Archive for Day: July 12, 2018
IHC Temporary Health Insurance Plan Overview
IHC Health Insurance has become one of many companies to surface over the last few years. IHC does not partake in any ACA qualified plans and focuses on consumer driven health products, such as Temporary Health Insurance. Many states allow clients to purchase back-to-back temporary policies. Many consumers have chosen this option as their preferred option for coverage. This is mostly due to the affordability of these policies and the flexibility of use.
This site works with a multitude of temporary and short term medical providers. We recommend filling out a quote form so shoppers can see the best selling plans in their area.
Temporary Health Insurance Options
IHC currently has two options for short term medical coverage. First we will discuss the Connect 2.0 plan which is the more affordable of the two options. The goal is to obtain affordable coverage and not worry about gaps in coverage while you’re between health care plans. Here are the most common reasons to buy a temporary policy.
Missed open enrollment: If you have missed the opportunity to Connect coverage during the open enrollment period, you may be ineligible to buy a major medical policy until the next open enrollment period, unless you have a qualifying event. No need to worry, we got you covered!
Waiting for an ACA plan to start: Many plans on the Health Insurance Marketplace are extremely expensive and offer only one effective
date, the first of the month. Depending on when you submit your application, and how long it takes you to prove qualifying for a SEP, Special Enrollment Period, you may have to wait up to 45 days for your coverage to begin. Often that is a best case scenario and sometimes it can take up to several months, or many consumers report having to wait until the next January 1st for coverage to begin.
Newly Hired: Often, an employer-sponsored plan includes a waiting period before health insurance benefits begin. No need to worry, we got you covered!
Filling the Gap: Coverage can begin as early as the day following your online application, if approved, and last up to 90 days. AND many states offer instant re-apply to obtain longer lengths of coverage.
Unique Plan Benefits
$50 Office Visit Copay: The copay applies to the first covered office visit during the policy period. After the copay, the balance of the
doctor office visit charge is covered at 100 percent. Additional covered expenses incurred during the office visit, including expenses for laboratory and diagnostic tests will be subject to plan deductible and coinsurance.
Deductible Options, You Decide: $1,000 | $1,800 | $2,500 | $5,000 | $10,000
The selected deductible must be paid by the covered person before coinsurance benefits begin. Family deductible maximum: Three individual deductible amounts per a policy term.
Coinsurance Percentages: a variety of coinsurance percentages including 20%, 30%, and 50% – You decide.
Out-of-Pocket Limits: $1,000 – $10,000 – You decide
Maximum Benefit per Term: $2,000,000
Check the rates on Short Term Health Insurance.
Covered expenses: includes treatments, services and supplies for:
- Physician services for treatment and diagnosis
- X-ray exams, laboratory tests and analysis
- Mammography, Pap smear and prostate antigen test
- Emergency room, outpatient hospital surgery or ambulatory surgical center
- Surgeon services in the hospital or ambulatory surgical center
- Services when a doctor administers anesthetics up to 20 percent of the primary
surgeon’s covered charges
- Assistant surgeon services up to 20 percent of the primary surgeon’s covered charges
- Surgeon’s assistant services up to 15 percent of the primary surgeon’s covered charges
- Ground ambulance services up to $500 per occurrence
- Air ambulance services up to $1,000 per occurrence
- Organ, tissue, or bone marrow transplants up to $150,000 per coverage period
- Acquired Immune Deficiency Syndrome (AIDS) up to $10,000 per coverage period
- Blood or blood plasma and their administration, if not replaced
- Oxygen, casts, non-dental splints, crutches, non-orthodontic braces, radiation and
chemotherapy services and equipment rental
Inpatient covered expenses:
- Hospital room and board, doctor visits and general nursing care up to the amount billed for a semi-private room or 90 percent of the private room billed amount
- Intensive care or specialized care unit up to three times the amount billed for a semiprivate room or three times 90 percent the private room billed amount
- Prescription drugs administered while hospital confined
Pre-existing Condition: Connect 2.0 will not provide benefits for any loss caused by or resulting from a pre-existing
condition. A pre-existing condition is any medical condition or sickness for which medical advice, care, diagnosis, treatment, consultation or medication was recommended or received from a doctor within five years immediately preceding the covered person’s effective date of
coverage; or symptoms within the five years immediately prior to the coverage that would cause a reasonable person to seek diagnosis, care or treatment. (Notice Plan Option 2, Connect Plus (see below) does have a higher level of coverage for pre-existing).
Usual and reasonable charge: The usual and reasonable charge for medical services or supplies is the lesser of: a) the amount usually charged by the provider for the service or supply given; or b) the average charged for the service or supply in the locality in which it is received.
With respect to the treatment of medical services, usual and reasonable means treatment that is reasonable in relationship to the service or supply given and the severity of the condition. In reaching a determination as to what amount should be considered as usual and reasonable,
we may use and subscribe to a industry reference source that collects data and makes it available to its member companies.
Continuing Coverage: If your need for temporary health insurance continues, most states allow you to apply for another short-term medical plan. Your application is subject to eligibility, underwriting requirements and state availability of the coverage. The next coverage period is not a continuation of the previous period; it is a new plan with a new deductible, coinsurance and pre-existing condition limitation. It is best to fill out a quote and shop all available options and speak with an agent to get the best plan for you.
Connect Plus – Temporary Health Insurance with a limited benefit for pre-existing conditions. Providing peace of mind during times of transition.
Connect Plus is a short-term medical (STM) insurance plan with a limited benefit for pre-existing conditions. STM, sometimes called short-term medical limited duration insurance, is designed to provide coverage during transitions or gaps in major medical coverage. Most STM plans do not cover healthcare expenses for pre-existing medical conditions. Connect Plus provides a benefit up to a maximum of $25,000 for eligible pre-existing healthcare expenses. This policy is a step above the standard Connect 2.0 policy explained above.
Why Short Term Health Insurance?
Short Term Health Insurance plans provide coverage during life transitions. When you are between group insurance or individual major medical policies, these temporary health plans pay for covered medical expenses due to unexpected illnesses or injuries. Covered expenses include diagnostic physician visits, emergency room treatment, hospital stays, surgery, intensive care and more, but do not include maternity care or outpatient prescription drugs. Learn more about Short Term Health Insurance.
An IHC Health Insurance Plan may be right for you if you:
- Have missed the open enrollment period and aren’t eligible for special enrollment under the Affordable Care Act (ACA)
- Are waiting for your ACA coverage to start
- Are waiting for health insurance benefits to begin at a new job
- Are looking for coverage to bridge you to Medicare
- Are turning 26 and coming off your parent’s insurance
- Are losing coverage following a divorce
- Are needing an alternative to COBRA
- Are healthy and under age 65
Customize Your Plan: Select from various benefit levels which best meet your coverage and premium needs. You can also include other supplemental coverage such as dental or a discount prescription drug program to obtain additional coverage.
Quick and Convenient: Coverage can begin as early as the day following your online application. The underwriting process is simple and policy fulfillment, including claims and ID cards, are available online.
Cost Effective: Temporary health insurance plans are affordable. While short term medical does contain limitations when compared
to traditional major medical plans, the premium is generally lower.
You may want to keep the following in mind as you plan for your needs and
explore your options:
- IHC plans do not meet the Minimum Essential Coverage requirements under the ACA and may result in a tax penalty. Temporary plans are designed to provide temporary healthcare insurance during unexpected coverage gaps.
- The ACA-compliant medical plans are guaranteed issue, meaning you cannot be denied coverage based on your health history. These plans are underwritten, which means you must answer a series of medical questions when applying for
coverage. Based on your answers, you may be declined for coverage.
- Unlike the ACA plans, which are required to cover the 10 Essential Health Benefits (EHB), These IHC plans cover some EHBs but not necessarily all. Plans will vary in what they cover, so you should check your plan details carefully.
IHC Plans are not Affordable Care Act (Obamacare) Plans
IHC plans do not meet ACA standards. The ACA is a Federal law that requires all major medical plans to provide specific benefits and mandates that most Americans have health plans that qualify as Minimum Essential Coverage (MEC). These rules do not apply to IHC plans.
Pre-existing Condition – How it works
Unlike most temporary health plans, Connect Plus provides a benefit for eligible preexisting conditions. The plan provides up to a maximum of $25,000 for eligible medical expenses for a pre-existing condition, per person, per policy. After the $25,000 maximum has been reached, expenses due to pre-existing conditions are not covered. The definition of a preexisting condition is listed below:
A pre-existing condition is any medical condition or sickness for which medical advice, care, diagnosis, treatment, consultation or medication was recommended or received from a doctor within five years immediately preceding the covered person’s effective date of coverage; or symptoms within the five years immediately prior to the coverage that would cause a reasonable person to seek diagnosis, care or treatment. This period of time may vary by state.
Utilize a network provider and save
With your plan, you have the freedom to choose any provider. In certain markets, you also have access to discounted medical services through national preferred provider organizations (PPOs). These network providers have agreed to negotiated prices for their services and supplies. While you have the flexibility to choose any healthcare provider, the discounts available through network providers for covered services may help to lower your out-of-pocket costs. At the time of service, simply present your identification card which will include
the network information needed for the provider to correctly process covered billed charges.
Continuation of Coverage: If your need for temporary health insurance continues, most states allow you to
apply for another IHC plan. Your application is subject to eligibility, underwriting requirements and state availability of the coverage. The next coverage period is not a continuation of the previous period; it is a new plan with a new deductible, coinsurance and pre-existing condition limitation. Note that based on your state, you may be limited to two or three consecutive terms only.
Is Temporary Health Insurance the Right Choice for Me?
It is recommended to get a short term medical insurance quote on this site, so you can see a multitude of options. Then it is advised to speak with one of our licensed agents so you may ask questions and review products. Products vary greatly from state to state and an agent can help explain what is unique about your state. Since the start of the ACA, temporary health insurance plans have become more and more popular.