Saturday, November 12, 2016

2018 Health Plan Choices in Texas:

Updated:  November 5, 2017

Our choices for 2018 coverage are not good!

See Ruth's notes about all of the stable insurance companies below...near middle of this screen.

Several Small Health Insurance Companies in Texas may not be stable!

If they run out of money to pay claims & you have a large claim, you might as well have no coverage at all.  

You wasted your money paying them a dime!

The main purpose for buying coverage is (or should be) to pay for a large, unexpected claim that could wipe us out.

This entire industry is in serious financial condition!

Most of the larger insurance companies won't participate in the ACA (Obamacare) scheme in 2018.
They've finally concluded that this concept is not stable....
.....after they've lost billions of dollars....
.....and you, the taxpayer, have bailed them out!

We do not expect congress to allow further bailouts, though!

For now, Obamacare is the it or not.....stable or not!

If you DON'T participate (or have a valid exemption), you pay a Federal Tax Penalty.  
See link at very bottom of this screen for help understanding the Tax Penalty & your possible exemptions from the Tax Penalty.

If you DO participate, you can only buy "affordable" coverage for "less than the price of a cell phone" if your income is very low.

You can get a decent Premium Tax Credit (to lower your monthly premiums) if your MAGI* (income) in 2018 is expected to be:

$12,100 - $32,000 - For a single taxpayer
$16,300 - $41,000 - For a tax-family of 2

$20,500 - $52,000 - For a tax-family of 3
$24,600 - $62,000 - For a tax-family of 4

$28,800 - $72,000 - For a tax-family of 5
$33,000 - $83,000 - For a tax-family of 6

$37,200 - $  93,000 - For a tax-family of 7
$41,400 - $104,000 - For a tax-family of 8

If your expected MAGI* (income) in 2018 will be higher than the above figures, you might still get a tax credit.  
Many will.
But, it's a very complicated formula!

Our Quick Quote Engine will figure it out for you...instantly:  

Quick Quotes with Estimated Tax Credits Deducted from Your Monthly Premiums HERE

* MAGI = Modified Adjusted Gross Income
                                      See info about MAGI here .

For most people:
- MAGI is nothing more than your AGI (Adjusted Gross Income...line 37 on your Federal Tax Return - Form 1040).

AGI = Adjusted Gross Income
           This is simply line 37 on your 1040 Federal Income Tax Return 
           .......................line 21 on your 1040A Tax Return
           ....................or line 4 on your 1040 EZ Tax Return

For AGI determine your MAGI...see MAGI link above...
...& you'll see what to:
- Add to AGI .....These additions don't even affect the average person
- Exclude from AGI ...These don't even affect the average person

Quick Quotes (with your Tax Credits deducted) HERE

In many Texas counties, you'll see several small insurance companies listed in the left column of your Quotes Screen.  

To see their quotes, you'll need to check their boxes.

They may not be stable risks!

Please don't buy their coverage on our Quote Engine above.  

But, you can view their quotes on our engine.  

We cannot represent these companies...

...and you won't have any legal protection if you buy their coverage.

Just google their online reviews.

Yes, they have lower prices.
But, what are you sacrificing?

- How far will you need to drive to get to their nearest Urgent Care Center...for something that's not a serious emergency (to them)?
.....If it's not a serious emergency (to them), you're not covered out-of-their-network.
- Will there be any network doctors near you?
- How far away is the nearest specialist or hospital (in their network)? 
- Is that doctor or hospital really in their network?
- Can you trust their Provider Finder Engine?
....Most of the online reviews say:  NO

- Will your claims be paid?
- Will your monthly payments be posted to your account?
....Many of the online reviews say:  NO

Most of the networks are very small.
But, you might not discover this until.....
   You NEED to see a doctor & can't find one (listed in the network) who will actually see you (take your insurance).

And, then:
Can you get your insurance company on the phone to help you?

We can't be there to help you, either...with these small companies.
The service calls would be a nightmare.
Agents aren't paid much (if anything at all) since Obamacare arrived.
We can't afford large phone systems & staff to handle large volumes of service calls.
...Especially when many of the people calling-in are in desperate need of immediate help!

The insurance companies can't either!
That's why hold times can be hours!
And, you can experience phone system outages...after holding forever! 
It happens!

Read their online reviews carefully!

If you don't mind enduring the above sacrifices... exchange for cheaper coverage...
...please buy the cheaper coverage directly from these small companies or from .

Their prices are available on our quote engine because:
- The Federal Government requires that we give you the opportunity to see all ACA quotes that offer Premium Tax Credits
- I like to see everything that's available, myself!
.....And, I like for you to see it, too!
......But, I had to warn you about the dangers ...before you make uneducated choices this year.

Our liability insurance does not cover these companies.
AM Best will not even rate these small, unstable companies (for financial stability).  Because, they are not stable.

The Federal Government doesn't even guarantee that these companies will pay your claims!

But, the Feds are desperate for enrollments.

They've poured many billions into lots of their small start-up companies.
That's why they can offer "cheaper" prices.  
....Govt constantly bails them out...when they're underwater & drowning.

It's not likely that congress will allow any more billion-dollar payouts/bailouts in 2018.  

Congress actually didn't directly allow the others.  
The ACA law gave the administration an open checkbook in many areas.

Too many loopholes to even begin to count!
Your grandchildren will never get it all paid off in their lifetimes...
....unless something lights a fire under this economy...
......and brings massive economic prosperity to our country!

For your own (limited) protection:
Buy coverage from these small companies directly from .
....Although, I'm not sure if they'll do anything more than sympathize with you for any losses you might incur.
....They've certainly done nothing more than that when you tell them that this stuff is not affordable.

Or, you can buy coverage directly from the small insurance company's website.


We'll only have legal protection for the following health insurance companies...

...for 2018 health plan enrollments:

- Aetna ...  Gone!


- Ambetter   ... Small EPO network in most areas!
                          Be sure that you can live with their selection of Doctors & Hospitals.
                           There is no coverage out-of-network...
                            .... except for serious life-threatening emergencies.



- BCBS-Tx  ...Still available in all Texas counties....but terrible prices!!!
                    ...ALL plans are HMO's
                    ...Medical Deductible applies before 
                          Rx CoPays / CoInsurance kicks in
                           with many of their 2018 plans!!!

                    ...NO coverage out-of-network
                        except for serious life-threatening emergencies
                         unless you buy a Plus Plan.

                    ...The Plus Plans don't give you much more.
                         They'll let you go out-of-network for Specialist Visits
                           ....with a referral from your PCP (Primary Care Physician)
                           ....Out-of-network deductible is VERY HIGH!
                           ....Out-of-network treatment has NO Max-out-of-pocket!
                           ....You could owe millions for treatment out-of-network ... even with the Plus Plans!

                    ...PCP (Primary Care Physician) selection is required.
                    ...Your PCP coordinates all of your care.
                    ...You can change PCPs.
                    ...A referral is required to see a Specialist except for ObGyn Visits & Emergencies


- Cigna ... Gone! ...unless you keep your old Grandfathered policy.
                                 The old GF policies can still use their large PPO network.


- Community Health Choice ....Available in Southeast Texas ONLY
                    ...I love this company!  
                    ...Excellent rates (compared to others) for 4+ years now!
                    ...Customer service is much better than most!
                    ...Largest HMO network in the areas (that they offer covg).
                    ...Better PCP CoPay benefits than the govt allows the engines to show on their Bronze Plan 003!  
                    ...Bronze Plan 003 gives you 3 PCP CoPays
                    .......BEFORE meeting deductible!
                    ..........for EACH family member
                    .............Max of 2 deductibles to meet per family
                    ...They've made small profits....despite their low(er) premiums.  
                    .......Their reward:  They had to bail-out other companies who wasted money!
                    ..........Result:  They had to increase their premiums substantially !!!
                    ...They do a lot of things right!
                    ........Like:  NO multi-million-dollar salaries to their execs for starters.
                    .................And, NO multi-million-dollar TV ads

I wish that all of the companies were as good as Community Health Choice (CHC).
Yes, they have problems.
But, they FIX their (your) problems.
Other companies don't.

No referral is required to see Specialists IN the HMO network.

There is no out-of-network coverage, except for serious life-threatening emergencies.


- Humana ...Gone!


- Memorial Hermann ...Gone!


- Molina ...Small HMO network many Texas areas
                ...Be sure that you can live with their small network before buying!

Molina coverage is only available ON-Exchange...with Tax Credits for those who can qualify.

No referral is required to see Specialists IN the Molina HMO network!

There is no out-of-network coverage, except for serious life-threatening emergencies.


- Oscar ...Available in San Antonio, Austin & New Braunfels areas in 2018.
               ...NO PCP selection required!
                ...Use any doctor in their EPO network
                 ...Use any of their Urgent Care facilities nationwide!!!
                  ...Call their Free Doctors-on-Call .....24/7
                   ...Their Doctors-on-Call are Board Certified in-house physicians
                    ...They'll write an Rx for you that can be filled nationwide.

Oscar Insurance Company is trying harder to please than most other companies!

Their networks are large & growing.

Excellent rates (compared to others) many counties.

If you live in Central Texas....and they show up in your quotes....consider them.
I'd personally pay a little more monthly premium to have them as my insurance company.

No referral is required to see Specialists IN the EPO network.

There is no out-of-network coverage...except for serious life-threatening emergencies.


- Scott & White ...Available in limited Central Texas areas
                                                            & limited DFW areas
                           ...Prices are terrible!
                           ...Only offering 2 plans.........ONE HMO Plan.....and ONE EPO Plan
                           ......Both plans have VERY-High Deductibles

Both of the Scott & White Plans are OFF-Exchange Plans.

They do not qualify for Tax Credits from the govt.

You must request an emailed quote from Ruth to view the Scott & White Plans.
My Yahoo account is fastest:   BestAgency

Be sure to tell me your county.
All prices (and plan availability) are based on your county these days.

I don't have everyone's counties in my database.


- United Healthcare ...Gone!

The prices are all terrible....unless you can qualify for a decent Premium Tax Credit... (that's paid directly to your insurance company each month from the federal govt).

Use our FAST On-Exchange Enrollment Engine to:
- Run Quick Quotes
- Compare plans 
- Research Networks
- Research Rx's covered by each company
- Enroll quickly


Our only reasonably-priced alternative: 

Temporary ShortTerm coverage....

...and it's NOT meant for everyone!!!

Don't buy it if you have pre-existing medical conditions!!! 

See more info about Temporary ShortTerm coverage        HERE

No, we can't recommend the Healthcare Sharing Ministry Plans.
See info  HERE

The Health Insurance Industry has imploded under the weight of Obamacare.

Many will buy a Temporary ShortTerm policy...
...hoping that relief will be provided by the new administration.  
But, we do not know how long that might take.

Obamacare is still the law.

Make wise best you can!

We can't tell you what to choose!  
This market is just too unstable !!!

And, you know your own situation much better than anyone else.


Be sure to read about Temporary Plans (at above link) before you buy one!!!


I can only provide you with your options...
...and guidance (above).
Nothing is ideal....for 2018!!!

I'm SO sorry that we can't provide any better options right now!
Ruth ... ...

The best ACA Tax Penalty calculator left online:  HERE

Tax Penalty & Exemption layman's terms HERE