With all the past, current and future unknown changes to health insurance, an independent agent who keeps up to date on health plan options can bring some stability to your health care coverage. Having adequate health insurance is crucial to mitigate the risks of catastrophic financial loss from a serious accident or illness. The process of selecting a “best fit” plan can provide advantages to maximizing coverage and minimizing cost. Saved premium dollars found through an effective analysis and selection process can potentially be moved to Health Saving Accounts or invested for future financial needs.
As an investment advisor representative who also specializes in health plans, I have been able to find significant reductions on monthly premiums for some of my clients. We are then able to reallocate those saved premium dollars to long term savings and investments such as ROTH IRAs, traditional IRAs, managed accounts, mutual funds or other products that have reduced risk. These savings can be achieved by shopping different health insurance companies or by going through the state exchange / health insurance marketplace and getting an APTC (annual premium tax credits) applied to monthly premiums (lowering the overall monthly premium cost).
Another option to reduce expenses is health cost sharing programs. These are mostly faith-based organizations that pool monthly contributions from all members to cover the medical cost of other members who make claims. These programs are not legally considered health insurance by state health insurance laws, but the four major health cost sharing programs are recognized by the federal government and their members were exempt from the mandate penalty under the ACA (Affordable Care Act, aka Obamacare). One of the leaders in this category, Medi-share has been effectively sharing medical expenses with its members since 1993.
Looking to the near future of health plan coverage, open enrollment for traditional health insurance is November 1st – January 15th in most states. If a person has a qualifying life event (losing health insurance, birth of a child, marriage, moving out of state, etc) , he/she can also enroll in a new plan within 60 days of the event. With the ACA mandate penalty cancelled by legislation in 2017 and a current case before a federal appeals court that could render the ACA unconstitutional, there are many unknowns about future of health insurance. Also, many Democrat presidential candidates are calling for a one pay government health care system and doing away with private health insurance options. All the above create much speculation about what health insurance will look like in the future.
Add some control and predictability
Bottom line, an informed agent who keeps up with the latest changes in the health insurance and health cost sharing industries can help remove much of the uncertainty. Each year an agent can assess the best program for each client based on the most current laws and programs available. Each year, insurance companies and health cost-sharing programs adjust to meet the legal and economic realities and can offer new plans. Knowing what plans and options are available is where an agent can help find the best fit for his/her clients. Again, maximizing coverage and minimizing cost are the two key considerations. Any savings can be added to a family budget or be reallocated to long term savings.
Below are the major options for individual health insurance or cost sharing programs:
- Direct to health insurance companies. Best for individual with income too high to qualify for a tax credit through a state exchange.
- Go through a state exchange (like Connect for Health Colorado) to qualify for an APTC which will lower the premium for a plan through a health insurance company (like Anthem, Cigna, Friday Health Plans, etc)
- Join a health cost sharing program such as Medi-share, OneShare, Samaritan Ministries, etc. I have literally saved some of my clients hundreds of dollars a month with this option. However, these organizations can exclude for pre-existing conditions. They can also exclude membership for behavior that does not adhere to their values.
There are also separate programs for businesses and non-profit organizations to provide health insurance coverage for their employees. The same variables listed above need to be considered for group health insurance plans. I’ll cover that in a future blog.
Author: Al Kearse, Founder, Steward Financial Solutions
Colorado Springs, CO 80920
719.532.1990 ext 235
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