It is that time of year. Time to renew your Medical Insurance for 2019. Open Enrollment goes from November 1 thru December 15. This is the shortest Open Enrollment period since the inception of the Affordable Care Act. This year will be one of considerable uncertainty. The Affordable Care Act (ACA) was designed to insure everybody but in 2019 the mandate to have Medical Insurance is no longer.
You will not be penalized or fined for not having medical insurance. So, you can choose to be un-insured, which was the reason the ACA was needed in the first place. Because being uninsured does not mean you will not get sick or injured. It just means you can file for bankruptcy.
The purpose of Medical Insurance is “In the event of illness or injury, there are funds available to pay for your care and recovery”. If you were to break your leg the bill will be $15,000. If you were to have a stroke or a heart attack the bill will be $150,000. If you were diagnosed with cancer the bill will be more than $250,000. Are you able to pay if your number comes up? I’ve been helping people for over 25 years and it really comes down to if your number comes up.
Billionaires get cancer, babies get sick, and everyone in between. You can exercise, eat right, and be good to animals and your number can still come up. So just because you don’t have to have coverage doesn’t mean you don’t need to get coverage. If you can foresee the future, please tell me which stock will be the next Microsoft or Amazon.
For now, the ACA is still in effect, if your income is below the threshold, you will continue to receive credits and reductions to keep your insurance premium manageable. The real challenge is when your income exceeds the threshold. That’s when it gets tricky.
Household Size Income Limit
- 1 – $48,560
- 2 – $65,840
- 3 – $83,120
- 4 – $100,400
- 5 – $117,680
- 6 – $134,960
- 7 – $152,240
- 8 – $169,520
If your income is below these limits you will continue to receive tax credits which reduce your premiums and your children will still be enrolled into Apple Health. But if your income exceeds these limits you can expect to pay another 30% for your medical insurance.
This is why I believe 2019 will be the year of Community-Based Medical Expense Sharing.
These programs are not Medical Insurance however, they share many of the same attributes of Medical Insurance. If it walks like a duck, and it quacks like a duck, it’s probably a duck. Well kinda.
They can restrict or exclude preexisting conditions – medical insurance companies do not like paying for things that happened yesterday. Can you really blame them, if I could give you $100, and then you would have to immediately give me a $1,000, would you do it?
These programs have coverage limits, where ACA plans have no limit. Would you rather know how much money you are on the hook for, or not?
These and other differences are the reason they have lower premiums. You can pay $750 per month for a Mercedes or you can pay $250 per month for an Escort. The Escort will not have heated seats, but it will get you to your destination.
During Open Enrollment I will be able to help you to determine benefits from Kaiser Permanente, Premera Blue Cross, Molina and Ambetter, ALLSTAR Financial Insurance will also be able to help you with:
Community-Based Medical Expense Sharing