From An Agent’s View…
November 1, 2013 was a day I remember all too well…for any individual health insurance broker, this particular day began with many unknowns and in a financial industry, not a comfortable place to start business. For those of you who don’t know, this was the first day that the “Marketplace” became live in Missouri (www.healthcare.gov, and “Obamacare’s” solution to unaffordable health insurance). My responsibility as your broker is to be informed, know the process, and at the end of the day, you leave my office with a plan in place for the following calendar year—accurately, efficiently, and by the book. While I was able to certify in advance, and study, and learn the law, what I couldn’t do was train…go through the process online to see how the process ACTUALLY worked. The end result on that day? Glitches, log in problems having nothing to do with user error, identity issues, miscalculations…all resulting in frustration and NO insurance in place. These were problems no one could have known or planned for, but as your broker, it was my job to learn it like the back of my hand—know how to avoid potential issues and glitches and try, try, try again until it worked.
And we did.
Four years later, I’m certainly now a proud “expert” on the Marketplace technicalities….sure, occasional problems arise, but after some years of training, they’re much easier to resolve, and quicker. What Open Enrollment 2018 brought, however, was a different vibe than 2014…in Greene and Christian counties in Missouri, there is a grand total of TWO available insurance plans on the individual market (meaning, for those shopping for insurance not available through their employer): our local Cox Health Plan, and a brand new option to this area known as “Ambetter”, based out of St. Louis, and a Mercy network plan. So what’s changed since 2014?
Premiums. Oh, the premiums. Sure, if you’re eligible for “tax credits”, or subsidies, the price may not be too steep, but for more people than ever, these subsidies don’t help, and health insurance premiums mimic that of an outrageous mortgage.
Deductibles. In years past, perhaps a higher deductible made sense if in return you could lower your premium. Today, high premium is the standard…and in many cases, the ONLY option. Again, unless you’re qualifying for nice subsidies, a household of two is looking at deductibles upwards of $12,000. Financially, the general opinion I get from my clients is that this just no longer makes sense….leading to….
Out of the Box options….Christian sharing ministries have been questionable by many opinions in past years; today, it’s a viable solution REGARDLESS of the risk. It’s simply the only option for many. Membership is growing, but more than that, the idea is that people are taking back control of their health plan and feeling GOOD again about paying that bill each month because it’s offering something better in return for lower prices.
Lack of primary care doctors. Finally, the entire REASON for health insurance in the first place, other than offering catastrophic protection…is one’s ultimate need to see a doctor when sick! Doctors are leaving the private practices not only because of stipulations imposed on them by the Affordable Care Act, but locally, since all individual health insurance buyers on the Marketplace had no network option, Mercy network, in particular, is now flooded with new patients. Longer wait times are now in order—and we thought this was a problem last year!
Ultimately, I believe change is on the horizon. But know that whatever may happen, at IGO we don’t “check-out” after Open Enrollment—we’re plugged in YEAR ‘ROUND. And you can count on us to look in the box, or out, for a solution for you!
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