Health insurance has become a nightmare in the past 4 1/2 years. The prices have skyrocketed and I do not know anyone who has not been affected by the results. Some of the “pros” of the Affordable Care Act have been:
All preventative is covered by“no money out-of-pocket”. (However, for instance, if you are going in for a colonoscopy and they find an issue, then that procedure is now curative rather than preventative. That means you will have to pay your co-pay or coinsurance for that procedure. As long as your test results come back normal the preventative procedure is “no money out-of-pocket.” This scenario is true of all insurance, whether it is individually purchased or purchased through the state health care website.)
There are no longer health underwriting issues to deal with. As long as you purchase insurance during the open enrollment period or under a special enrollment period it does not matter if you have past or current medical issues. You do not pay any more for insurance than somebody who is perfectly healthy at your age. Gender is no longer a premium factor, in the past men were cheaper to insure than women up until the age of 50/55. Then women became cheaper to ensure.
The major drawback or “con” of the Affordable Care Act is that it is mandatory to purchase insurance. Recently President Trump rescinded that part of the law, so next year there will no longer be penalties if you do not purchase individual health insurance as of January 2019.
Another negative, in my opinion, of the Affordable Care Act, is that many health benefits were made mandatory for the insurance companies to cover. When these benefits were made mandatory for all insurance companies to offer it greatly increased the cost of providing health care. The companies have had to make a lot of changes to be compliant.
The drawback of this is that health insurance is no longer true “insurance”. You cannot legally drive a car without having automobile insurance in most states, however, you cannot purchase automobile insurance after you have had an accident and expect that those accident damages will be covered. In the same token, if you do not have fire insurance in place on your house, you cannot after the fact purchase fire insurance to pay for the damages caused by fire. It is simple logic.
The way all true insurance works is that everybody jumps into the “pool” before they have a need so that when they have a need there is money state-regulated healthcare set aside to cover it.
Another problem with Fed/State regulated healthcare occurs when people choose to purchase the insurance with subsidies. You must estimate what you are going to earn the year before you earn it. If you are in a job where you get a paycheck every week and your hours are stable, then that is probably not a big issue. But for the majority of people who use the subsidies, they are small business owners who have no clue what they are going to be earning the following year. What happens in that scenario is that you may end up earning several thousand dollars more than you thought you were going to earn, but you reported what you anticipated based on your history, so you got this nice big fat subsidy to where your premium was very, very low. After you do your taxes for that year and Access Health in CT is notified of the increase in income, they come back and bill you for the money that they gave you in excess of what you should have gotten based on your true income rather than your estimated income. I have had clients who had to pay $3000, $5000 or more.
Another issue with purchasing insurance through Access Health Connecticut with subsidies is that if you are 55 or older and they have to pay a lot of money out on your behalf for medical issues, at your passing they pull what they paid out on your behalf out of your estate.
You may, however, purchase health insurance through Access Health Connecticut without subsidies and then the 2 scenarios directly above do not apply. I have helped almost all of my clients use AHCT without subsidies this past year, beginning January 2018, because it saved them literally hundreds of dollars a month. In order to do this, I had to take a cut in commissions, but I would not be able to sleep at night if I didn’t offer this option. I get paid $10 a month per person up to a maximum of 2 people with ConnectiCare and $5 with Anthem Blue Cross and Blue Shield a month per person, Max 2 on a policy before I was getting $16 a month per person. But it would cost my clients $200, $300 or more a month. This is why I ask everyone to please refer me to your friends because that is the only way I can make up this loss in commissions. Not many agents are willing to work with Access Health Connecticut because of these cuts in commissions. But I am very dedicated to my clientele and I still go through the process of getting recertified every year so that I can help my clients if they ever have an issue. I am their advocate when it comes to their health insurance. I even got recertified last year (2017) when Access Health was not paying any commissions at all to agents. Money is not my motivator. I truly believe this healthcare nightmare is going to turn around and these people will stay loyal to me because I have been there with them through the trenches.
There are multiple ways you can purchase individual health insurance, from a privately owned company, i.e. ConnectiCare, Anthem Blue Cross and Blue Shield, United Healthcare, who are the major players in Connecticut. You can purchase ConnectiCare or Anthem Blue Cross and Blue Shield through Access Health Connecticut. United healthcare dropped out of Access Health Connecticut over a year ago. You can also purchase some ERISA Based Plans if you are a business owner or work for a small business owner. Remember each state is different. Most of my clients are in CT. When my client move, I often get licensed in their new state so I can keep them! <3
You can only purchase individual health insurance during an open enrollment period or if you have a special enrollment period. For instance, you just moved to the area, you recently lost insurance through a divorce or you got married, changing jobs, getting laid off, etc.
Each state has different insurance companies, and we are licensed in 8 states.
If you have any questions please call the office, we are here for you. 860-464-0121
We can also help companies put in place group health insurance for their employees. The Affordable Care Act also put a big burden on employers who own businesses of 50 or more employees. It also is costly to get health insurance for groups with less than 50 employees. People who own businesses who have less than 50 employees, please send your employees to us, we can help them get individual insurance even though they work for your company. See the information above regarding individual health insurance.
IF YOU ARE A HUGE COMPANY AND YOU ARE MAKING REALLY GOOD MONEY I WOULD LOVE TO HELP YOU!
IF YOU HAVE A QUESTION CALL US AT 860-464-0121. WE ARE HAPPY TO HELP.
IF WE ARE IN THE OFFICE, WE ANSWER OUR PHONES!