Category: Cost of Healthcare, Health Insurance

What Did You Actually Buy?

Sometimes I’m just overwhelmed by how much the internet, specifically search engines, has changed our lives. A few nights ago, my lovely wife and I were watching one of our favorite British cop shows, “Inspector George Gently,” on Amazon Prime. (I highly recommend it – GREAT show!).

After a few minutes, we realized we recognized Gentley’s (Martin Shaw) sidekick on the show from somewhere. We thought on it and chatted, but despite our best efforts, we couldn’t figure it out. My lovely bride finally said, “Oh, just Google it!” And in about five seconds, we had the answer: that actor had a small part in the Harry Potter films. He was the ticket-taker on the Knight Bus! Problem solved!

Now, I know we all use search engines for way more important things than celebrity identification. I want to talk today about what could happen when using a search engine to shop for health insurance. It’s very EASY to make a mistake.

Watch Your Search Terms

There are a lot of pseudo-insurance products being hawked online, and the last thing you want to do is get stuck with one of these when you really, really need some help or have a serious medical condition. The last thing you want to hear when you hand over that insurance card at the doctor’s office is, “I’m sorry, this isn’t actually health insurance!”

Even in this day and age, this type of confusion happens to folks every day, at all ages and different incomes and levels of experience buying health insurance. Let’s see if we can make sure that never, ever happens to any of you!

To illustrate, I just typed “health insurance” into a popular search engine. The first eight links I got were all advertisements masquerading as information, and most of the first page was not particularly useful. In fact, the ONLY website you should be using to buy health insurance online in Louisiana (other than going directly to www.bcbsla.com or the website of a particular carrier) is www.Healthcare.gov. When you use the federal marketplace or shop directly on an insurance carrier’s website, you can rest assured that you will be given access to federally approved and funded Qualified Health Plans that meet the Affordable Care Act’s terms. In other words, REAL health insurance.

But, if you’re starting with a basic internet search, you have to be careful. Sites with names like healthcare.com, healthinsurance.com, healthcare.org, buyhealthinsurance.com are all out there, and none of them will sell you what you could buy for the price you could buy it on the official government website, healthcare.gov.

Sadly, there are aggregator sites and national representatives who call themselves “brokers.” They will sell you products that mimic health insurance and may offer some benefits, but these types of plans are not regulated and not required to cover anything when you get sick. Yet people can sell these products online and make them look as much as possible like health insurance to get people to click.

Sharing Doesn’t Mean Coverage

Probably the largest products in this not-real-health-insurance category are health care sharing ministry memberships. The founding of these ministries was quite amazing and a good thing, in my opinion. The framework was based on a Christian Biblical ideal to live under a scripture that requires each and every one of us to take care of each other, especially in times of illness and need. To me, that’s what being human is all about, and this intention is an honorable one.

As the name implies, in a sharing ministry, groups of people with common religious or ethical beliefs each commit to pay a monthly amount to be part of the ministry. The members’ contributions are pooled and used to pay for medical costs of other members.

One problem with the legitimate sharing ministries is that because they are not subject to requirements, rules and standards like health insurance plans are about what they cover and when, the members get to decide if your care gets paid for or not. And if you have a serious diagnosis, get in an accident or have lots of long-term conditions and need a lot of health care, you could end up with some huge bills you’re responsible for on your own.

And another issue is that the sharing ministries selling their wares on the internet to all comers may be more interested in picking up members to put money in the pool than in banding together with people who share a common set of beliefs. Over the past few years, several sharing ministries have been told to stop selling in certain states because they don’t actually meet the definition of a sharing ministry.

Unfortunately, there are people hawking these plans to folks who are never told, or don’t really understand, that the coverage is not regulated like healthcare.gov plans, and the plan is not required to pay for anything or any health care costs that you incur. In other words, you have very few legal protections at all if the members of the ministry decide your illness is unworthy of their contributions. There is no state insurance commissioner protection for you because these plans have fought in court to have the legal system say they are NOT INSURANCE. The flip side of that is they can’t be regulated or forced to act like an actual insurance company. If you don’t like their coverage decisions, you are on your own.

You might ask, “Why on earth would anybody buy one of these memberships?” Typically, people choose these because they are cheaper than real health insurance plans. But that’s because they cover very little, and they are usually quite profitable. And because the online sales folks who push them all too often aren’t really interested in educating purchasers that their new product is not insurance and contains no guarantees of paying their claims.

I’m not saying everyone in a sharing ministry is miserable and being cheated. If you want to be part of a community with similar faith beliefs and you understand this isn’t a true health plan, that’s one thing. But we’ve seen lots of situations in the past few years that show it’s not unusual for people to enroll in one without really understanding what they have purchased. Health care sharing ministries ARE NOT HEALTH INSURANCE by their own admission, and you can’t expect it to act that way.

If It Sounds Too Good to Be True, It Probably Is

The other product that you must be careful about buying online are combinations of products that cover minimal hospitalization costs plus drug discount cards, called “mini-med” plans. These are also not federally approved Qualified Health Plans, they are not eligible for federal assistance, and they typically don’t cover things like doctor visits, labs, imaging or complex drug treatments.

These products are sometimes sold as “temporary coverage,” or “short-term medical coverage.” They typically have cost limits on how much care you can get, unlike real insurance which has no annual or lifetime limits. Depending on the issuer, these products can be very, very skimpy coverage.

Another pro tip: If you never heard of the insurance company issuing the plan, best to avoid it completely. Or at the very least, look into it before you buy to make sure it’s what you expect.

My advice: If it’s not a Qualified Health Plan, don’t buy it. You want the peace of mind knowing you’ll have guaranteed coverage and the option to appeal any denials if you end up in a very serious, very expensive health situation.

What Should You Do Instead?

There is solid coverage available right now on Healthcare.gov, or through our website www.bcbsla.com, that covers everything required under the Affordable Care Act and other federal rules PLUS all the state mandates. Currently, heavily enhanced federal subsidies have made this comprehensive coverage the least expensive ever, even for folks who have very high income levels. Open enrollment for all these plans starts again on Nov. 1, but if you’ve lost health coverage or you got married, had a baby, moved from another state, or had some other big life change, you can shop and enroll now.

Straight Talk is, the best health insurance coverage, at the cheapest price since at least 2014 is available to you right now. Don’t get snookered into buying anything else from anybody else, and don’t start your shopping with a search engine! You’ll be so glad you did it the right way.

Posted on: June 17, 2022

Leave a Reply

Your email address will not be published.