Because of recent changes in law, short-term health insurance plans aren’t so “short” anymore; They can now be renewed for an extended period of time. Should you as a solo or small practice owner obtain this coverage for yourself? On the surface, short-term coverage may be an attractive option: it may appear to be flexible, affordable health insurance coverage. Your employees may be considering this as an option for themselves as well.
At TMA Insurance Trust, we want you to understand the details of short-term health insurance so that if you do decide to purchase a plan, you will be aware of what you are buying.
Shortcomings of Short-Term Health Insurance
The substantially lower premium of a short-term health insurance plan may seem attractive when compared with HMO or PPO policies. And short-term health insurance plans can provide some protection in the event you have an unexpected serious illness or accident. But there are serious drawbacks to short-term health insurance plans.
You Might Get Turned Down: Short-term plans do not cover pre-existing conditions. Some people are not able to obtain this coverage at all because of a health condition; others may be able to get coverage, but any treatment related to a pre-existing condition may not be covered. This could leave you with significant out-of-pocket expenses that your insurance will not cover.
Limited Scope of Care: Even if you are approved, most short-term plans do not cover regular office visits, maternity care, mental health care, and other preventative care. These types of medical care must be paid out-of-pocket, the cost of which adds up quickly for yourself and your employees.
When they were originally created, short-term health insurance plans were intended to provide stop-gap coverage for 30 to 60 days. They were never designed to provide long term health insurance coverage.
Through our research, we’ve uncovered two little-known waivers that might help you qualify for ACA-compliant group PPO health insurance. With these waivers, you do not have to pay 50% of your employees’ premiums – as typically required. You could contribute as much or as little as you want. Additionally, you would not need 75% of your employees to participate in a group plan; there would be no number of employees required to participate. These waivers may provide the access to the comprehensive group insurance you prefer while helping to control the cost to your practice.
If you are a practice owner who has a Tax ID number and at least one full-time employee on payroll, you may qualify to take advantage of this alternative. Contact us during Health Insurance Open Enrollment and we will give you the information you need to help you make the best health insurance decision for yourself and your practice.
For over 60 years, TMA Insurance Trust advisors have been serving Texas physicians, their families and staff. TMA Insurance Trust prides itself on offering unbiased information and strategies to members, along with exclusive group rates on a range of the highest-rated plans in the industry.
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