Wednesday, January 22, 2020

ACA/OE Puzzler

From CMS in this morning's email:

[click to embiggen]

Pretty sure that that ship has long since sailed:

I spoke with Medical Mutual about this a while back, and they assured me that the grace period only extends to in-force plans, and so if the initial premium wasn't paid by January 1, the plan would not, in fact, be put in-force.


Tuesday, January 21, 2020

And now for some *Good* news:

From co-blogger Bob V:

New Birth Missionary Baptist Church, partnering with RIP Medical Debt, has arranged for over $1.3 million of medical debt to be wiped clean:

"I jumped up and down and started praising God for this letter,” said Malcome, 58, who is disabled. “Other than my mother and God, no one has ever done anything for me like this. Oh, it was such a blessing.”

In a remarkable gesture of faith and generosity, the church's Senior Pastor, Jamal Harrison Bryant says:

"We are blessed to be a blessing and this effort has truly helped families start the new year without the stress, worry and concern that often accompanies looming medical bills and calls from debt collectors."

#Kudos to Pastor Bryant and his comminity.

Monday, January 20, 2020

What a convoluted mess (not to mention the circumstances)

I really don't even know where to start with this.

Okay, here:

"[Courtney Wilson] had moved to St. Thomas ... “for a change in, well, everything: scenery, culture, weather, people, way of life and of course the beauty of it.”

She took a waitressing job, but passed on buying health insurance.

Some three years later, she was in what appears to have been a very serious car accident, and she was careflighted to a Miami (FL) hospital for treatment. There, she was treated (uninsured, so she accepted full financial responsibility) and when she had recovered sufficiently, she "took a flight home to Paso Robles, California."

Umm, does anyone else see the glaring contradiction here?

Okay, moving along:

Once back in California, she applied for, and was retroactively accepted in, that state's Medicaid program. When she informed the Miami hospital of this change in circumstances, and requested that they bill MediCAL instead, they demurred:

"[T]he health system told her it does not bill out-of-state Medicaid programs outside of neighboring states like Georgia and Alabama."

Seems reasonable. After all, she had chosen to self-insure, and they were simply respecting her initial wishes.

Now comes the kicker (and the denouement we're all supposed to applaud):

"After the Herald inquired about Wilson’s case, she said UM reversed its billing decision."

How nice for her.

But notice this:

She moved away from California and took up residence in St Thomas, and then, when she faced substantial medical bills, she moved back  to
graciously allow Golden State taxpayers to foot her bill.

Gee, kudos for sure.

[Hat Tip: FoIB Holly R]

Friday, January 17, 2020

More #Winning from the MVNHS©

But remember: Free!


Looking Ahead: A Life Insurance Poser

Recently, had a client refer her adult daughter to me for some life insurance. She's relatively young, and single, and without much debt, so I asked why she was even considering a policy. She replied that she wanted to lock in her rates while she was young and healthy (which was what I wold have suggested to her, so kudos to this bright young lady). She originally asked about several hundred thousand dollars in coverage, and specified that she wanted a whole life plan (we'll circle back to this). So I collected what information I needed from her to run some quotes, and got to work.

I looked at both Whole Life and Guaranteed Universal Life, and sent her the quotes. She thanked me, but then wondered if perhaps she'd be better off buying a smaller amount now, and then increasing it later. I explained that one can't really do that (well, not on a guaranteed basis, anyway), but that we could write a smaller plan now, and then buy additional coverage down the road (assuming her continued good health).

But then I got to wondering: it seemed to me that we used to have a Future Increase or Guaranteed Purchase Option rider, but that was long ago, does that even exist anymore?

So I reached out to our friends at Issue Insurance, to whom we turn for products and/or carriers outside our normal, day-to-day needs. Tana said that no, she didn't know of any carriers that offered that with the Guaranteed UL product, but that our own primary carrier had one on their Whole Life plan.

I hadn't even looked - Yikes!

Sure enough,m there it was, the Insured Insurability Rider:

"This rider allows you to increase the specified amount of the policy on each option date, without evidence of insurability. This rider expires in year 11."

So, 10 "bites at the apple."

Here's how I explained it to my young client (and her mother):

"So looking at permanent plans (that is, where the rate never increases, and the coverage lasts to age 100+), there are basically two "flavors:" Whole Life (WL) and Guaranteed Universal Life (GUL). The biggest difference is that the WL plan will accumulate a cash value over time, while the GUL does not. This means that the WL is going to be more expensive, because you're paying for two things: death benefit *plus* cash value. Not a huge deal, but important to understand.

"Off the shelf," neither plan will let you increase the face amount (death benefit) as/when you get older, you'd have to buy additional policies to do that. BUT: The WL plan offers an inexpensive rider that lets you buy additional insurance each year until (until the 11th year- so 10 "additions") at $10k each. So if you exercised all those options, your plan would increase from (for example) $50k (originally) to $150k (original plus 10 times the $10k additions). Of course, the premium would increase each time you did that (because more insurance). But that's the only plan I could find that let you do that.

So, numbers:

GUL (just insurance), $50k is $30/month.

WL ("off the shelf"), $50k is $40.moth (so paying $10/month more to build some cash vaue over time).

WL with "Additions Rider," as described above, starts at $41/month (the rider costs about $1/month). Of course, each time you increase the policy $10k, the premium will increase some, as well

She's currently traveling, so I don't know which way she'll go (if at all), but thought that readers might find it helpful.

[Major Thanks to FoIB Tana H at Issue Insurance]

Thursday, January 16, 2020

Medicare Part D: Explained

Co-blogger Bob V has another outstanding vid, this time on how to navigate drug plans:

Wednesday, January 15, 2020

More Canadian Health "Care"

Sure, sure, but hey: Free!

A Few Short (Term) Words

I have mixed feelings about using Short Term Medical plans for long term needs:

That is, they were originally developed for limited durations, such as group plan probation periods, that kind of thing. And, for a long time, the maximum policy period was generally 180 days (6 months). A while back, the Feds clamped down on even that, limiting them to no more than 90 days (3 months).

Recently, that cap was lifted, and a number of carriers now offer 360 or even 364 day plans (essentially a year).

But what happens at the end of that policy if one has developed a medical issue?

STM plans, unlike their ACA counterparts, are underwritten, and exclude any pre-existing conditions. This means they're generally a lot less expensive, and can offer a lot more benefit design options. But it also means that if, for example, one develops asthma during one policy term, then that condition will be excluded if/when a new policy is written; plans can be re-written, but not "renewed."

One of the cooler things I've seen lately has been a feature offered by at least one carrier (I'm sure there are others, just haven't had a need to look): concurrent plans.

That is, one can write a 364-day plan, and when that's up, can re-write  a second one, and anything that cropped up under the first plan is not considered pre-ex for the second. Nice.

The carrier that I've been using, Pivot Health, offers this option with a fairly modest extra "processing fee" (about $20 per policy). I like that a lot. My only real quibble with them is that they limit their policy maximum to $1 million. That's not a deal-breaker, but UHC (for example) offers a $2 million policy maximum.

Oh well, can't have everything.

Tuesday, January 14, 2020

2:1, an ACA:Medicaid Story


By the way, that 8.3 million is folks who signed up during this year's Open Enrollment. As noted, almost twice as many folks qualified, and signed up, for Medicaid, which, as we've long pointed out, is not insurance.

But hey: Free.