I'm coming off of COBRA at the end of November and trying to decide what insurance plan me and DW will be under going forward. Both age 52, will not qualify for any ACA subsidies, and both reasonably healthy.
I've pretty much ruled out any ACA policy as none of our current DRs are on any of the plans. I do have access to retiree health insurance from OldCo that will cover me until Medicare. I can sign up for this during any open enrollment period even if I don't take it right after COBRA. It would probably be about $400 more per month than the option discussed below.
I contacted an insurance broker and they presented an "indemnity benefit" plan. From what I can tell the plan includes fixed payments/reimbursements for various types of DR visit. For example, for a regular DR visit it pays me $160/visit no matter what the DR charges me with a cap of 20 visits/year. Then it covers $200 for a “specialist” visit, with a max of 2 visits per year and after two visits a specialist visit reverts to a regular DR visit payment at $160 and counts as part of the 20/year max.
It has other coverage amounts for various types and fixed amounts of inpatient and outpatient hospital visits, lab work, generic and non-generic meds, etc. It has max/year ($1,000,000) and max/lifetime ($5,000,000) amounts. Its non-ACA compliant (but the tax penalties don’t apply at least not right now).
It also comes with some life insurance and some other random accident coverages which I probably don't need. It also has a one year preexisting condition limitation so anything that we have been “diagnosed” with over the past 12 months, such as my wife's migraines would not be covered for the first 12 months of the policy.
I’ve just never heard of anything like this and it seems very confusing and I can’t tell if its a decent plan or if its a really bad idea to even consider. Have you ever encounter something like this?
I've pretty much ruled out any ACA policy as none of our current DRs are on any of the plans. I do have access to retiree health insurance from OldCo that will cover me until Medicare. I can sign up for this during any open enrollment period even if I don't take it right after COBRA. It would probably be about $400 more per month than the option discussed below.
I contacted an insurance broker and they presented an "indemnity benefit" plan. From what I can tell the plan includes fixed payments/reimbursements for various types of DR visit. For example, for a regular DR visit it pays me $160/visit no matter what the DR charges me with a cap of 20 visits/year. Then it covers $200 for a “specialist” visit, with a max of 2 visits per year and after two visits a specialist visit reverts to a regular DR visit payment at $160 and counts as part of the 20/year max.
It has other coverage amounts for various types and fixed amounts of inpatient and outpatient hospital visits, lab work, generic and non-generic meds, etc. It has max/year ($1,000,000) and max/lifetime ($5,000,000) amounts. Its non-ACA compliant (but the tax penalties don’t apply at least not right now).
It also comes with some life insurance and some other random accident coverages which I probably don't need. It also has a one year preexisting condition limitation so anything that we have been “diagnosed” with over the past 12 months, such as my wife's migraines would not be covered for the first 12 months of the policy.
I’ve just never heard of anything like this and it seems very confusing and I can’t tell if its a decent plan or if its a really bad idea to even consider. Have you ever encounter something like this?
