Medicare doesn't cover everything. Here is a partial list of what is not paid by Medicare.
Routine dental care, dentures, crowns, bridges, routine eye exams, eyeglasses, contacts, cosmetic surgery unrelated to illness or injury, OTC vitamins and supplements, hearing exams, hearing aids, long term care, medical treatment outside the country.
Most of these items were not covered by your employer group health plan either. Things like vision, dental and hearing were covered by insurance plans OTHER THAN your major medical. You probably had a separate plan for dental and another for vision care.
Different policy.
Different insurance carrier.
Should You Buy Extra Insurance?
In many cases you can purchase separate insurance coverage for the following.
- dental care
- vision coverage
- hearing exams and hearing aids
- international travel medical
- hospital indemnity
- cancer plans
- critical illness
The list goes on.
But before spending good money on these kinds of insurance, ask yourself if you really need it?
I make an exception for International Travel Medical. That is something you should definitely consider when traveling outside the country. But for the rest of the list . . .
Do you need to spend $40 - $60 per month for a dental plan that limits your annual benefit to $1,000?
Do you need to pay monthly premiums of $50 per month for a plan that pays $600 per day for inpatient care only?
Most people would be better off stuffing that money in a mattress than paying for additional insurance that may never pay off.
Thing is, folks in the "benefits press" (for lack of a better term) keep referring to ACA-compliant "High Deductible Health Plans" as if this has any actual meaning.
Okay, Henry, what the heck are you going on about?
Well, until the age of ObamaCare, HDHP's meant HSA-compliant true Catastrophic coverage, no bells or whistles, just policies that paid for the truly disastrous claims (think cancer or brain surgery, for example). Not low cost maintenance meds, flu shots or a simple primary care. In other words, what insurance should be.
Now comes O'Care, with $6,000+ deductibles and $14,000+ out-of-pockets, but with a panoply of first dollar preventive care "benefits" (well, mostly just for women), and premiums that look like mortgage payments on a mansion.
These are not what we should be calling "HDHP's," confusing non-industry folks who just want to be able to afford their premiums (and to use their plan).
Well, it's that time of year again, when agents must decide whether or not to participate in ObamaCare Open Enrollment (this year: v6.0). For most folks, this year's festivities run from November 1 through December 15 for a January 1, 2019 effective date.
I say "most folks" because DC and Golden State citizens have their own, quirky schedules:
Californians who sign up after December 15 will have February '19 effective dates.
"[O]open enrollment in DC will begin November 1, 2018, and will continue until January 31, 2019. DC residents who enroll between December 16 and January 15 will have coverage effective February 1, while those who enroll in the second half of January will have coverage effective March 1."
Everyone got that?
Good!
Adding a little fuel to the fire is the fact that folks in DC will get their own insurance mandate:
As for my part? Well, regular readers know that I've long since bailed from actively engaging in the Open Enrollment circus process, but that I continue to do the online training necessary should I change my mind (or, as in recent years, be available to help folks out from the sidelines). This week, I got email from CMS announcing that:
"Marketplace agent and broker registration and training for plan year 2019 is now live!"
I can choose the free (no Continuing Education credit) version from CMS itself, or pay for the training (which includes CE for most folks) from their preferred vendor, AHIP.
Not an AHIP fan, and don't need the CE. So: hard pass.
Way back in 2013 #JohnHawkins had this to say about Obamacare. No one has a crystal ball but he got some things right, and some not so right.
What he got right.
If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what.”
Well, that promise turned out not to be true and I can tell you that from personal experience. - https://ift.tt/2v8itRy
Mr. Hawkins was notified he would be losing coverage well before the clock struck midnight ending 2013.
It's difficult to blame my insurance company for that (cancelling his coverage). After all, it's hard for a service to be viable when the government forces consumers who buy it to pay a massive new tax for the privilege
Yup.
Currently, I pay $191 per month. That will go up to $274. That's nearly $1000 a year more for a service that I already have. In addition, the deductible on my current plan is $200 and that will be going up to $6000.
And that's just for 2014. Wonder what he is paying now?
What he got wrong.
Originally, my health insurance provider told me that my plan wasn't going to be canceled. The agent just said it wouldn't qualify under Obamacare and so, I'd have to pay a tax to keep it.
Grandfathered plans exempted.
Technically his agent was wrong. Can't put all the blame on John.
When you hear about people who are going to be paying an extra $6000 a year out of $47,000 in income
Those folks SHOULD have qualified for a subsidy. A rob-from-the-rich-give-to-the-poor taxpayer funded subsidy. Depending on many factors, their premium could have been $0.
What a country!
The law couldn't pass today and had Obama told the truth instead of lying shamelessly, even Democrats would have never voted for this law in the first place
Half right. Half wrong.
The law would not pass in 2018. But I do believe the left wing party would still vote for it if given a chance.
The good news is that they've lifted the 3 month max, the bad is that they've left a potentially huge gap in that 365th day.
Still, one should avoid letting the perfect be the enemy of the good, and this is at least a step in the right direction.
As to why have they've made this change, well, let's just say that ObamaPlan signups have been ... disappointing:
"[T]he number of people enrolled in the individual market without subsidies declined by an alarming 20 percent nationally in 2017 ... Many state markets experienced far more dramatic declines, with unsubsidized enrollment dropping by more than 40 percent in six states"
Ooops.
Now, it's important to remember that coverage ≠ care, and these plans have their own limitations, including exclusion of pre-existing conditions. But they are generally much more affordable, and offer much lower out-of-pocket options, than ACA-compliant policies.
Will be interesting to see how this plays out, and hat impact it has on Open Enrollment v6.
