As Paul Harvey would say.. “and that is the rest of the story”

As Paul Harvey would say.. "and that is the rest of the story"

I was reading an article yesterday, it was written in a journal called “Mother Jones” about the canceling of policies under the Affordable Care Act.  The article talks about Michelle Malkin’s plan that was a Health Savings Account, which under the law, no longer meets the standard of the Affordable Care Act.  I too had one of these plans. My plan had a family deductible of $5200.  The only, what are called essential benefits under the ACA that it did not have was maternity coverage, which I do not need.  It was not a so called “junk” policy or a subpar product.  Quite honestly, it was structured how all policies should be structured.  When I purchased the policy I had the option to buy maternity, but I do not need that benefit.  It had what was called an out of pocket maximum of $5200 same as the deductible.  It was perfect for my needs.  I also have what is called an accident policy which also covers some of my deductible if I have an injury.

The author of the article basically says it is a “rip off policy” then she refers to a company who sold predominately limited benefit plans and some Blue Cross plans that are limited benefits and insinuates that is the same as a high deductible health plan.  Two separate things.  Now there is a place in the market for Limited plans, normally for people with limited resources, and often times they make sense.  The problem with them is they have a “limit” on all services as to how much they pay for each service.  If your procedure exceeds that amount you are responsible of all charges.  Limited plans are dangerous. I can  understand why you may not want them sold.  Again, I would state as long as the client knows the risks, then maybe it is ok.  I would also guess that many times the client does not completely understand how they work.

However, a Health Savings Account or a High Deductible Health Plan, are not limited.  On my cancelled plan, if I had a claim that was $1 million dollars, I would have been responsible for the first $5200 and that is all.  If you look at many of the ACA plans you will now see a family deductible of $12,700.  Some do not have co-pays (I am ok with that).  The Plan Blue Cross Blue Shield of Illinois was going to move me to after cancelling the policy was a $6000 individual deductible $12,700 family deductible with maternity coverage which I do not need and my premium was going to INCREASE by $120 per month.  Which plan would you take?

The article continues about a realtor in Florida who had a policy cancelled, but it was a “supplemental policy”, ok that is not a major medical plan nor is a limited benefit plan.  There is a huge difference between the supplements, limited plans and a major medical plan.

Here is my last point, both the proponents of the Affordable Care Act and the writer of the Mother Jones article entitled “The Real Story Behind the Phony Cancelled Health Insurance Scandal” continue to say the new ACA plans come with Free preventive care.  Please understand that these costs are built into your premium.  They are not “FREE.” I would also argue if you really look at the purpose of insurance, whether it be Health or Auto or Home insurance, it should be for things you cannot pay for, that is why you have insurance.  I can afford to pay $100 for a physical.  Just like I pay $30 or so two or three times a year to get my oil changed in my car, which by the way is a preventive service for my car.  The more you add to a policy the more it will cost.  Maybe we should make the minimum standards offered by each carrier and allow the consumer to decide what he needs.  I am quite certain I will never give birth, yet the Affordable Care Act increases my premium for that service.  As Paul Harvey used to say.. and that is the rest of the story.

Thanks for reading.

Eric Wilson
Eric Wilson
Eric has been serving clients throughout the country since 2004. He Specializes in Individual Health, Group Health, and Medicare, and planning a tax-free retirement. He is also an expert on the Affordable Act. I am passionate about what I do, and it shows in my work and proven track record. Want to learn more? Follow me on my social channels, or contact me directly - I’d love to hear from you!

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