The Clock is Ticking - Take Action

We are nearing a few important dates that you need to know to prepare yourself and your family. We are clearly in a period where procrastination will be costly so you must take action to prevent overpaying or missing out on having coverage.

NOVEMBER 30TH - While today is Thanksgiving, there is still time to save a significant amount of money IF you are healthy. Health insurance shoppers that are in good health can still buy a fully underwritten plan from the carriers that will save them 30%, 50%, or even 70% for a one year period. In order to obtain a policy like this, you must apply for this coverage and have it submitted by November 30th (for Blue Cross, you have a few days more with Cigna and Humana). These plans will be forced to convert to an ACA compliant plan in 2015, but why pay more for coverage you don't need or subsidize others by paying more than what you need.

DECEMBER 1ST - If you qualify for a subsidy you will be interested in this date. The President has promised that the broken website will be working at the beginning of the month. We are not sure it will be fully functional, but people that need subsidies will only get them by going to the website and qualifying by answering their questions. Once you get approved, we suggest that you do not purchase a plan through, we suggest that you shop directly with the insurance carriers (or use us and we'll help you look at all of the plans and all of the carriers). Call us at 713-422-2935 or click CONTACT US and we'll walk you through the process.

DECEMBER 23RD - The administration has delayed the drop dead date in which you need to buy an ACA plan to have it begin on January 1st, 2014. Because they have had all of the technical problems on the website, you will now be able to purchase a plan later and still have it begin at the beginning of the year.

High Risk Pool - Talks About Delays / No Action

We've heard a few statements from David Dewhurst stating that he'd like to move to delay the termination of the Texas High Risk Pool. He's stated that the reason that he'd like to do this is that people are unable to shop for and obtain new coverage. Personally, I think his planning is laudable as we don't know how effective the site will be when the "floodgates" open and people really start looking for their subsidized coverage on the site. At this point there has been no concrete action to push the termination date of the risk pool back. We will post information if we see anything new. I would ask anyone on the High Risk Pool to call us or email us and we'd be happy to help them find coverage. As of this morning, we've helped 25 current High Risk Pool members into better coverage options. In almost every case we've been able to reduce their deductibles and out of pocket expenses and also reduce their monthly premiums. When you call us, please let us know that you are in the high risk pool and we'll send you quotes that include your current plan so we can make comparisons to your specific insurance easily!


MORE SUCCESS - We are seeing better functionality with all of the health insurer's websites and have had many applicants apply and get approved for policies in the last two weeks. We are still working with our clients that are obtaining subsidies and many of these have opted just to wait before proceeding and dealing with the site. We have had a few successful applicants get through this process.

Texas - and the Medicaid Gap

The most troubling thing (among all the troubling things) I've seen in this rollout is that many folks are being left out of the benefits of subsidies. Low income earners are caught between the state of Texas and their refusal to sign up for the Medicaid expansion and the federal government's subsidy plans.

The best example I can give is that I have a couple that is 63 years old that make around $15,000 a year. In this situation, they need subsidies to help obtain coverage as the cheapest PPO plan they can purchase is around $1000 a month. At their current income level, this couple cannot obtain a subsidy as the federal government states that they should be eligible for Medicaid. Unfortunately, in Texas, the couple does not qualify for Medicaid because they don't meet the criteria for receiving benefits. (To receive benefits you must be a pregnant woman, have small children, or be a senior citizen that is disabled). The crazy thing about the federal rules is that if this couple made $20,000 a year, they'd receive a federal subsidy of $800 a month!

We have seen this issue too many times and have called Texas Health and Human Services to discuss the issue. There is just no real solution. The federal government will blame Texas governor Rick Perry for failing to expand Medicaid, but he has stated that the costs over the long run will be crippling. This is probably true, but the real situations I am seeing of people caught in the gap are hard to see.

The clock is ticking, it's time to take action. If you are healthy, call us and we'll help you look at your options with plans starting 12/15, but you need to apply by 11/30! If you aren't so healthy or have missed the 11/30 deadline we may be able to get you a policy with Humana or Cigna that start on 12/15, just call us. If you are on the High Risk Pool and you need help comparing options to what you have now, please contact us at 713-422-2935 or simply CONTACT US!

Have a wonderful Thanksgiving and we look forward to serving you!

Jason W Bohmann
Texas Health Design