June 15, 2018 Jonathan Nolan

Avoiding Insurance “Scams”

The passage of the Affordable Care Act clarified some important points within the health insurance industry. You can call anything “insurance”, but as far as the new law goes, an insurance plan must meet some fairly strict guidelines in order to be compliant.

“Compliant”, in this case, means that the health insurance plan meets minimum standards. For consumers, these standards help to ensure that the plan in which they’ve enrolled is a good one that provides real value. What it means for you, as an individual or a business owner, is that by enrolling in this plan you’ve fulfilled your obligation in complying with the ACA.

The Bronze tier of plans is the most minimal level of coverage that you can obtain, while still accessing an ACA-compliant plan. These plans come with a $5,000 deductible, in exchange for the lowest premiums (as compared to the other tiers of plans). Bronze plans also offer a $6,250 out-of-pocket maximum, provide all required preventive services, and offers three office visits per year, at a price of 60 dollars, before you have to pay toward your deductible.

Here’s a problem that sometimes happens: Sometimes after you’ve purchased one of these Bronze plans, an insurance agent might offer you a supplemental insurance plan to go along with it. This offer can feel tempting, because you do have a high deductible and you worry about affording your healthcare throughout the year.

Many terrific supplemental insurance plans do exist on the market. However, buyers should understand that some of these plans include clauses, stating that the plan won’t cover anything that is already covered by your primary insurance plan. So, if you’re under the impression that a supplemental plan will kick in and cover something, simply because you haven’t yet reached your deductible, that might not be the case. You could find yourself paying premiums for a supplemental plan that rarely pays out any claims.

Please make sure to read any fine print carefully. And as always, don’t hesitate to contact us if you have any questions. We can help you understand what your insurance plans do, and do not, provide.

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