Health insurance in Tupelo, MS has gone through huge changes in the last several years. When the Patient Protection and Affordable Care Act was passed in 2010, it took a few years to start seeing it go into effect. When I started my career in insurance after getting out of the Marine Corps at the beginning of 2014 it had just started to have legitimate plan offerings. Early on these plans were not well received in many areas due to network inadequacy (meaning that many doctors and hospitals were not accepting them) and many people not qualifying for subsidies to help bring down the massive cost associated with them.
As time has gone on the networks have improved and there are now multiple companies offering these plans in most areas. In Tupelo, MS for instance we will see at least 3 companies next year offering a variety of plans on the marketplace. However, it is important to note that many people fall into income ranges that cause them to still pay unexceptionally high premiums, and those people often look for viable alternatives.
Our process is simple; First, we look to see if someone qualifies for an acceptable deal with a marketplace plan by gathering household info and the person’s Modified Adjusted Gross Income (MAGI). We also look to see if there are secondary insurances that can close some of the gaps with these plans. If we determine that these plans are not a fit, we go on to step 2.
Determining Eligibility for Alternative Health Coverage
This step for our agents is to see if someone has pre-existing health conditions. This is because all other alternatives have pre-existing health condition clauses. These clauses can be a future headache or can be an outright deal-breaker for someone with specific pre-existing conditions. Typically, mild conditions like High Blood Pressure, minor Anxiety, or old accident-related injuries without much future medical care required are less of a concern than chronic conditions.
If we determine that there isn’t any notable interfering medical condition, we can explore Short Term Medical, Fully Underwritten Indemnity options, and/or Healthcare Sharing Ministries like Medishare.
We first make sure our customers understand the difference in these by explaining the difference in all health insurance options.
A quick breakdown of each could be helpful in the decision, so read on for more details about alternative plans that are available.
Short Term Medical Health Insurance
Short-term health insurance has undergone a ton of changes in the past several years due to the political climate. Currently in many states, remaining true in Mississippi, the law allows for short-term health insurance to be purchased in increments of one year at a time renewable up to three years. One of the problems with many people buying this online is that it isn’t properly explained how the underwriting works. You must answer the health questions truthfully when applying because if a significant claim is filed the insurance company will certainly underwrite at the time of claim. This means they can go back and check your health record for anything that might have caused it to be declined or anything exclusively limited from coverage within the fine print. However, if there is nothing, of course, they must pay. So, someone in excellent health should not be overly concerned with this. Someone who has had some surgeries in the past or crazy diagnoses should look further into the limitations and exclusions. Why would someone consider an option like this? Well, for someone whose income knocks them out of qualifying for a subsidy with the Affordable Care Act this can be a much more affordable way to get Major Medical coverage.
UnitedHealthcare (GoldenRule) and National General (Allstate) are the primary offerers of these plans currently. They’re often associated with the network that they subscribe to which may be Cigna or Aetna.
Hospital Indemnity with Robust Outpatient Benefits
These plans rose to popularity when Short Term Medical plans were limited to 30-90 days by heavy regulation under President Obama’s administration. They were a permanent or long-term health insurance option, but unfortunately many do not understand that they aren’t Major Medical. While the benefits can be quite robust there are many holes for things like Kidney Dialysis or Durable Medical Equipment Rentals. Still, many qualified beneficiaries who educate themselves choose these routes occasionally to offset some risk while acknowledging there is still some risk associated with this decision.
Philadelphia American, Manhattan Life, National General, and UnitedHealthcare (Golden Rule) are the main providers of these plans.
Healthcare Sharing Ministries
The first thing to note related to these plans is that they are not regulated by the department of insurance. They rose in popularity early in the Affordable Care Act rollout due to the mandate requiring people on traditional health insurance and not an ACA qualified plan to pay a tax penalty. This tax penalty was waived if you were on an exempt plan meeting the Healthcare Sharing Ministry or religious exemption criteria. Most states do not currently enforce this penalty since there was an executive action rolling back the mandate under President Trump’s administration. Still, HCSMs are a relevant option for many to mitigate healthcare costs on a budget. Medishare is perhaps the largest one in the country by enrollment, and that is currently the only one we endorse the use of.
Combination of Plans
We have often been known to advise someone to combine a Short Term Medical or Healthcare Sharing Ministry with a robust permanent Hospital Indemnity Plan. This gives you some of the safety net coverage of a Major Medical or Maximum Out of Pocket component with the long-term viability or guaranteed renewability of a Hospital Indemnity Plan.
We hope this information has been helpful. We have been helping people in Mississippi with their health insurance needs for a very long time. Tupelo, MS now offers Ambetter, Cigna ACA, Molina, GoldenRule STM, National General’s Aetna or Cigna PPO STM, Manhattan Life’s Affordable Choice, Philadelphia American’s Health Saver Plus III or Health Saver Gold, Medishare, and many other options.
Some for sure things to avoid in our opinion Freedom Life, US Health Advisors, and Alieria Healthcare. Also, to reiterate a point above, make sure what you’re getting that you understand the pre-existing condition clauses and the importance of answering income and health questions accurately.
Self-Employed Individuals may have an especially hard time with finding health insurance. For further clarification, watch this video.