






Other Temporary Short Term policies on the Texas market....offering Domestic-Carrier USA coverage




Companion Life (BCBS of South Carolina):

Prices are good....if you're only comparing price.

But, coverage is complicated and limited !



United HealthCare:
https://www.uhone.com/insurance/short-term

Complicated & limited!

UHC offers PPO Plans.
None of the Temp Plans have the dreaded HMO networks (that we're now forced to endure with ACA-Obamacare plans).


You must look at Domestic Carrier - USA coverage before you buy the Lloyd's of London policy.
They are only allowed to offer coverage if you look at "Made in America" policies first.




~~~~~~~




You probably ARE subject to the ACA Tax Penalty!


You might be subject to the Federal Tax Penalty if you don't own ACA-approved (Obamacare) coverage!

Pres Trump has asked for a waiver.
But our congressmen haven't made this legal yet!

Temporary policies are free-market policies!
....(They existed before Obamacare.)
They are still legal to buy.

But, they are not ACA-approved coverage (Obamacare approved).


They are cheaper because the prices are still driven by the free market...
...not by the federal government.

And:
- They don't cover pre-existing medical conditions
- They don't cover most wellness benefits (check-ups)
- They don't cover maternity benefits (having a baby)
- There are usually underwriting questions (to qualify for coverage)
- They'll end





You can only buy an ACA-Obamacare policy during Open Enrollment...
...or Special Enrollment exceptions (after a Life Changing Event).


2018 Deadlines to buy an ACA policy:


Nov 1st - Dec 15th......for coverage to be effective Jan 1, 2018


Unless:
You have a life-changing event that would qualify you for a Special Enrollment Date exception (during the year).

See bottom of this screen for more info about Special Enrollments.


~~~~~~~




The ACA (Obamacare) Tax Penalty is the greater of:

- 2.5% of Annual Income...with a few adjustments to AGI (Adjusted Gross Income).....See MAGI (below)

- $695 for each adult + $695 for up-to-2 children (in your tax household) = $2085 max (flat rate per family)
              $695 x 3 = $2085 Max



MAGI = Modified Adjusted Gross Income
              Adjusted Gross Income ......with a few modifications.
              Most of these modifications do not even apply for the average person.

               The only thing that applies for the average person:
                - Tax Filing Threshold
                   .......Deduct your Tax Filing Threshold from AGI


AGI = Adjusted Gross Income
           This is simply line 37 on your 1040 Federal Income Tax Return 
           ......................line 21 on your 1040A Tax Return
           ....................or line 4 on your 1040 EZ Tax Return


Tax Filing Threshold
            Add:
           Line 40 on your 1040 Federal Tax Return (for 2016)
           ....Standard Deduction
           PLUS line 42
           ....Exemptions


The penalty can be complicated for some.
So:
Consult your Tax Accountant
.....or.....
You can use this 2017 Federal Tax Penalty calculator     HERE

This is the best ACA Tax Penalty calculator left online.
If you find a better one, please send Ruth the link.
This one is not ideal.

~~~~~~~





New Law passed in 2016.......effective April 2017:

 The Federal Govt will only let you buy up-to 3 months of Temporary ShortTerm coverage!

But, we do have companies that will let you buy continuous policies.
.......Anything that's pre-existing after 3 months of coverage (that occurred during your initial 3 months of coverage) will be covered on the second 3-month policy!



~~~~~~~



I have personally owned Temporary ShortTerm coverage for myself & my own children in the past.
I always bought from a strong insurance company.
We were in excellent health.
And, I understood that I was paying for their well-child check-ups out of my own pocket.
It was a wise choice for me.

I couldn't afford permanent coverage.
But, I sure couldn't afford a catastrophic illness or injury out of my own pocket!


Everyone has different situations to consider.
No one understands your situation better than you!


Please don't ask me to make this decision for you.
I've given you the facts above.
And, I'll be happy to answer all of your questions.


I'm over 65 now & on MediCare.
So, this is not something I'm doing myself....in 2017.
But, I have done it....many times....when I was a young, struggling single Mom.......and I was very comfortable with my decision to own Temporary ShortTerm coverage.


If this huge ACA mess causes/helps our un-stable financial markets to implode, we're all in the same sinking ship together...no matter which coverage we own!

We'll all need to re-think everything (about our lives).






I'm happy to help.......all that I can!

Just call (or email) if you have questions!

We're here 7 days/week......16 hours/day.....during Open Enrollment.
Usually:
Later in the day is BEST:  4pm to 9pm

Thanks!
Ruth        
More info at: www.InsTexas.com 
888-777-0474 - Toll Free Line
713-932-9072 - Houston Line (if it's not long distance for you)


Jan 20, 2017:
Executive Order signed by President Trump is here:
https://www.whitehouse.gov/the-press-office/2017/01/2/executive-order-minimizing-economic-burden-patient-protection-and

But, most changes to Obamacare must be formally passed by congress.



~~~~~~~


ACA (Obamacare) Open Enrollment.......for 2018 coverage:

     Nov 1 to Dec 15, 2017 

Coverage will be effective 1/1/18

Quick ACA Quotes.....anytime..... HERE


~~~~~~~

Special Enrollment Exceptions:


You can't normally buy ACA (Obamacare) coverage after Open Enrollment ends!

But, there are exceptions.....including:

- Loss of coverage (at no fault of your own)

- Changes in household size
.....Marriage, divorce, death, childbirth, adoptions

- Moving to a NEW county
....This one can be really complicated!
....We'll help you wade through the red tape.

- New US citizens

- New classification as a Native American or Alaskan Indian

- Release from incarceration

- Domestic abuse/violence


You are limited in your plan choices during an SEP enrollment for many of the above exceptions.

The rules are complicated!
And, each SEP exception has different rules.

With many/most SEP exceptions, you'll have a 60-day window to buy coverage.

Some exceptions require at least 1 day of ACA coverage within the past 60 days.

Some will only let you change to a new plan in the same Metal Level (Bronze, Silver or Gold Plan)....unless you've had a substantial change-in-income that gives you an opportunity to buy a Silver Plan with better benefits.

The entire law is complicated !!!
We'll be here to help you when you need us!