Archive | November 21, 2013

Why your healthcare insurance was cancelled and why it isn’t coming back

Why you lost your old health plan.

1 Your plan did not cover Outpatient care, such as Urgent Care.

Emergency rooms visit

Treatment in a hospital as an inpatient

Care before or after your baby is born

Mental Health or substance abuse treatment

Prescription drugs

Services to help you recover from illness or injury, disability or a chronic condition. Including PT, OT, speech therapy, psychiatric rehab and others

Preventive services including counseling, screening, vaccines and care for managing chronic disease

Pediatric services including dental and vision.

All plans must have these things. If they didn’t they were substandard and have to be replaced.

2. There is a second reason your plan was cancelled. It was not affordable.

“Employer coverage is considered affordable – as it relates to the Advanced Premium Tax Credit (APTC) – if the employee’s share of the annual premium for self-only coverage is no greater than 9.5% of annual household income. Starting in 2014, individuals offered employer-sponsored coverage that’s affordable and provides minimum value won’t be eligible for a premium tax credit.”

So if your deductible, premiums, out of pocket or life time maximums or copays were too high then it wasn’t affordable. This means things like mental health plans with a $10K deductible are not affordable since you can’t afford to use it.

That is why your health plan is not going to continue and because the insurance companies design and install plans before they are supposed to start and put the terms dates in the computer systems months in advance, no matter how the President says you can keep that non-compliant plan, you probably can’t. I know the company I worked for has already put those termination dates in the system. That was done October 1st.

That is just the way the system works and if you have a cancellation notice you probably will not be seeing that plan again. It’s way too late for that. It might behoove you to look at what wasn’t covered under your old plan and what your deductible and co pays or out of pocket costs were before you start yelling your old plan was better.