Honest Discussion About Hospital Indemnity Plans?

Bob Johnson

New Member
3
I’d like to start a candid and professional dialogue about these plans. I’ve heard negative reviews of hospital indemnity plans. In the past, I’ve even shared some of these opinions. But, in this new market climate, I am now revisiting these types of plans as a viable sales options for a certain market segment.
Lately I have been hearing a lot about hospital indemnity plans for a few different scenarios.
1. Let’s assume we have a NSNP (non-subsidized – non-penalized) client who needs something but cannot afford an ACA plan (sure, there are usually short term medical plans, but this would provide “permanent” coverage that could include pre-ex after the first year depending on the carrier).
2. Out of state college student who is on their parent’s out of state plan – for example, family lives in Chicago insured by BCBS of ILL. Child goes to school in Texas. Sure they have Emergency coverage, but do not have access to non-emergency services due to a limited network HMO in Illinois.
3. Clients who want to offset their high OOP’s associated with an ACA or medishare plan. In some cases, I’ve seen where a hospital indemnity plan can pay the deductible and coinsurance of a bronze plan and even provide additional cash for ongoing living expenses.
What are the downsides of these plans in these situations, opinion or fact, which you can share with me?
 
#4 Medicare Advantage members with a $0 premium and a MOOP of $6700.

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1. Let’s assume we have a NSNP (non-subsidized – non-penalized) client who needs something but cannot afford an ACA plan (sure, there are usually short term medical plans, but this would provide “permanent” coverage that could include pre-ex after the first year depending on the carrier).

If you don't buy MEC, you will pay the piper(IRS). Exception: Christian Faith Health Plans.

Short term plans do not provide "permanent" coverage. And, I have never known a short term plan that covers pre ex. Maybe someone else has...anyone??
 
Once worked with a woman who was a christian scientist whose father died of a heart attack while the family stood over him praying while he died. "His faith or their faith, weren't strong enough", pretty crazy if you ask me...



I've never been able to sell a Christian Scientist health insurance.:no:
 
The issue I started running into with both "gap filler" indemnity plans and STM plans, is that the carriers are $$$ gouging. That is, they're taking advantage of the super-high ACA premiums, by raising their Indemnity and STM plan premiums higher than they should be.

The last Indemnity I wrote was in 2014, from Philadelphia American. It was $434 a month, for a 54 year old smoker. No way would it have cost $434 before the ACA QHPlans took over in 2014. No additional benefits, but the premium was suddenly 50% higher.

The last STM I wrote was last week. Three person family in their 40's, and a $10,000 OOP. Premium = $463.00 a month for 6 months. This would have been under $200 a month, before 2014.

Both STM's and Indemnity plans actively look for reasons NOT to pay claims. But at least with an Indemnity, like you said, it can be kept far beyond when the "pre-existing conditions" restriction has ended.
 
The issue I started running into with both "gap filler" indemnity plans and STM plans, is that the carriers are $$$ gouging. That is, they're taking advantage of the super-high ACA premiums, by raising their Indemnity and STM plan premiums higher than they should be.

The last Indemnity I wrote was in 2014, from Philadelphia American. It was $434 a month, for a 54 year old smoker. No way would it have cost $434 before the ACA QHPlans took over in 2014. No additional benefits, but the premium was suddenly 50% higher.

The last STM I wrote was last week. Three person family in their 40's, and a $10,000 OOP. Premium = $463.00 a month for 6 months. This would have been under $200 a month, before 2014.

Both STM's and Indemnity plans actively look for reasons NOT to pay claims. But at least with an Indemnity, like you said, it can be kept far beyond when the "pre-existing conditions" restriction has ended.


So, the ACA made health care more affordable across the board.:skeptical: Thanks a hell of a lot Barry O'bama.:no:
 
#4 Medicare Advantage members with a $0 premium and a MOOP of $6700.

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If you don't buy MEC, you will pay the piper(IRS). Exception: Christian Faith Health Plans.

Short term plans do not provide "permanent" coverage. And, I have never known a short term plan that covers pre ex. Maybe someone else has...anyone??

Technically, they would not pay the piper if they were truly an NSNP. With ACA premiums going up, the lowest cost bronze plan is forcing more ACA consumers into the hardship exemption (which a lot of people don't even know about).

Sorry for the confusion - I was not implying STM was permanent or covered pre-ex - only that HIP plans can be permanent and eventually could cover pre-ex.
 
So, if a 40 year old couple with 2 kids that swear they have no pre ex, and exempt from penalty due to cost, 5000 max oop for 400 a month with United Health Care would seem to be a much smarter deal than any indemnity plan or medishare option.
 
IHC Group has a new Indemnity plan that looks okay: Critical Access Plan

Couldn't one choose this and add a skinny MEC plan that offers preventive-only care and then have okay nationwide coverage at about 30-40% lower cost and be "compliant"?

I like it. A lot. (And normally, I think these are crap)

Wheres the rates?
 
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