Short-Term Medical Insurance
Alternatives to Obamacare
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Hummingbird Insurance agents are licensed to help out folks in North Carolina, Florida, Georgia, Texas, Virginia and Oregon.
Looking to set yourself up with the most robust coverage possible, while still enjoying substantial savings?
Here at Hummingbird Insurance, we've handcrafted our 3-Point Plan:
The Short Term Medical or Tri-Term Medical plans provide strong coverage for your core health insurance needs. In our 3-Point Plan, they pair well with one of the following indemnity options:
A) Health ProtectorGuard "Hospital & Doctor" fixed indemnity plans, or
B) Accident ProGuard with up to $10k Accident and $10K-$50k Critical Illness benefit, or
C) Accident ProGap with up to $10k Accident, $10k Critical Illness and $2500 Hospitalization/Sickness benefits.
The options available include the most popular plans this year in the 'Alternatives' market, which is non-ACA off-Marketplace coverage. These are great plans from the strongest insurers in that state, but it's important to know that they will not cover pregnancy, mental health or substance abuse, and they will exclude any pre-existing conditions in the past 2 years or 5 years, depending on the condition.
The Tri-Term Medical plans cover allowed pre-existing conditions after 12 months of coverage; whereas, the Short Term Medical will always exclude coverage for any pre-existing conditions within the exclusionary time frame. Both options, however, will provide coverage for any medically necessary expenses that are not pre-existing, and at a much lower premium than full-price ACA or Obamacare plans are available for.
The Tri-Term Medical plans are becoming one of the most popular coverage options available! You purchase a policy with the deductible and starting month of your choice, with plans available to begin the very next day. Coverage lasts up to three years, with the deductible(s) resetting annually per person. Family deductibles are 2x the chosen deductible for an individual per policy year. There are two main versions of this plan:
1. The Plan 100 Max, which pays all medical costs after you reach the deductible. This plan has a "true" deductible, in that there are no doctor copays, but there is a $75/copay for urgent care. Once the deductible is met, all eligible medical expenses are covered entirely by the plan, with no further copays or coinsurance.
2. The Copay Select Max, which allows each individual in the plan to enjoy covered doctor visits for a flat $50 copay, up to 4x each per term (per year). There is a 30% coinsurance once the deductible is met, for a maximum out-of-pocket of $4,500 beyond the deductible. This plan is becoming popular with families who want to enjoy predictable copays for regular doctor visits.
These Tri-Term plans will not cover any pre-existing conditions that you've had claims on in the past 24 months for the initial 12 months, but would then cover allowed pre-existing conditions after that for the remaining 2 years on the policy. Pre-existing conditions that would not be allowed include things like recent heart attacks or strokes, congestive heart disease, kidney failure, diabetes, cancer, etc. We should look at ACA plans available if we need to deal with one of these conditions.
Short-Term Medical plans could be the right fit if you're looking for the most affordable options. They have a wide range of customization, and are excellent for bridging a gap in coverage. Just need something to get you through to Obamacare Enrollment, or hold you over until your employer offers insurance? These plans are affordable ways to get the coverage you need. Each plan has a minimum 30-day length. Short-Term Medical plans were recently changed to allow up to 364 days of coverage on one policy in most states. Also, you can purchase 2 plans at one time, with the second plan starting up to 90 days ahead from the date of application. This allows us to provide continuous, guaranteed coverage for up to 453 days straight, with one plan of 89 days followed by a second plan of 364 days on joint applications. Our Short-Term plans provide a $75 copay for Urgent Care services.
What are indemnity plans? These are unique policies that send you a certain flat amount as "indemnity reimbursement." Some, like the accident plans, will reimburse you for the cost of an accident up to a certain amount. Others, like the ProtectorGuard series, pay out a flat amount for a number of different services, such as hospital stays and doctor visits. These are "first-dollar" plans, because they have no deductible.
Health ProtectorGuard Select Value "Hospital & Doctor" plan - Fixed indemnity plan with coverage for hospitalization, doctor visits, prescriptions, outpatient imaging or surgery with Unlimited Benefits. Benefits received may be more than actual costs incurred; you would get to retain any extra funds received. Fixed benefit of $3,000/day of hospitalization is paid directly to you, regardless of when another medical plan starts covering expenses charged.
Accident ProGap - Coordinated indemnity plan which will reimburse you medical expenses that arise from an accident basis up to the amount spent, or the benefit limit - whichever is less, with a Critical Illness benefit equal to the accident benefit amount. No extra funds would ever be received by you from the Accident Benefits listed. The Critical Illness benefits listed are a fixed amount and are lump sum with these plans. The Hospital/Sickness benefit is reimbursable.
Accident ProGuard - Coordinated indemnity plan which will reimburse you medical expenses that arise from an accident basis up to the amount spent, or the benefit limit - whichever is less, with Critical Illness benefit amounts from $10,000 to $50,000 available. No extra funds would ever be received by you from the Accident Benefits listed. The Critical Illness benefits listed are a fixed amount and are lump sum with these plans. There is no Hospital/Sickness benefit on this plan. All of these plans are claims-based and benefits are paid directly to you, not coordinated with any other coverage or carriers. The money sent to you is your to do with as you wish - you can use it to pay medical providers directly for bills due, reimburse yourself, or on other bills altogether.
The most common combinations we've seen of Short-Term Medical + Indemnity plans over the past year are listed below:
(Tri-Term or Short Term Medical) + Health ProtectorGuard
Basic Shield A:
(Tri-Term or Short Term Medical) + Accident ProGap
Basic Shield B:
(Tri-Term or Short Term Medical) + Accident ProGuard
If you don't already have affordable primary care and you live in Western North Carolina, we highly recommend exploring the Integrative Life Membership at Integrative Family Medicine of Asheville (IFMA). IFMA is located in the River Arts District on Depot Street, and has consistently been one of the highest consumer-rated providers in the area over the past several years.
IFMA were pioneers and are leaders in the 'Direct Primary Care' membership-model revolutionizing the nation, providing healthcare with clear and simple pricing upfront. The normal IFMA membership for an individual is currently $69/mo for EFT payments, or $74/mo for credit card payments. We are able to SAVE you $80 and eliminate the normal enrollment fee to refer you in! By the way- there is a $250 early cancellation fee is the membership is quit in under 12 months. You can learn more about IFMA at their website: integrativeasheville.org. Just let us know if you'd like to get the discount at IFMA.
Another, lower-priced access to care includes our ‘telemedicine’ or ‘telehealth’ option from HealthiestYou by Teladoc which gives you unlimited video-phone access to doctors 24 hours a day, 7 days a week with NO additional copays. Labs and tests can be ordered, and prescriptions can be sent from your virtual 'visit' - all without the need for any waiting rooms, germs or regular copays. Most common ailments can be handled easily and quite affordably with telemedicine.
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