Fine Print

Cheaper Premium Doesn’t Mean Less Costly

Sign-ups for 2019 individual health care coverage will begin Nov. 1. This year will see more uncertainty than ever for Central Texas consumers. Don’t expect to be offered more options – but also be much more careful when selecting a plan.


Caution #1: Short Term Plans

For example, cheaper, so-called “short-term” policies are being strongly marketed, due to relaxed regulation by the federal government. Expect to get phone calls, emails and other pitches offering short-term plans at significantly lower costs than other plans available compliant with the  Affordable Care Act. Yet, like most deals that seem “too good to be true”…. Well, you get it.


A new report shows these cheaper plans offer limited or no coverage for many ailments and injuries, prescriptions, hospital stays, ambulance rides and more. You might be scratching your head thinking, well, what do they cover. We are, too?! This makes it imperative to read all the fine print (which short-term policies will have aplenty).


Brokers and agents expect lower-cost, short-term policies to attract healthier individuals betting on staying healthy and not needing costly medical services next year. But, that bet might not actually save them money. (Did we mention fine print?!)


Caution #2: Non-Health Insurance Entities

Another option drawing interest in the health plan marketplace: “health care sharing ministries,” groups with common religious beliefs to help pay medical bills. Know what these aren’t: actual health insurance plans. They do not promise to pay claims. You pay up front and they consider the level of reimbursement later. They tend to limit what’s covered (like some pre-existing conditions), omit services violating their faith (like contraception and certain drug treatments) and do not offer ACA consumer protections (like out-of-pocket limits).


Before you decide to ditch your health insurance for a healthcare sharing ministry, research the difference before making the switch.


Caution #3: Cheap Premium

Jumping on the plan that has the cheapest monthly premium, might make financial sense until you actually need medical care. Is your doctor on the plan? What hospitals are on the plan? (Are any of them nearby?) Do you take a prescription medicine and if so, what’s your cost? Before making such an important decision (we are talking medical care), make a shopping list.


Bottom line: Focusing solely on monthly fees when eyeing new 2019 health plan alternatives can cost you a lot more.