What are the Holes in STM plans?

[somarco]

better to have some sort of security blanket vs going completely exposed.

That's debatable, and you and I differ on this. I just don't need that kind of drama in my life. That's why I walked away from Obamacare and all the trick ponies that allegedly make health insurance affordable.

Plans also can be renewed for up to 36 months

But with what caveats?

No coverage for ongoing claims?

Higher premiums to reflect increased risk to the pool?

Limits on payout for ongoing claims?

Affordability is not just about premiums. It is also about OOP costs.

The irony is that the Trump rule would allow “guaranteed renewability” that can protect consumers from higher premiums if they become ill.

Serious question.

How does this work?

 

[Yagents]

It works until the STM prices are higher than ACA full premiums

 

[somarco]

It works until the STM prices are higher than ACA full premiums

Paraphrasing 42, I guess what your definition of works, is . . . .

 

[Yagents]

So, I don't believe I'll be selling the "rider" to go 24 months or 36 months.
Some speculate it could be 20-100% higher premium for STM with renew ability.
Kind of like the old Assurant plans that 24-36 month buy up option.
By far some of the best advice I've given my clients back then.
But, if priced to high, and your not saving enough to go STM vs ACA for a substandard policy, then the client has to make the choice.
As long as their is a 33% discount on STM compared to ACA, then it will remain attractive.
50% cheaper is easier to swallow if diving into the swamp.

 

[Yagents]

So, if given the choice:
1. Go uninsured
2. Buy an affordable STM policy
What would you do?
What would your advice be to the client?

 

[somarco]

So, if given the choice:
1. Go uninsured
2. Buy an affordable STM policy
What would you do?
What would your advice be to the client?

I would probably opt for one of those health care sharing plans.

Don't like them either but figure they have fewer holes than STM and even the old indemnity plans.

 

[Yagents]

See, I don't touch non major medical structured plans. It has to have an OOP max.
Won't do non "insurance" plans CHM plans, nor indemnity.
That's a waste of money IMO.

 

[somarco]

I have an option since I am 65+.

I got sucked into your trap. The best choice is get a job with benefits, or some other way to come into a group plan.

 

[yorkriver1]

I see a problem for now with the STM's if sold off calendar year. If ACA rules are still in effect, and an STM can be cancelled or ends within open enrollment, the person who is going to have long term claims can hop on ACA. If the STM ends mid year, and the person has pre-ex they won't be able to buy coverage at all, or the coverage will exclude the things they want paid. Eventually, those who enroll in ACA at open enrollment now that they have pre-ex, after not having ACA for a while will cause adverse selection to make ACA premiums even worse.

 

[yorkriver1]

See, I don't touch non major medical structured plans. It has to have an OOP max.
Won't do non "insurance" plans CHM plans, nor indemnity.
That's a waste of money IMO.

There are probably OK other companies besides UH1, but one I recently found looked good until the coverage certificate (and nowhere else in their literature) only to be seen upon issue, mentions that certain occurrences, such as appendicitis, have a low dollar limit per incident. $2,500 in this case. So, not a true 80/20 to a max out of pocket situation. Not what I want to sell.