Lindeen Warns Montanans About Short-term Health Plans

csimt 2016, Insurance, Press Release

Open Enrollment for Individual Health Plans Ends Sunday Night

With just days remaining before the Jan. 31 deadline for purchasing 2016 individual health insurance plans through www.healthcare.gov, Montana’s insurance regulator reminds consumers to look closely at the plans they consider and weigh the benefits that the plans offer.

Montana Commissioner of Securities and Insurance Monica Lindeen warns that consumers should do their homework, especially if they are considering short-term medical plans,

“Many people may only consider the monthly costs, but short-term plans may end up costing you more in the end,” said Lindeen.

All plans offered through www.healthcare.gov are termed major medical insurance. These policies offer coverage for preventative care and treatment of pre-existing conditions with no lifetime or annual maximums.

While short-term medical plans may be a good choice for some consumers, such as those seeking temporary stopgap coverage between open enrollment periods, they differ from major medical insurance plans. Short-term plans set lifetime or yearly dollar limits, fail to pay for preventative health care, exclude many accidental injuries and care of pre-existing conditions. They also do not guarantee renewal, putting Montanans at further risk should they suffer injury or illness.

And, people who buy these plans will still have to pay a tax penalty for failing to have the minimum coverage required by federal law. That penalty is $695 per adult or 2.5 percent of your gross income – whichever is higher.

“The penalty could come as a surprise for some who may have been told that short-term plans would meet the federal health insurance requirement,” Lindeen said.

Lindeen said all plans offered through www.healthcare.gov meet the requirements, and it is the only website that offers tax credits and subsidies to those with qualifying income levels to help offset the premium and other out-of-pocket costs.  So far in the current open enrollment period, about 80 percent of Montanans getting coverage through www.healthcare.gov will qualify for those tax credits or cost-sharing reductions.

If consumers are considering plans sold outside of www.healthcare.gov they should ask the following questions:

  • Is renewal of the insurance plan guaranteed?
  • Does the policy have unlimited payouts?
  • Does the plan cover pre-existing conditions?

If the answer to any of these questions is “no,” the plan does not meet the minimum threshold of coverage needed to avoid a personal income tax penalty under the Affordable Care Act. Consumers should ask if the person selling the plan is a licensed insurance agent in Montana and then ask for their license number.

The current period of open enrollment under the ACA ends at midnight (Pacific Time) on Sunday, Jan. 31. To enroll in a plan that meets the minimum requirements under the ACA, go to www.healthcare.gov or see your insurance agent. Those who seek one-on-one assistance to enroll can find a list of people trained to help navigate www.healthcare.gov at the commissioner’s website www.montanahealthanswers.com.