The "Uninsurables"

Anyone with "pre existing conditions" has heard this term before.  There are many reasons that Insurance companies decline potential clients.  They range from pre existing conditions, expensive prescriptions, to dangerous lifestyles.  I happen to believe that some people get declined because that underwriter was having a bad day (purely conjecture).  There are some scenarios in which "uninsured" folks can get insurance, but the insurance company will place a rider (refusal to cover) on the very condition that the client wanted the insurance for.  The purpose of this article is to detail the different options that "uninsurable" people have today, and will have going forward. 

There are many options for people that cannot get a traditional major medical.  Each state offers a plan that everyone qualifies for (provided they have been declined from a traditional insurance company), but it is not free.  There are a number of companies that offer indemnity plans, or plans that define the maximum benefit (limit the maximum amount of coverage provided).  Another option for these people is a membership to various associations that provide a myriad of discounts/benefits.  Some folks elect to do apply for cash payout policies (the client recieves cash for accidents, illness, or injury).  There is one more program that is offered through the state that is reserved for people the fit into the "low income" category, and there no underwriting requirments (other than being poor). 

I will go into a little more detail on the programs that I outlined above. 

There are two major plans that are run by the state (in AZ).  The AZAHCCS (often called "access") http://www.azahcccs.gov/Default.aspx is the program that is based on income.  There are a number of subgroups under the "access" umbrella, but the takeaway is that it is for "low income" earners.  These programs are becoming more difficult to qualify for due to the increasing amount of applicants.  As far as the plans go, they are very good.  There are some restrictions regarding doctor choice, but the overall care is comprehensive.  The bottom line is if you are poor enough, you can get free insurance (thank your neighbors...).  The other plan offered by the state is call the PCIP plan, https://pcip.gov/.  This plan is available to all persons with pre existing conditions that have not been insured for at least 6 months, and have been declined from one or more insurance companies.  This plan does cost money.  The monthly premium is based on a persons' age.  The coverage offered in this plan is comparable to a traditional individual plan, and quite affordable. 

I won't dive too heavily into the indemnity plans.  The short story is that there are a number of companies that offer plans that put a cap on the benefits available to their clients.  These plans have their place at the health insurance table.  By limiting the amount paid out, the insurance companies can make premiums more manageable for the consumer.  As ObamaCare nears, these types of plans will grow in number in an effort to offer "us" more affordable options.

The next option for the "uninsurables" is memberships to various associations.  There are many nonprofit organizations that offer discounts (often medically centered) for everything from doctor/hospital visits, to prescriptions, to roadside assitance, and even movie tickets and groceries.  These associations are great for the person that is willing to take on some risk regarding their health care costs, or just wants additional coverage to bolster their existing plan.  One example of this type of association can be found at www.affordableservices.org.  Like I said, there is no shortage of groups with discount packages to help the consumer in their quest for better coverage. 

The final option that I detailed is the cash payout policies.  These policies are truly personal coverage. Many people elect to use these policies to improve their overall coverage.  They don't offer any doctor copays, or any other "doctor" centered options.  They are designed to put cash in the pocket of the person in need when an accident or major illness occurs.  It gives the consumer a certain amount of control over their healthcare options when disaster strikes.  The fact is that if you get injured or sick, the hospital/doctors will fix you , and bill you later.  Once you have recovered from your afflication, you can figure out how to cover said bills.  This alone is not the most responsible plan for health coverage, but if you are "uninsurable", or just want to have some personal coverage, it is a decent option.  Some of the major companies that offer these coverages are Aflac, and Surebridge (http://www.surebridgeinsurance.com/).  There are others, but these are the major players in the personal coverage game. 

I am sure that there are other options for the "Uninsurables", but I just wanted to hit the high points to give a better understanding of the situation.  When the Affordable Care Act comes to fruition (October 2013), the idea of being "uninsurable" will be a thing of the past.  The new question will be "how can we afford this".  Time will tell.

Opinions, thoughts and comments are always appreciated.

 

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Todd Uzzell
www.insphereis.com/tuzzell
todd.uzzell@gmail.com