AFORDABLE CARE ACT MADE SIMPLE

We all know through experience that Our government could complicate a one float parade and so it is with the Affordable Care Act. However there are a few people out there that work with it for a living, they are experienced insurance brokers like me. My name Is Jeff Mathis and I am well educated in the new era of health insurance and it isn't what most people think it is, Obama Care or nothing. There are alternatives and loopholes you should know about. The purpose of this blog is to inform people about how to navigate a more complicated system and to make the right choices for themselves and their families based on real knowledge not the propaganda you get on cable news.

First let me describe in simple terms what the the Affordable Care Act actually does. First and foremost it does provide healthcare coverage for millions of people who would otherwise be without any health ins. care at all. Keep in mind when someone is uninsured and gets sick we pay for it one way or the other through Medicaid or higher costs. This is America, healthcare is not free and we have to pay for our healthcare one way or the other. The ACA provides a situation where a person or family can take responsibility and take care of their own healthcare costs themselves. The people who benefit most from the ACA are those whose income was relatively low and insurance was unaffordable yet they would not qualify for Medicaid These are working people who were priced out of the traditional health insurance market. The other class of beneficiaries was people with preexisting conditions that caused insurance companies to reject application or excluded the condition from coverage. The ACA did in fact help all these people.

Who got the shaft? People who had insurance before the ACA found themselves paying much higher premiums, higher deductibles and often had to change doctors. I have seen this many times and there is no denying that premiums went up for many people and not just a little but a lot. Other problems are portability and sometimes small networks of providers.

There are also nasty consequences for not getting an ACA plan that will get worse each year. (see the penalty page) What most people don't know and the Government won't tell you much about is that most people will be exempt from penalties for many different reasons. One of the most common is income.

Explanation , If the lowest cost Bronze ACA plan in your zip code has an annual cost greater than 8% of your gross adjusted income you are exempt.

Example:

One of my clients has an income estimated at 42K for 2015 and about the same for 2014. His adjusted income is about 31K , that would be the adjusted gross income.

The lowest cost bronze plan is about 420/month which amounts to $5,040 for the year. If you divide that by .08 it comes to 63K. In other words he would have to make well over 63K to be hit with a penalty. It was not even close. At Tax time ask your tax person for the appropriate form to fill out and file for the exemption.

Tax advisers and preparers are forbidden by law to even bring this up. You must ask.

So, should he just blow it off and get no health coverage because he can? The bottom line is that if you are not covered and have to go the hospital for illness or injury you could be bankrupt period, no doubt about it. Medical bills are by far the leading cause of financial ruin in this country.

There is a solution for my client which I presented to him that solved the problem and that was how do I get health insurance that isn't so expensive? The answer is;

TERM HEALTH INSURANCE

Term health insurance is lower cost for several reasons. It requires underwriting

so preexisting conditions are not accepted or at least excluded for a period of time.

They also often have a high deductible and higher co pays. I hear a lot of people say well what good is a 10K deductible and a 30% co pay? The answer is no one ever went bankrupt over 10k. The maximum out of pocket total expense is also

10K or less.

If you are otherwise healthy and want to be covered but don't want to pay the high premiums of Obama Care this is the way to go. Terms run from 30 Days out to one year and must be renewed each year.

The reason they are termed non qualifying is because they more resemble the old traditional healthcare insurance in that they exclude certain preexisting conditions

and limit life time benefits usually to about 1 million dollars.

To get a quote on a Term Healthcare Plan and see if you are exempt from a penalty (click here). You could save hundreds of dollars. Remember this only works if everyone is healthy. But if there is someone with health issues this can be circumvented, To find out (click here).

Open Enrollment

This is the time period designated by the Government that any person can choose to enroll in an ACA plan. You can continue your current plan, Change plans, Choose to drop out of the system (not recommended) without any qualifications

other than Income. This time period starts in the last quarter of a year and extends through the middle of the 1^st quarter of the following year. It is usually best to get it done at leased 30 days prior to the expiration of your current plan so there is no gap in coverage. Applications submitted before the 15^th of the month will have an effective date of the 1^st of the following month. Applications submitted after the 15^th will have an effective date on the 1^st of the month after the following month.

Example:

I apply on December 10^th my effective date will be Jan 1^st . If I apply on December

20^th my effective date will not be until Feb 1^st. To avoid gaps plan accordingly.

The best way to insure there are no problems and especially if you will be applying for a subsidy on the market place use a good broker. I make it a point to remind all my clients well ahead of time so that they will not have a gap in coverage. Keep in mind that a Broker will shop for the best available plan based on your needs and will discuss this with you before submitting a quote. You will also save time and the frustration of navigating the system. A Broker can also help you avoid costly mistakes. The good news is that a broker assisted enrollment in an ACA plan costs you nothing. If you have questions about open enrollment or what kind of plan you should have you can contact me (click here), I would be happy to answer any questions. There is absolutely no obligation.

What is the alternative to ACA major medical plan

DO NOTHING

-No premiums to pay

-No health care coverage

-May be penalized at tax time

-Risk financial ruin from medical costs

BUY A SHORT TERM HEALTH INSURANCE POLICY

-LOWER PREMIUMS

-EXCELLENT HEALTH CARE INSURANCE

-DON'T PAY FOR WHAT YOU DON'T NEED.

WHO SHOULD CONSIDER A SHORT TERM PLAN?

The person that is best suited for a Short term plan is Someone who is in good health, not qualified for a subsidy on an ACA plan, or is temporally uncovered because of employment changes. The reason these plans are referred to as NON

Qualifying plans is due to the Underwriting and life time benefit limits. The bottom line is that anyone who can meet the underwriting criteria can purchase a Short Term Plan. Below is a short list of reasons to consider a Short Term Plan.

• Self employed (shows a low income on tax returns)
• Will not qualify for a subsidy for an ACA Plan
• Will be exempt from any penalty (talk to me to find out)
• Travels or needs portability
• Healthy individuals and families who will meet underwriting guidelines
• Need to get out of an expensive COBRA but still wants coverage
• Blew off Obama Care but still would like Healthcare Insurance.

Should you go with a Short Term Healthcare Plan? I don't know but I would be

happy to talk to you about the alternatives to the ACA major medical plans. For more information (click) here.