Trumpcare Health Insurance Plans
Open enrollment for 2021 is approaching, and there are now many websites that are advertising that they are offering Trumpcare insurance or Trumpcare plans. This is a little deceptive, and you should be aware of what they mean when they are offering Trumpcare medical insurance policies.
The first thing that you should understand is that there is nothing officially named Trumpcare or Trump Healthcare. It is a play on words similar to when everyone was referring to the Affordable Care Act as Obamacare.
Trumpcare plans are three types of insurance products that are outside of the health insurance marketplace and do not work like your standard medical insurance policy.
What Are The Three Types of Trump Medical Insurance Plans?
The Trump administration wanted to expand the types of health insurance plans that were available to the public. It was their belief that by adding these new types of plans that more people could afford to have some type of medical coverage. The new Trump healthcare plans include:
- Short Term Medical Policies
- Association Medical Policies
- Health Reimbursement Arrangements
– Short Term Medical Plans
Short term medical plans are plans which allow a person to purchase coverage for a year, often at a steeply discounted price. These plans are very attractive to people who have no medical issues and just want coverage “in case” something happens.
Short term plans can be renewed twice under the law, for up to three years of total coverage. After that period, the covered person would have to change to a different plan.
Short term policies are not covered under the Affordable Care Act. This means that they can deny coverage based on preexisting conditions, limit the amount of care that you receive and place a cap on the amount of coverage you have each year.
The Affordable Care Act initially limited these policies to three months as a way to help individuals between jobs, but the Trump Administration has expanded the coverage periods to help those who want to have a policy in place but are not concerned with all the coverage.
– Association Medical Plans
Under the new guidelines, groups of small businesses or individuals in a similar situation, such as a group of freelancers, can ban together and purchase a group health insurance plan for all the members. This type of association plan was designed to help these small businesses and individuals get better pricing on their coverage.
However, these plans are not covered under the Affordable Care Act, which means that they can charge higher rates based on age and gender and that they can deny coverage for preexisting conditions.
These plans generally have higher deductibles and copayments than other insurance plans. In the long run, the small businesses and individuals are often much better off seeking plans through the healthcare marketplace than joining an association.
– Health Reimbursement Arrangements
A health reimbursement arrangement is a program that is funded by an employer that will reimburse employees for covered medical expenses. As of January 1, 2020, the employee can also use the HRA to cover medical insurance premiums that are purchased outside of the employer, only if the employer does not offer these benefits.
These reimbursement plans are solely operated by an employer, and the only real requirement is that each employee in a class, such as all office staff or all warehouse workers, etc., are given the exact same amount in their reimbursement account.
The amount that is given by the employer is up to that employer. These benefits can only be used for approved medical expenses and are reimbursed after the employee submits a receipt showing that medical care has already been provided.
If the reimbursement account runs out of funds before the end of the year, the employee will not be able to draw from the account again until the next year. If the employee does not use all of the money during the year, the balance does not rollover.
This type of medical coverage is not health insurance. Employers are not required to provide this type of account to any employee. This type of account does not transfer over to new employers.
Healthcare Options That Are Not Trumpcare Medical Insurance Policies
Each of the Trumpcare insurance products listed above has its place in the system and may provide some help to people. If you are looking for a more standard health insurance plan, you will be better off looking at plans offered under the Affordable Care Act marketplace.
The health insurance marketplace offers standard health insurance plans at four different levels. Each state will have several insurance companies offering different plans within the state. It will be crucial to take the time to compare what these plans offer so that you purchase the best plan for your needs.
Health insurance plans offered on the marketplace will fall into one of the following categories:
- Bronze Level Plan
- Silver Level Plan
- Gold Level Plan
- Platinum Level Plan
A Bronze Level Plan is generally a low-cost plan that has high deductibles and higher copayments than other plans. These plans will cover everything that is required under the Affordable Care Act, but they generally have a smaller network of providers that are part of their service. Most bronze plans will not cover anything outside of their network of providers.
Bronze level plans generally do not offer any additional benefits or offer to add on services such as dental or optical insurance.
Silver Level Plans are a little better than the Bronze plans. The copayments are a little better, but the deductibles are often just as high as the Bronze plans. The network of providers is usually a little larger, and additional services such as imaging and testing are generally a part of the plan.
Silver plans may come with additional benefits like options to use a virtual doctor or gym membership discounts. Wellness programs may also be available for free or at a discounted rate under these plans. Optional insurance plans for vision and dental may be able to be added to the policy.
Gold Level Plans are premium plans that offer the policyholder many benefits. These plans are more expensive than your standard plans, but they have lower deductibles and lower copayments. These plans have larger networks of providers and generally include imaging, testing, and walk-in clinic services.
Gold plans generally have additional benefits like gym membership discounts or benefits, virtual doctor appointments, discounted, or free wellness services. You can often get additional benefits added to these plans for dental and vision. These plans often allow out of network treatments with a larger copayment.
Platinum Level Plans are the best plans that you can purchase. These plans have the highest monthly premium but have low yearly deductibles and low copayments. These plans often include many additional benefits, and some may automatically include dental and vision plans.
Coverage Under The Affordable Care Act
Health insurance policies under the Affordable Care Act have been regulated so that the consumer gets the most benefits from their policy. Under these laws, health insurance policies must abide by the following guidelines:
- All policies must provide basic services such as annual exams and some preventative services and screenings for free.
- Policies cannot discriminate based on age or gender when setting prices for policies.
- Insurers cannot deny coverage for preexisting conditions.
- All policies must cover mental health care.
- All policies must cover pregnancy.
- All policies must cover addiction treatment.
- Insurers cannot put yearly gaps in coverage
- Insurers cannot limit lifetime care costs
Plans purchased through the marketplace must comply with all federal guidelines for coverage. If your state has additional provisions that must be met, those policies will also be in compliance with those laws.
Purchasing policies through the healthcare marketplace is the only way to guarantee that you are getting all the coverage and protections granted to consumers under the Affordable Care Act.
Purchasing The Right Health Care Plan For Your Needs
When searching for a healthcare plan, it is important that you look over all aspects of the plan before you make the purchase. While it is tempting to click on the lowest monthly cost plan, you may not get the coverage that you need.
Make sure when you are selecting a plan that you know the following:
- If the plan is being offered through the healthcare marketplace
- Which of the four levels of plans does the one you are selecting fall under
- Yearly deductible for individual and family
- Copayment amounts for services you most often use
- Additional benefits that the policy provides
- The ability to add on services if required
- Is the plan protected by the Affordable Care Act
I will always be in your best interest to look for plans that are covered under the Affordable Care Act. Trumpcare plans do serve a purpose for some people, but they offer fewer protections than your standard healthcare plans. This is something that you must consider when purchasing your coverage for the following year.
Purchasing health insurance policies can be overwhelming when there are so many factors to consider. If you feel overwhelmed by the options available to you and want to make sure that you purchase the right policy, you are encouraged to contact one of our reps for help.
Our service is dedicated to helping you find the right health insurance product for your needs. We are familiar with the available plans and the options that can enhance your insurance products. Even if you already have an insurance policy in place, we can make sure that you have the right one for the new year.