Unsubsidized health insurance consumers turning to short-term coverage, new report finds

Dec 4, 2018

  1. Brian Anderson
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    Brian Anderson Executive Editor

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  2. AllenChicago
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    AllenChicago Guru

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    Several states have restricted or totally eliminated Short Term Health plans.

    Illinois gave insurers 5 hours advance notice on December 7th, that 1 Year STM's could no longer be sold. Now limited to 6 months, with a 60-day gap required between STM plans.

    ACA/ObamaCare is a disaster for our industry and for millions of Americans.
     
  3. Newby
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    Newby Guru

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    I’ve been pitched some of these short term plans by telemarketers. They pitch them as major medical every time. They misrepresent the plans. They misrepresent what a PPO network is. And the poor people that buy them thinking they have health insurance coverage are screwed if they get an expensive chronic illness.
     
    Newby, Dec 19, 2018
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  4. Northeast Agent
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    Northeast Agent Guru

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    What are the telemarketers saying about PPO networks?
     
  5. Sherota1
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    Sherota1 Super Genius

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    You will need to mystery shop them to find out. Though about doing this but have not had time. STM's are more catastrophic gap plans. Unsubsidized choose them due to pure need and lack of choice. Low prices and wider networks.

    To sell present them as "true major medical health insurance" without disclosing their limitations is just irresponsible. Most seasoned agents sell them with caution and full disclosure of their limitations but the agents that get highlighted in the news are those that bypass these precautions.

    Best thing is to know the laws in the states you serve and do right by the client. There is no 100% perfect plan that fits all.
     
    Sherota1, Feb 10, 2019
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  6. somarco
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    somarco GA Medicare Expert

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    Do you really believe consumers understand the caveats and will remember them when their claim is denied?

    I have dodged a lot of bullets in my career but the one that caused me to take stock in what I would and would not push came early on. I was doing an employee meeting (group insurance) and taking questions. One woman asked if the plan covered maternity. I said it did and moved on to the next question.

    Months later I got a call from a man who was very irate because I told his daughter the plan covered maternity. Because I neglected to mention the maternity benefit did not extend to dependent CHILDREN he was pissed when his daughter went to deliver and was told she did not have coverage.

    He wanted me to pay but I declined since I was not the father.

    You never want to take anything for granted and assume your client fully understands.

    I don't sell STM and never will.
     
    somarco, Feb 10, 2019
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  7. Sherota1
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    Sherota1 Super Genius

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    Completely understand your position. We all choose what products we will offer and which ones we will avoid. STM's are being used now for unintended purposes. Which I consider to be a misuse of the product and not everyone agrees with that. Many feel that unsubsidized uninsured who can't afford ACA plans only have two choices stay uninsured or pick the best of the imperfect plans that are available.

    I can't say I have never sold an STM but only for it's original intended purpose to ones looking for something to cover a small gap in coverage. I get your point but as we know there are ones that offer them on the regular as something that they really are not. Some states are changing the benefits to include more protections but certain limitations will still be there.

    Nothing covers 100% even ACA plans. Though we explain that to people most hear what they want to hear. Assuming that the word "Covered Benefit" means it is paid for 100% by the plan when in many cases it is covered but goes toward their deductible.

    In my opinion it is the Independent Agent that needs to be the most careful since we know our clients and see them as real people and not a "What's your member number". Larger companies with anonymous agents have money and persuasion on their side. I often find I need to explain the meaning of their questionable commercial claims.

    Thanks for your response


    Short-term health insurance in Colorado: find affordable coverage
     
    Sherota1, Feb 10, 2019
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  8. Newby
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    Newby Guru

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    They say that PPO means you can go to any doctor and hospital in the country and they can not refuse you. They also say that you will pay the exact same co-pay at all doctors and you do not need to worry about networks.
     
    Last edited: Feb 11, 2019
    Newby, Feb 10, 2019
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