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Not All Health Coverage is Created Equal – Get the Facts! by Laura B. Sedlacek

LENOIR, NC (July 26, 2019) — People are always on the look-out for a bargain which of course includes their health insurance options.  Plans sold through the ACA Marketplace as well as most plans purchased through an employer have consumer protection laws that for the most part govern them.  But there are other plans out there somewhat masquerading as health coverage where there are not protections in place for consumers.

These types of plans with no consumer protections are discount plans, risk sharing plans and health care sharing ministry plans.  The best way to protect yourself as a health care coverage consumer is to either take out traditional health care coverage such as ACA Marketplace plans or perhaps an employer-based health plan or to educate yourself about the non-traditional option you prefer.

Health Care Sharing Ministry plans are organizations where members share the costs of health care. The members may have common ethical or religious beliefs. These plans don’t have to comply with the Affordable Care Act.  For example, ACA Marketplace plans cover treatments for pre-existing conditions and cap your out-of-pocket costs, but Health Care Sharing Ministry plans don’t have to do that.  A Health Care Sharing Ministry plan is not insurance and doesn’t guarantee payment of claims. They may share funds with members with health needs but legally they aren’t required to do so. State insurance regulators do not supervise them either and there are no provider networks so members may pay full price to doctors and hospitals.  While these plans may help some, they can be risky due to their limited benefits.

Discount plans offer discounts on health care for a monthly payment.  Again, this is not health insurance no matter how much it “looks” like it is.  There are no consumer protections.  Often these so-called discounts are ones you could negotiate or find yourself without paying a monthly fee.

Non-Licensed Risk Sharing Plans are groups or an association that take your monthly fees and then put them in a trust or savings account along with funds from other people who are participating.  Then as needed they may help pay some of your health expenses.  However, these are not insurance plans and there are no consumer protections.

Because none of these plans:  health care sharing ministry, discount plans, or non-licensed risk sharing plans are actually insurance you need to be beware before you sign up with them!  While you may pay less per month in premium, what consider what will happen when you need health care and it is not covered?  While an individual health ACA Marketplace plan and/or group plan may cost you more in premiums, ask yourself how much would it cost you if you had to pay your medical expenses out of your own pocket which you very well may with one of these non-insurance type plans!

No matter what decision you make, check in with your local insurance professional for all the facts!

~Bush and Associates insurance offers Free complimentary quotes, with no obligation, on ACA Individual Health, Group Health, Short-term Health, Dental, Vision, Life, Disability, and Medicare Supplements.  You can reach them at (828) 754-2601 or quotes@bushandassociates.net or online at www.mynchealthplan.com   Or visit with them in person at 916 Wilkesboro Blvd. Lenoir, NC