Affordable Non-ACA Plans
Health Insurance Advisors has completed our analysis of the 2018 Non-ACA plans available with different insurance companies. Based on our research, we are recommending the Pivot Health plans by Companion Life; a 40 year old, A+ rated company.
These plans do not cover Pre-existing conditions and are not appropriate for clients with recent or ongoing medical conditions.
These plans have very good coverage for accidents and new medical conditions that emerge after the policy start date.
Affordable Non-ACA Plans:
- Cost approximately 50-60% less than ACA / Obamacare compliant plans
- Have access to a large quality network of providers in Georgia and nationally
- Require passing a simplified medical history questionnaire
- Currently subject to the ACA tax penalty – although legislation is pending to cancel it
- The downside: Plans will not cover Pre-existing conditions, Preventative care or Pregnancy.
Please read the Pre-existing condition definition – think it through carefully how it will affect your family.
The “look back” period is five years, please call with any questions.
A recent executive order from Washington now allows these policies to be issued for four consecutive 90 day coverage periods.
Previously, under Obamacare rules – they could only be issued for a maximum of 90 days, which prevented them from being a reasonable option.
With the new 4 consecutive 90 day policies, clients will have continuous coverage for 360 days starting January 1, 2018. New legislation is expected to extend it to 365 days.
- Current law requires the deductibles and out of pockets limits to reset each 90 days, as does the member’s policy maximum benefit.
- There are no medical questions to qualify or new waiting periods after the initial enrollment.
Medical conditions that arise, that are covered by the initial 90 day policy will be continue to be covered through the 360 day period.
I have read the Exclusions, Limitations and Pre-Existing conditions definition.
a. Charges resulting directly or indirectly from a condition for which a Covered Person received medical treatment, diagnosis, care or advice within the sixty-month period immediately preceding such person’s Effective Date are excluded for the first 12 months of coverage hereunder.
b. Pre-existing conditions includes conditions that produced any symptoms which would have caused a reasonable person to seek diagnosis, care or treatment within the sixty-month period immediately prior to the coverage effective date
Pivot Health Provider Network
Pivot Health members can see any doctor and go to any hospital. Pivot Health fee schedule for doctors is 125% more and hospitals and facilities 150% more than the Medicare fee schedule.” Doctors and hospitals have approximately 30% – 35% of their patients on the Medicare fee schedule.