family-insurance-1316543_640The current health care options can be overwhelming. This article is an attempt to make the choices a bit clearer. If you own your own business or work for an employer that does not provide health insurance coverage, you now must buy insurance or pay the penalty for not having insurance on your tax return. This applies to every working person in the USA.

So what are your options?

Qualifies for ObamaCare exemption:

1. Sign up at your state’s health care exchange online or at the federal government site healthcare.org.

Fill out an application and your federal tax savings will be calculated (if any). Then choose one of the plans that are offered in your state. Your federal tax savings will show as an automatic deduction on the plans available. Some states only offer 1 option, others offer many options. This is the easiest avenue to take.

2. Health care sharing ministry

These are voluntary, charitable membership organizations that share medical expenses among the membership.  Members of recognized health care sharing ministries are exempt from the requirement to have health insurance.

Samaritan Ministries –. http://samaritanministries.org

Christian Care Ministry (Medi-Share) – https://mychristiancare.org/medi-share/

Liberty HealthShare – https://www.libertyhealthshare.org

Healthcare sharing ministries operate entirely outside of ObamaCare’s regulations, and typically offer benefits for about half the cost of similar health insurance.

3. Natural Medicine Healthcare.

GreenSurance– an alternative to Obamacare that recognizes natural medicine mygreensurance.com

O’Na HealthCare – an alternative to Obamacare, this is a healthcare co-operative formed under a Native American Tribal Community. Includes coverage for complimentary and natural modalities, services, and protocols including nutritional supplements, homeopathic remedies, herbs and more. Onacare.com

4. Health care cooperatives

Some consumer-owned health care co-ops provide prepaid health care services to their members, while others may pool resources to purchase health insurance at a better rate. A member becomes an owner, so each member can participate in decisions about how the co-op is administered. Any savings of the co-op are returned to the member in the form of lower costs or better services.

Group Health Cooperative is one example and provides care for 600,000 people in Washington state. HealthPartners is another example and provides care for 1.25 million people nationwide. Both have been in existence for over 50 years.

 

Does not qualify for the ObamaCare exemption:

1. Specific insurance plans

Fixed-benefit, critical illness, or accident insurance are other options. These policies pay cash in the event you are diagnosed with cancer, spend a night in the hospital, or need some other medical treatment. These policies cost a fraction of health insurance premiums under ObamaCare. Reimbursement is in cash which means one isn’t locked into any particular provider network.

2. Motor vehicle insurance

You can obtain medical insurance related to auto accidents through your auto insurance policy. These policies could have very reasonable premiums. It would be prudent to have a full coverage insurance policy, but it could give the option of choosing a more affordable partial insurance benefit.

3. Short-term health insurance policy.

These policies usually last between one and 11 months and are not regulated under ObamaCare. It is designed for the person with a gap in insurance coverage, such as a job loss or divorce. The insurance agency can deny coverage for preexisting conditions. These policies do not have to cover routine preventative care. When short term coverage expires, it may not be possible to immediately enroll in ObamaCare because open enrollment may not coincide. There may also be a limit to the amount of time you can be on a short-term policy (for example, in Minnesota, short term insurance is limited to 365 or 555 days).

4. Telemedicine service

This is a lower-cost option in which doctors treat relatively simple medical issues via phone calls, email, or a video connection. Telemedicine especially works well for common conditions and illnesses.

5. Concierge primary care

For the patient who visits a doctor more than a couple times per year, a direct primary care practice could give access to nearly unlimited primary care visits for a modest monthly fee.

 

Unusual exemptions

Here are a few exemptions most people don’t know about.

a. if the lowest cost health insurance plan exceeds 8.05% of your income, then you may be exempt from the penalty. The calculation is based on the income you or your family will earn this year and the lowest cost health-insurance plan available to you or your family, either through employers, or the federal marketplace.

b. It seems that, according to the way the rules are set up, unlike with some other tax penalties or consequences, there are no levies, liens, or criminal penalties imposed if you don’t pay. And because the penalty is subtracted from your tax refund, if you have no refund, you won’t lose that money.

c. If you were uninsured for less than three consecutive months. The fine only applies to people who have been without insurance longer than that.

d. Late in 2013, the government added 14 new waivers for people who have experienced personal hardships such as domestic violence, substantial property damage from a fire or flood, the death of a close relative, a utility cut-off, or bankruptcy. Many of those hardship exemptions do more than cancel the fine. They may also let you buy coverage after the open enrollment period ends on Feb. 15, or permit you to purchase insurance that doesn’t meet Obamacare’s strict rules for “minimum essential coverage.”

Up-front “package” prices for surgical self-pay patients

The Surgery Center of Oklahoma and Regency Healthcare have prices typically much less than what is charged at most hospitals. There are also internet sites such as MediBid with doctors bidding to provide surgery or treatment, often yielding substantially less cost.

For example, in Idaho, IDID (Independent Doctors of Idaho) do not contract with the large hospitals and can typically offer office visits, surgeries and procedures more affordably.

Medical tourism

Medical tourists can be patients willing to travel internationally for affordable health care or to get medical care more expediently than in their own country. This can involve medical, dental and surgical care. Certain therapies could be illegal in the home country, but offered legally abroad (fertility treatments). Costs could be ¼ to 1/3 the cost in the US.

Affordable pharmaceuticals

Less expensive generic pharmaceuticals are sometimes available at large chain pharmacies such as Walmart and CVS.  Online sites such as GoodRx.com and WeRx.org allow patients to view competitive medication pricing at local pharmacies.