How to lookup fair costs for health care

By | Uncategorized

Ever wonder if you are getting ripped off by your healthcare provider?

Healthcare Services ShoppingHow do you know if you are being charged a fair price for health care services and products? If your health insurance didn’t cover something – how do you know what the fair price should be?

Health care is one of the few professions that doesn’t give a reliably accurate estimate of costs before the buyer receives services.  So before you commit to a medical expense visit this site- .  FAIR Health’s mission is to help you understand your healthcare costs and health coverage and to bring transparency to healthcare costs and insurance.

Do you need help sorting out health insurance and finding an affordable solution?  Call us 1-800-257-1723 or click here to schedule an appointment.

This Years Rates Going Up As Much As 55%

By | Uncategorized

Insurers seek health care policy clarity as critical deadlines loom

 Health Care FOXBusiness

trumpInsurers face two critical deadlines in September, by which time it appears increasingly unlikely they will have clarity on a number of key issues, including whether the federal government will continue funding key ObamaCare subsidies.

“Unless Congress acts by September 27—when insurance companies must sign contracts with the federal government to sell insurance on the federal exchange in 2018— 9 million Americans in the individual market who receive no government help purchasing health insurance and whose premiums have already skyrocketed may see their premiums go up even more,” Senate Health Committee chair Sen. Lamar Alexander (R-Tenn) said in a statement on Monday.

Alexander said lawmakers will begin hearings in September on stabilizing the insurance marketplace. He has also asked President Donald Trump to continue funding cost-sharing reduction subsidies, or reimbursements for discounted care provided to low-income individuals, until lawmakers develop a working solution to remedy rising health care costs. The White House has been making payment decisions on a month-to-month basis, while insurance companies have sought a more solid commitment, particularly after the president proposed letting ObamaCare “implode” by eliminating the subsidies altogether.

Meanwhile, insurance companies have been searching for ways to deal with the CSR payment quandary. One of the nation’s largest insurers, Anthem (ANTM), warned late last month that without certainty regarding these payments, it could be forced to narrow its participation on the exchanges even further. In the weeks since Anthem issued that warning, it announced its withdrawal from the ObamaCare marketplace in Nevada and a dramatic reduction of participation in Georgia.

Aetna (AET) and Humana (HUM) announced earlier this year they would not offer plans on the individual marketplace for 2018, citing marketplace volatility and the damaging costs of participation.

For the companies choosing to remain, hiking premiums is one of the popular ways to mediate policy uncertainty. Molina Healthcare (MOH) announced earlier this month it would seek a 55% premium increase in the marketplaces where it would remain next year. That number would drop to 30% if cost-sharing reduction subsidies were definitively funded, the company said. Meanwhile, PacificSource Health Plans in Idaho has requested a 45.6% rate increase. In California, monthly health premiums are set to rise by an average of 12.5%, state officials said earlier this month.

Insurers have to submit final premium proposals for 2018 by September 5, the first day of the Senate Health Committee’s hearings. Unless the government makes a decision on CSR payments by then, insurers will be flying blind on how to price plans accurately. They have asked the federal government for $8 billion in payments to fund discounted consumer care over the coming year.

September 27 is the final deadline for insurers to sign contracts for next year’s health care plans.


Where Obamacare Has Become Unaffordable, Short Term Health Insurance Can Help

By | Health Reform, Uncategorized
UnaffordableSeth Chandler, Contributor

Next time you run into someone who minimizes the problems with Obamacare, I want you to introduce them to Fay. She’s a reasonably healthy 60 year old grandmother living in Fayette County, Illinois and earns about 450% of the federal poverty level ($53,460) working for a small employer that does not provide her with health insurance. Right now, if she wants the second lowest silver plan in her area, she needs to pay 28% of her pre-tax income in order to get it — $1,247 per month. Fay just doesn’t have that kind of money and thus lives in fear of medical bankruptcy should something go wrong.

Fay is imaginary, so your introduction will need to be metaphorical. But lots of people like her exist throughout the United States. In one third of the rating areas covered by the federal individual health insurance Exchanges, a 60-year old earning about 450% of the federal poverty level ($53,460) would need to pay at least 20% of their pre-tax income in order to pay for a typical Obamacare health insurance policy. Indeed, in over 70% of the rating areas for which policies are sold on, the second lowest silver plan would cost at least 15% of a person like Fay’s income. To calibrate these facts, recognize that Congress wrote a law that basically says that someone earning just a bit less that Fay, say $47,400, should pay no more than about 10% of their income to purchase the same policy.

It’s clearly going to get worse. If premiums go up about 20%, which is a pretty conservative estimate for 2018, over 50% of the rating areas will feature health insurance premiums that bust the 20% barrier for people like Fay. And in 91% of the rating areas, people like Fay will be paying over 15% of their pre-tax income if they want health insurance on the Exchanges. And it’s not lavish health insurance either. These policies often have deductibles over $3,500 and out-of-pocket limits over $5,000. That, my friends, is crazy.

Moreover, it’s not just people of ages and incomes highly similar to Fay. There are a lot people who are going to find that the individual health insurance market has, for all practical purposes, collapsed, even as various pundits cheerfully point to the low number of areas in which it has not done so literally.

Let me draw another example from the middle class: Humphrey, a 50 year old from Key Largo, Florida earning a decent 500% of the federal poverty level ($59,400) per year as a self-employed termite exterminator. Humphrey will be deemed too wealthy to qualify for any Obamacare subsidies. He is going to pay the full gross premium, which is $853 per month — over 17% of his pre-tax income. That’s almost twice what he would pay if he killed fewer termites and earned about $48,000 instead.

Again, Humphrey (imaginary) is not alone. In 8% of the studied rating areas, those people are going to need to pay at least 15% of their pre-tax incomes in order to buy a typical Obamacare health insurance policy. Maybe 8%  is below your concern threshold.  But next year, Humphrey will have more company.  If gross premiums go up on average by 20%, about 27% of the studied rating areas will require 50 year olds like him to pay at least 15% of their pre-tax income if they want health insurance.  Again, the idea at the time of Obamacare’s enactment was that people shouldn’t have to spend more than 10% of their income on health insurance.

It didn’t used to be this way. Remember those halcyon days of 2014 when ACA proponents were boasting of how much lower than alleged expectations exchange premiums had come in. If we’d run a similar analysis back then, here’s what we would have found. In fewer than 2% of the rating areas would our 60 year old Fay earning 450% of the applicable federal poverty level have to pay at least 20% of their pre-tax income for a typical policy. And there’d be no rating area anywhere on the federal Exchanges where our 50 year old Humphrey earning 500% of the federal poverty level would have to pay 15% of their pre-tax income for a policy. In fact, there’d only be 7% of areas in which they’d have to pay more than 10%.  In most of the nation, the idea that people shouldn’t have to pay more than 10% of their income to get decent health insurance was arguably in force.  These statistics show that the world of Obamacare in 2017 and 2018 is an entirely different animal than it was back in 2014 when things started out.

We need to consider different Obamacare regulations in light of the changed Obamacare conditions.  We should not just let the ACA blunder on. One of the problems with the ACA — and I am fully aware that this was intended to be one of its virtues — is that it basically ended the unregulated individual health insurance market. That might make some sense if the regulated insurance individual health insurance markets were functioning properly. But when premiums cost this large a percentage of many individuals’ incomes in the regulated market, the destruction of imperfect alternatives becomes less of a virtue and more of a vice. Where Obamacare has effectively failed, there needs to be an alternative — today. Fay and Humphrey’s situations are simply unacceptable.

All of this has a particular policy implication with respect to short term health insurance policies, currently a subject of some controversy. These are policies that have a duration often well under a year and that have limitations and cost sharing requirements that often go far beyond what the ACA permits. In its final months,  the Obama administration tightly regulated their sale. They did so because federal law does not require them to comply with all of the Obamacare rules (no pre-existing condition limits, ceilings on out-of-pocket maximums, essential health benefit requirements, etc.) Among other things, the Obama rules said that short term health insurance policies (also known as temporary health insurance) could be immune from ACA rules only if their duration was three months or less and if tight restrictions existed against “auto-renewals.”

The reason to close off this escape valve was the same advanced by many Democrats in opposing recent Republican health plans that also would have permitted a less regulated market to co-exist with an Obamacare market. These alternative markets — be they regular health insurance or short term health insurance — tend to siphon the healthy away from the regulated market. As such, the regulated market becomes ever more a high risk pool, charging ultra-high premiums and costing individuals and a subsidizing federal government a boatload of money.

The Trump administration is apparently considering relaxation of the recent Obama rules.  Perhaps the “short term” could be longer than the 3 months than is current permitted. Perhaps policies could be renewed more easily. Liberal pundits and organizations such as the Commonwealth Fund have aspersed this possibility. Before others reflexively propagate their criticisms, however, they ought to consider whether letting more people purchase “short term health insurance policies” even with their many imperfections might actually be better than having no insurance at all.  Larry Levitt, for example, a massive ACA supporter from the influential Kaiser Family Foundation, has apparently acknowledged that perhaps short term insurance rules could be more flexible where, as in some few counties, there is no Obamacare insurer at all.

This same argument, however, that concedes the validity of short term health insurance in jurisdictions where Obamacare has literally collapsed applies with almost as much force in the many jurisdictions where, although there is an Obamacare insurer on paper, it has effectively collapsed because none of its policies are really affordable to my Fays and Humphreys of middle age and middle income. A very reasonable rule would relax the restrictions on short term health insurance for persons unable to purchase the second lowest silver plan for less than 15% of their income. Short term policies there could be permitted to last six months and permitted to auto renew.

At Health Life Dental Insurance we have perfected the art of using short term medical – We offer a layered approach and can provide ONE YEAR of Coverage without Pre-existing Conditions on Short Term Medical. In addition, we combine our STM with Guaranteed Renewable Additional coverages to reduce or completely eliminate your of pocket expenses.   Furthermore, these coverages can provide Preventive Care, Office Visits, Testing Copays and even Lump Sums of Cash for Chronic and Critical illness to protect you from medical bankruptcy.   Click here to learn more and get your quote.

Obamacare Is Uninsuring the Insured

By | Uncategorized

The law expanded coverage among the poor at the expense of coverage among the middle class.medicalcosts


The number of people with individual health-insurance coverage is shrinking.

Despite $146 billion in federal subsidies to low-income households and well-capitalized insurers, 2.6 million fewer people had individual policies in March 2017 than in March 2016, a drop of nearly 15 percent.

The most precipitous decline has occurred among people who pay their own premiums without government help. The number of those with unsubsidized coverage fell by nearly one-fourth between March 2016 and March 2017, from 11 million to less than 9 million. There are now nearly 3 million fewer people with unsubsidized individual coverage than in 2013, the year before the government began doling out Obamacare premium subsidies. If the current trend persists through December, the individual market as a whole will insure fewer people this year than it did in 2014.

And the decline isn’t limited to the individual market. There were 3.6 million fewer people with job-based coverage in December 2016 than in December 2013. While 8.4 million people received Obamacare premium subsidies last year, private coverage increased on net by only 1.7 million between December 2013 and December 2016.

While there are no perfect data, these numbers are far more precise than survey results, the standard source of coverage estimates. They derive from insurance-company regulatory filings compiled by Mark Farrah Associates and on reports issued by the Centers for Medicare and Medicaid Services. The MFA data capture the total number of people enrolled in individual policies through March 2017; CMS tells us how many people had exchange-based individual coverage through February 2017 and how many of them received subsidies. Subtracting the CMS numbers from the MFA data yields the number of people who have unsubsidized individual coverage. Data on the individual and small-group markets through December 2016 come from an analysis by the Heritage Foundation’s Edmund F. Haislmaier and Drew Gonshorowski, who also used the MFA data set. The decline in individual health-insurance coverage is almost never reported (NRO being a rare exception) and contradicts the prevailing Obamacare narrative. A recent New England Journal of Medicine editorial recited the received wisdom: “The ACA’s individual market structure — though not perfect — is sound and has succeeded in greatly expanding coverage. As 2017 began, the market was poised to leave behind the growing pains of the past few years. Then the President and Congress acted to create needless turmoil.”

Virtually every assertion in that passage is false. The individual market is not “sound”; it is contracting as rising premiums are pricing millions out of the market. Nor can it be credited with “greatly expanding coverage”; the individual-market coverage gains achieved by distributing subsidies to some have for the most part been offset by coverage losses in the individual and group markets among unsubsidized consumers. Obamacare was not “poised to leave behind the growing pains” in 2017; it was entirely predictable that those pains would worsen.

And all this “needless turmoil” antedated the Trump administration. He took office during the closing days of the 2017 open-enrollment period. By then, the die was cast.

The narrative nevertheless endures. Believing it requires indifference to millions of people who can no longer afford individual policies and to millions more who may forfeit their policies with the next round of rate hikes. For many of them, Obamacare has been a serial nightmare, producing policy cancellations, skyrocketing premiums and deductibles, and a narrowing choice of doctors before finally leaving them uninsured.

Obamacare is insuring more poor people and uninsuring millions of middle-income people. That suits the Democratic party and many congressional Republicans just fine. They measure social progress in the number of people receiving government assistance. Those struggling to pay their own way evoke little sympathy. Lawmakers of both parties, whose consciences were lacerated by CBO’s theory that millions would “lose” coverage under the GOP’s “repeal and replace” legislation (most of those “losses” the result of people voluntarily dropping insurance once the individual mandate was repealed) are unmoved that millions actually have lost coverage under the law they fought to preserve.

Legislators do, however, grieve over insurance-company losses. The NEJM editorial urged Congress to “bolster insurers’ confidence” through a “permanent reinsurance program” — a new entitlement to corporate welfare.

t is a familiar story: Corporations get bailouts, the poor get benefits, and those in between get the bill. Government will tax people to subsidize insurance companies whose product they themselves can’t afford.

It is of course possible that Congress will set a different course. Republicans won elections by promising relief for Obamacare’s victims. That sentiment faded once they gained power. Perhaps they can revive it. Democrats could bolster their political brand by working to make health insurance accessible to those who used to be able to afford it.

Congress could start by relaxing the federal death grip on the regulation of the individual and small-group markets. Federal regulatory rigidities are driving prices higher and pushing insured people into the ranks of the uninsured. Relinquishing at least some regulatory authority to the states might produce more functional markets, where insurers can offer consumers the coverage they want at a price they can afford.

Members of both parties instead hope to pass a relief package for the insurance industry. Once it becomes clear that insurers will raise their 2018 rates despite the bipartisan largesse, each party will blame the other for the higher premiums.

Should Congress play out that script, the individual market will likely continue to shrink.

Low-Cost Health Insurance Limits Access to Top Cancer Doctors

By | Uncategorized


Insurers say specialized care available for those who need it, but Oncologists at premier cancer centers cut from some insurance

Excluded DoctorThe nation’s top cancer doctors are more likely to be excluded from low-cost health insurance plans offered on the nation’s individual market, potentially crimping access to the highest-quality care for Americans when they need it most, a new study found.

The individual exchanges, opened in 2014 as part of the Affordable Care Act, often include lower-cost policies that limit the number of physicians available to members as a way to cut costs. Those “narrow networks” are becoming more prevalent in Obamacare, as insurers seek ways to offer cheaper coverage, according to McKinsey & Co. The study was published in the Journal of Clinical Oncology and examined data from 2014.

The study offers a sense of the tradeoffs Americans face when buying health-care coverage on their own: Plans with lower premiums often get costs down by limiting choices of doctors and hospitals, asking patients to pay more out of pocket, or some combination of the two. It’s an issue patients are increasingly facing in insurance provided by employers, too, and one they’d likely continue to deal with under Republican plans to replace Obamacare. The current GOP proposals offer less financial help for people to buy coverage and could shift more people into lower-cost plans.

For the study, researchers from the University of Pennsylvania analyzed data on 23,442 oncologists in the U.S., evaluating how often doctors affiliated with National Cancer Institute-designated centers were covered by lower-cost insurance plans. The University of Pennsylvania is an NCI-designated cancer center.

Oncologists working at the U.S.’s 69 NCI facilities in the U.S., which offer access to scientific research and are known for their handling of complex cases, were twice as likely to be excluded from plans with the narrowest networks, according to the study.

“Most common cancers can be treated well anywhere,” said Justin Bekelman, associate professor of radiation oncology, medical ethics and health policy at the University of Pennsylvania, and one of the researchers. “But there are many patients with rare or uncommon tumors who need access to the most advanced clinical trials, and that access is often only at these NCI cancer centers. On the individual market, when people are spending their own hard-earned dollars, they can chose to have access or not. But right now they are choosing in a blind way.”

Network Questions

The Obama administration had been working to make it easier for people to figure out whether individual doctors and drugs were covered by their Obamacare plans by looking up such information online. It’s harder for consumers to determine the comprehensiveness of an insurance plan’s network, however, and so far there’s only been a limited effort to require plans to disclose the overall size of their networks.

Regulating insurers’ networks is largely left up to the states. The Trump administration has said it will defer to states rather than conduct its own reviews, for the most part.

“Certainly there are real issues with consumers trying to understand what kind of network they’re getting,” said Justin Giovanelli, an associate research professor at Georgetown University’s Center on Health Insurance Reforms who wasn’t involved in the study. “What you want is to have more information so you can make good choices about it.”

Health plans have procedures that let patients who need specialized care get to the appropriate doctors, according to a statement from the industry group America’s Health Insurance Plans. The group noted that the study dealt with coverage for individual physicians, not for the facilities themselves.

“Patient access to an oncologist affiliated with an NCI-designated or NCCN cancer center is separate from patient access to treatment at these centers,” Kristine Grow, an AHIP spokeswoman, said in the statement. “Community oncologists who are part of the plan’s network can recommend patients to these centers based on patient needs.”

Higher Costs

According to the researchers, doctors at NCI-designated cancer centers, such as Memorial Sloan-Kettering in New York, Dana-Farber in Boston, MD Anderson in Houston and the University of Pennsylvania, may be excluded from the narrow networks because of their cost. Because of the doctors’ status, the centers may be more able to negotiate higher reimbursement rates for their services. They may also attract more complicated, and thus costly, patients. Excluding them could help insurers control expenses at the price of limiting access to high-quality, specialized care, the researchers said.

“In an ideal world, narrow networks could be a great tool for insurers to steer patients toward these higher quality providers, to ensure that overall costs are actually lower,” said lead researcher Laura Yasaitis, from the department of health economics at the University of Pennsylvania. “It looks like in the data we looked at that prices may be the more prominent motivator for insurers.”

The Penn researchers analyzed 248 insurance networks across the U.S. operating in areas with NCI-designated centers. They found that one in every three significantly limited the number of oncologists in their insurance plans. Of all the cancer doctors who were part of those narrow networks, 17 percent worked at NCI centers. Of all the doctors who were excluded from those plans, 35 percent participated at NCI centers.

The discrepancy wasn’t seen in broader insurance networks. In those plans, 34 percent of included oncologists were affiliated with NCI centers, compared with 29 percent of those cancer doctors who were excluded, according to the study.

Insurers Look to Ramp Up Premiums in Health Law Exchanges

By | Uncategorized

Rate requests underscore struggles under ACA to enroll enough healthy people to offset costs of the sick

A growing number of major insurers are seeking premium increases averaging 20% or more for next year on plans sold under the Affordable Care Act, according to rate proposals in more than 10 states that provide the broadest picture so far of the strains on the marketplaces.

As Republicans try to pass a health-care bill to overhaul the ACA, the attention has focused on insurers’ withdrawals that may leave certain areas in at least a few states with no company selling coverage through the online insurance marketplace, or exchange, next year. But the rate requests by major insurers show stress on the marketplaces stretches beyond those trouble spots.

The biggest ACA-plan insurers in Delaware, Virginia and Maryland are asking for average increases greater than 30% for next year. In Oregon, North Carolina and Maine, the rate proposals from market leaders were around 20% or higher.

The insurers’ proposals reflect continuing struggles under the 2010 health law to enroll enough healthy people to offset the costs of the sick—but also uncertainty at the federal level about the law’s future. Insurers are particularly concerned about the fate of federal government payments that are used to reduce out-of-pocket costs like deductibles for low-income ACA-plan enrollees, which the Trump administration has threatened to halt, and enforcement of the individual mandate meant to prod young, healthy people to buy insurance.

“It’s still a very volatile market,” said Rick Notter, an executive at Blue Cross Blue Shield of Michigan. “There are so many uncertainties.” The market in his state isn’t stable, he said, but the problems are being exacerbated by the lack of clarity in Washington. For health-maintenance-organization plans, the insurer seeks a 22.6% increase if the federal cost-sharing payments end, or 13.8% if they don’t.

A new survey of health insurers by consulting firm Oliver Wyman, a unit of  Marsh & McLennan Co s., found that 43% were planning to propose rate increases greater than 20%, while another 36% were looking at boosts of between 10% and 20%. The average rate increase in the May survey, with responses from 14 insurers, was around 20%. Nearly all of the responses assumed that the cost-sharing payments would continue—if they didn’t, insurers said they would either seek further increases or withdraw from the market.

Insurers’ rate proposals, which often need to be approved by regulators before going into effect, are likely to give fodder to both Republicans and Democrats in the argument over the ACA.

Republicans, who have passed a health-care bill through the House and are trying to do so in the Senate, have pointed to insurers’ struggles as signs of problems with the current law. “The laws of economics were in place long before today. These companies were losing hundreds of millions of dollars,” a White House official said.

Democrats argue that the markets would be poised to stabilize, but Republicans are hurting the marketplaces by threatening the cost-sharing payments and raising questions about enforcement of the ACA’s coverage mandate.

“These actions, these statements, these inactions, this uncertainty, has created a huge set of chaos in the individual marketplace leading to instability for insurance carriers, higher premiums, and reduced competition,” said Sen. Tim Kaine (D., Va.) on the Senate floor Thursday.

The insurance industry’s stance on replacing the ACA has been somewhat muted, though it has sought some changes, including the repeal of a tax on insurance plans included in the current health law. Insurers have also said that if the cost-sharing payments aren’t locked in, they expect rate increases and pullbacks from the exchanges.

On Friday a bipartisan group of governors sent a letter to the Senate leadership urging Congress to focus on ways to stabilize the private insurance market.

Some of the biggest rate increases reflect a combination of lingering issues in the marketplaces and federal uncertainty. In Maryland, CareFirst BlueCross BlueShield is proposing a 52% average increase, which it said will need to go even higher if cost-sharing payments aren’t guaranteed. The insurer, which said it has been losing money on the exchanges, said its rates have been falling short of the costs of the relatively unhealthy group of people it enrolled.

Also, CareFirst believes even more healthy people will drop out because they don’t think they will face penalties for lacking coverage. CareFirst said it thinks consumers don’t believe the Trump administration will enforce the mandate, and the House Republican bill would officially end enforcement, if it becomes law.

“The attempt to get back to basic adequacy, together with a worsening risk pool, together with federal actions that lead to uncertainty, that’s what causes it,” said Chet Burrell, CareFirst’s chief executive.

In Delaware, Highmark Health said about a third of the 33.6% rate increase it seeks is due to projected loss of the cost-sharing payments and concerns about the individual coverage mandate, with the rest tied to the need to catch up to higher-than-expected costs that have been generating losses, among other factors. Highmark, set to be the only remaining exchange insurer in Delaware after Aetna Inc.’s withdrawal, said it is still weighing whether it can even offer marketplace plans in the state. “We have to let the next several months play out,” said Alexis Miller, a Highmark senior vice president.

Other insurers said they were seeing signs that markets were steadying and rate increases could be limited—if the federal cost-sharing payments were locked in. In New York, nonprofit Fidelis Care seeks an increase of 8.48%. Blue Cross and Blue Shield of Vermont wants 12.7% in that state. And Blue Cross and Blue Shield of North Carolina said its requested 22.9% boost would have been 8.8% if it could rely on the federal funds.

“There is no evidence to suggest [cost-sharing payments] will be available,” said Brad Wilson, chief executive of the North Carolina insurer.

Insurers are also worried that if they put more rate increases into place, it will lead even more healthy people to drop their coverage, pushing rates up further in the future as there are fewer premiums to offset the higher costs of covering sicker policyholders. Many consumers’ premiums are largely funded by federal subsidies under the ACA, but some people bear the full brunt of premium rises—and may not stick around as the rates go up.

Kevin Lewis, chief executive of Maine Community Health Options, said its 19.6% requested increase is linked closely to expected lack of coverage mandate enforcement.

“It’s the classic case of people who are healthier jumping out of the market,” he said. “It’s a bit of a self-fulfilling prophecy.”

Write to Anna Wilde Mathews at and Louise Radnofsky at

Appeared in the June 17, 2017, print edition as ‘Health Insurers Seek Big Premium Increases.’

Don’t be a Do-It-Yourselfer and cobble together Cut-Rate Health Insurance!

By | Group Health Insurance, Health Insurance, Uncategorized

If you are like a lot of hard working Americans and have decided that paying $1,000 or more a month for family health and dental plans through your job has become an excessive burden – then listen up.Worried Mature Couple Reviewing Domestic Finances

You’ve probably searched for individual family plans on These polices are usually more expensive plus have high deductibles. They only make sense if your family’s income is low enough for subsidies.

For many people the next step has been to cobble together different policies that each provide limited coverage for you and your family: a short-term plan with a high deductible that provides up to $1 million in coverage; a critical illness plan that pays a $20,000 lump sum if one of you is diagnosed with invasive cancer, heart attack or stroke; and a dental plan that provides $1,000 in coverage. The total monthly tab for this might be around $350.

But there are a couple of catches:

  • The protection you have pieced together is not the best protection – it leaves you wide open to financial disaster. With a lump sum payout of $20,000 for an individual market critical illness plan, according to insurer Gen Re, the policy won’t come close to covering treatment for a serious illness.
  • Under the health law, most people are required to have insurance that meets minimum standards or pay a fine. Limited benefit policies such as short-term, critical illness, accident, dental and vision plans don’t qualify. (In 2016, the penaltyis $695 per adult and $347.50 per child, or 2.5 percent of household income, whichever is greater.)

Still, faced with sky-high premiums and high deductibles for traditional plans, families earning $70,000-$180,000 are looking for ways to reduce health insurance costs.

Be Warned: if not done correctly it’s a roll of the dice, and if something bad happens, you could find yourself on the hook for a very big bill.

There is a solution!

Trust us.  We’ll deliver the right coverage and help you avoid the Obamacare penalties.

Our Agents specialize in alternative health insurance programs (all from A+ rated companies) that we call the Real Life Protection Pyramid. The Real Life Protection Pyramid provides better financial protection and superior access to healthcare than Obamacare or group plans.  Our Agents understand how to steer you around the issues of penalties, place you with companies that offer superior lump-sum-payouts for critical illnesses and structure your health insurance program to minimize deductibles.  If no one in your family has had treatment for Heart Attack/Disease, Stroke, Cancer, or Diabetes in the last 5 years, needs coverage for addictions, mental health, or maternity or is taking more than $250 a month of daily medications, you’ll probably qualify and save $400-$700 per month.

How to be Legally Opt Out from Obamacare

By | Health Insurance, Health Reform, Supplemental Coverage, Uncategorized


We get asked, on a daily basis, if there are ways to legally avoid the high cost, low value of the Obamacare insurance exchange products AND not pay a penalty for purchasing insurance that best fits the insured’s needs.  Here are the options that we share:

1) If the lowest-priced “Obamacare plan” coverage available to you, through either a Marketplace or job-based plan, would cost more than 8.13% of your household income, you are exempt from the Obamacare Shared Responsibility Tax and can purchase alternative insurance without penalty.  Click on the links to get the forms and details for the Marketplace affordability exemption or the job-based affordability exemption.

By the way, there are other exemptions.  Here is a complete list:

2) If you are comfortable with the Affordable Care Act’s specific instructions to the IRS that they may not “TAKE’ the money from you— only withhold it from a refund that is due you —  you may avoid the Obamacare Shared Responsibility Tax.  Learn more here: Obamacare Penalty: Proof Its Not Enforceable

3) If you are concerned about the IRS, you can join Christian Health Ministries (NO WE ARE NOT JOKING!) This is an excellent option if you combine it with other off-exchange insurance options.CropperCapture[119]

Christian Sharing Ministries is $45 per month for a single bronze membership, $90 for Husband & Wife or Parent with children or $135 for Family (remember you are not buying it to pay a claim as they NEVER guaranteed they would send a dime, you are just getting it to avoid the potential penalty).


Click here to go to the Christian Health Ministries site.  Next, RUN A QUOTE  BY CLICKING ON THE RED INSTANT QUOTE BUTTON – CHOOSE BRONZE—- Buy it in February each year.  To claim the Christian Ministries Exemption click here. To view the Christian Health Ministries booklet, click here.

If you purchase the Christian Health Ministry program please contact us so we can set you up with an insurance program that you can count on for your health care needs.  NOTE: THIS COMBINATION FOR THE HEALTHY FAMILY IS LESS THAN HALF THE COST OF AN “OBAMACARE” PLAN.

One more thing:  When you sign up for Christian Health Ministries, please list Mark Deschenes’ member number: 278378  Christian sharing offers a free month to a referring member— So please list me! Thank You!





Texans Go Naked as Rates Rise Under Obamacare Sign-ups are lagging as Americans opt to drop their coverage and pay a fine instead.

By | Health Insurance, Health Reform, Uncategorized

|Nov. 18, 2015 4:00 pm

So much for the Affordable Care Act being affordable.

Higher insurance premiums are pummeling Texans in the age of Obamacare, and health-care analysts say ever-bigger increases are inevitable.

Now Texans are getting out, opting to pay a penalty instead of digging deeper for coverage.

“The law was never going to work. It’s actuarily unstable. Now the logical consequences are playing out,” said John Davidson, director of the Center of Health Care Policy at the market-oriented Texas Public Policy Foundation in Austin.

Premium costs for Texas’ giant Blue Cross/Blue Shield HMO are going up 18.7 percent. With 700,000 customers, the plan is one of the biggest in the state.

In 2014, the HMO collected $2.1 billion in premiums, but claims were $2.5 billion under Obamacare.

“This is the transfer cost of a mandate onto individual policyholders,” Davidson told

Meantime, Humana’s Texas HMO announced a 4 percent premium hike. But the final rate was jacked up to 23 percent when the federal Centers for Medicare and Medicaid Services required higher reserves for the 1,000-customer plan.

Other plans in the state are charting increases of 20 percent to 30 percent.

As premiums rise, so is the number of people dropping their health insurance and taking their chances.

With 19 percent still uncovered by health insurance—the most in the nation—more Texans are canceling policies. Individuals can opt out of the insurance mandate by paying a fine—$695 per adult or 2.5 percent of household income in 2016, whichever is higher.

“The more premiums go up, the more affordable it is to pay the penalty,” Davidson notes, even as Washington keeps ratcheting up the tax. The fine was 2 percent of income this year and 1 percent the year before.

The IRS fined more than 7.5 million Americans for not having health insurance in 2014. That was 1.5 million people more than the administration projected.

A breakdown for Texas was not available through the state Department of Insurance or the Texas Health and Human Services Commission. But data from California show that about 80,000 people there went “naked” last year and opted to pay the fine.

Nationally, Obamacare enrollment is deteriorating.

The Congressional Budget Office last summer projected that 20 million people would sign up next year. Now ACA tracker Charles Gaba is predicting just 12.2 million. Gaba, an Obamacare proponent, was nearly spot-on with his 2014 and 2015 estimates.

Government subsidies are not luring Texans at any price. About 1 million residents eligible for discounted coverage under Obamacare have not signed up, according to the Kaiser Family Foundation.

Politico this month reported on one county where only 12 people enrolled in Obamacare plans.

“I hope Obamacare goes down the toilet,” said Brenda Copeland, an uncovered employee at the Coyote County Store and Café in Borden County.

Shikha Dalmia, a senior health-care analyst at the libertarian Reason Foundation, says the oxymoronically named Affordable Care Act is circling the drain for two reasons.

“Risk corridor and reinsurance that were meant to ‘stabilize’ rates in Obamacare’s first few years so that insurers could obtain the right mix of enrollees are set to expire next year,” she said.

In Rube Goldberg-style market manipulation, the risk corridor program imposes a fee on insurers that have lower-than-expected medical losses and compensates those that have more.

The reinsurance program levies a fee on insurance policies and funnels it to insurers with high-risk individuals.

“With these programs gone, the challenge of maintaining a balanced risk pool will become even harder,” Dalmia concluded.

In one of the most sweeping critiques, Republican presidential hopeful Carly Fiorina said during last Tuesday’s GOP debate: “Obamacare is crony capitalism at its worst. Who helped write it? Drug companies, insurance companies, pharmaceutical companies—every single one of those kinds of companies are bulking up to deal with big government.”

This article originally appeared at