How to safely purchase Short Term health insurance after January 1, 2020

 

On October 12, 2017 President Donald Trump signed this Executive Order designed to restore consumer choice in the non ACA-qualified Short Term health insurance marketplace. Short Term health insurance is the only kind of non ACA (Affordable Care Act) qualified health insurance available in the individual marketplace. Short Term health insurance is considered major medical health insurance but it is not ACA-qualified. As such, Short Term health insurance does not cover preexisting conditions and you do have to answer health questions in order to qualify. As of October 2, 2018, President Trump’s Executive Order became the new Federal regulation and as such non ACA-qualified Short Term policies that keep you consistently insured for up to 360 days became once again available for all Americans to purchase. However, states retain the right to accept or reject the Trump restoration of non ACA-qualified Short Term health insurance policies.

From October 2, 2018 to December 14, 2018 Illinois residents were able to purchase non ACA-qualified Short Term health insurance policies for up to 360 days thanks to Illinois Governor Rauner’s VETO of HB2624 which was the Illinois Democrat led attempt to block the Trump restoration of non ACA-qualified Short Term health insurance policies. Unfortunately, after Rauner lost his reelection bid, Illinois Democrat Senator Antonio Munoz began working to undermine President Trump’s much needed restoration of non ACA-qualified Short Term health insurance policies. Munoz’s effort was unfortunately successful and as of December 14, 2018 Illinois residents can now only purchase Short Term health insurance for a maximum policy term of 180 days. 

This action by Illinois Democrats has once again left Illinois consumers who do not qualify for Federal health insurance subsidies with no other safe option but to purchase ACA-qualified health insurance at a premium that is not only not “affordable” but now exceeds their mortgage payments. A non ACA-qualified Short Term policy that lasts for only 180 days exposes consumers to unique and significant risk by potentially leaving them uninsurable in the middle of the year if at the end of the first 180 day Short Term policy, they are at that juncture too sick to qualify for another 180 day Short Term policy.

As of January 1, 2014, Americans can only purchase Individual ACA-qualified (Obamacare) health insurance policies that cover preexisting conditions during a short “open enrollment” window between November 1st and December 15th of each calendar year. So, a consumer whose Short Term policy ends in 180 days could be left without the ability to obtain health insurance that covers preexisting conditions again until January 1st of the following year. This could happen if they were to develop a medical condition that would render them unable to qualify for another Short Term policy. There is a way to ensure that small business owners have access to health insurance that covers preexisting conditions at any time throughout the year. This can be accomplished by purchasing group insurance.

PLEASE NOTE: Since Group health insurance is available all year long and it covers preexisting conditions. It is absolutely essential for Illinois residents who plan on continuing to purchase Short Term health insurance (after January 1, 2020) to ensure they have the proper business structure in place in order to be able to purchase group health insurance at any time. This way, when a six month Short Term policy ends (at the end of June for example) you will be able to purchase group health insurance if at that juncture you or a family member becomes too sick to qualify for another Short Term policy. Since Short Term policies do not cover preexisting conditions, it is extremely important to have your company properly structured ahead of time so that you can purchase group health insurance at any time should you need coverage for preexisting conditions. As few as two people can purchase group health insurance, even husband and wife teams who have no employees. To learn how to structure your small business in order to ensure you have coverage for preexisting conditions at any time throughout the year, please call us directly at (630) 674-1551. Or, click “Contact” above to email us.

Wisconsin, Indiana and Texas regulators have accepted the Trump restoration. So, their residents can still purchase non ACA-qualified health insurance for up to 360 days. Below is more information about United Healthcare’s non ACA-qualified Short Term health insurance policies:

United Healthcare’s non ACA-qualified Short Term health insurance policies are the most comprehensive non ACA-qualified Short Term health insurance policies in the industry. Unlike other non ACA-qualified policies, these policies cover outpatient prescription drugs and your health plan deductible is waived for Urgent Care visits and the “Short Term Medical Copay” plan waives the health plan deductible and only requires a $50 co pay for three outpatient doctor office sick visits each year. United Healthcare also covers each insured member to $2,000,000. Their best designed plan is their “Plus Elite” plan which provides 100% coverage after the deductible has been satisfied. It also provides a “first dollar” (no deductible required) benefit for outpatient Urgent Care visits. To view their new non ACA-qualified Short Term health insurance brochure click here. For quotes and to apply online click United Healthcare logo below:

Please note: Non ACA-qualified Short Term health insurance plans are not required to cover certain “Essential Health Benefits” that are covered with ACA-Qualified plans. These benefits are:

1.) Maternity and newborn care
2.) Mental health and substance use disorder services
3.) ACA mandated Preventive care benefits. However, routine mammograms and cancer screens ARE COVERED with non ACA-qualified Short Term health insurance policies.
4.) Pediatric Services (including both oral care and vision care).

The ACA (Obamacare) Individual Mandate was REPEALED by congress on 12/20/17. However, the Tax Cuts and Jobs Act of 2017 does not include repeal of this mandate until Jan. 1, 2019.

President Trump has also provided a way to avoid paying the Individual Mandate penalty for 2018 also.

 

2020 ACA Open Enrollment begins on November 1, 2019 & ends on Dec. 15, 2019. 

Depending on your projected 2020 MAGI – Modified Adjusted Gross Income – you may qualify for one or more federal health insurance subsidies to lower your premium, deductible, coinsurance and copays. To learn the income levels necessary to qualify for health insurance subsidies scroll down this page. Questions? Call (630) 582-1043. Out of state? Call toll free at (866) 724-7123.

If you qualify for a subsidy please click “Shop for ACA-qualified (Obamacare) plans.” You will be able to pick a plan, get your subsidy and finish the entire process much faster than working solely with Healthcare.gov. You can also purchase ACA-qualified plans without a subsidy using Health Sherpa if you do not qualify. If you are healthy, do not need coverage for preexisting conditions and do not qualify for a subsidy click “Shop for non ACA-qualified Short Term health plans” for more affordable non ACA-qualified Short Term plans. 

                         

 

Determining your eligibility for one or more federal subsidies

Depending on what you expect your 2020 total household MAGI – Modified Adjusted Gross Income = (after deductions but before taxes) to be, you may qualify for a significant APTC – Advance Premium Tax Credit (federal subsidy) under the new health care law to lower your premiums. You may also qualify for a Cost Sharing subsidy to lower your deductible. If you believe your 2020 total household MAGI will be lower than:

$49,960 for an individual
$67,640 for a couple
$85,320 for a family of three
$103,000 for a family of four
$120,680 for a family of five
$138,360 for a family of six

you will be better off financially by shopping for a plan on the exchange (via Healthcare.gov) in order to receive an Advance Premium Tax Credit and/or a Cost Sharing reduction to reduce the premium and deductibles of either the Bronze, Silver, Gold or Platinum QHPs – Qualified Health Plans.

If you qualify for a subsidy please click “Shop for ACA-qualified (Obamacare) plans.” You will be able to pick a plan, get your subsidy and finish the entire process much faster than working solely with Healthcare.gov. You can also purchase ACA-qualified plans without a subsidy using Health Sherpa if you do not qualify. If you are healthy, do not need coverage for preexisting conditions and do not qualify for a subsidy click “Shop for non ACA-qualified Short Term health plans” for more affordable non ACA-qualified Short Term plans.

                         

Shopping from another state? Call us toll free at (866) 724 7123 to get quotes from carriers in your state. 

Please note: If you expect that your M.A.G.I. – Modified Adjusted Gross Income will be lower than 138% of the Federal Poverty Level, you will be offered Medicaid and as such will not be able to qualify for subsidized private health insurance. You can purchase private health insurance even if you qualify for Medicaid but you must do so at full price without a Federal subsidy. Click the chart below to determine the current Federal Poverty Level and percentages above it. 2020 Federal Poverty Levels will not be released until late January of 2019 so, the 2019 FPL chart must be used to determine 2020 subsidy or Medicaid eligibility.

Please also note: If you qualify for a federal health insurance subsidy and your state has expanded CHIP – Children’s Health Insurance Plan – under Medicaid you may not be able to insure your children on your policy. Healthcare.gov will instead send them to Medicaid. You may wish at that juncture to purchase private health insurance at full price for your children instead.

 

Are your doctors in the 2020 Blue Cross Blue Shield of Ilinois PPO and HMO networks?
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Dental insurance coverage from Blue Cross Blue Shield of ILLINOIS
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bluecaredental1a to see the outline of coverage for Blue Care Dental 1A plan.
bluecaredental1b to see the outline of coverage for Blue Care Dental 1B plan.
bluecaredental1aforkids to see the outline of coverage for Blue Care Dental for kids 1A plan.
bluecaredental1bforkids to see the outline of coverage for Blue Care Dental for kids 1B plan.

To apply for BCBSIL Dental insurance please download and print the paper application here > bluecaredentalapplication
Once completed, please fax your Dental insurance application to (630) 582-1043.

To see if your dentist is in the BCBSIL Dental PPO click here > BlueCare® Dental (DPPO)

Prescription drug coverage from Blue Cross Blue Shield of ILLINOIS
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Preventive care coverage from Blue Cross Blue Shield of ILLINOIS
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