Now more than ever in recent history, Alaskans have a wider variety of health insurance options available. But having too much choice can sometimes be counterproductive and make it difficult to come to a decision. If you’re looking for health insurance as an Alaska resident, you’re not alone. Many people find the process tedious, confusing, and some even give up. But we are here to simplify the process so that you can get the coverage you need to protect yourself from financially devastating medical bills.
Major Medical Insurance in Alaska
Back on March 23rd, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act into law. These days, that law is commonly known as the Affordable Care Act, the ACA, or Obamacare. It set up the Health Insurance Marketplace, where you can fill out an application and apply for a federal subsidy so that you can purchase major medical insurance for a discounted rate.
In order to apply for a major medical ACA plan, you have to fill out an application during the Open Enrollment period which starts on November 1st and ends on December 15th each year. The only time you can apply for coverage outside of those dates is if you qualify for a special enrollment period. Some states have local, state exchanges where you can also enroll and search for qualifying major medical plans; for better or worse, Alaska is not one of those states. So your best option is to fill out an application through HealthCare.gov during the Open Enrollment period.
One good thing about major medical policies that most other forms of health insurance don’t have is that they are guaranteed issue. This means that if you apply for a policy, you can neither be denied coverage nor charged more based on things like sex or preexisting conditions. Your premiums can only be calculated based on medically relevant factors, such as:
- Your age
- Your location
- Your use of tobacco products
- Whether you are applying for an individual policy or a family policy
Another aspect of major medical health insurance which many consumers enjoy is the list of guaranteed essential coverage benefits that you will get, no matter what policy you purchase or which company you purchase it from. Here is a list of the 10 Essential Health Benefits you will get with every major medical policy:
- Ambulatory/outpatient services
- Emergency services
- maternity/newborn care
- Mental health and substance abuse
- Prescription drugs
- hab/rehab services and devices
- Lab tests
- Preventive and wellness services and chronic disease management
- Pediatrics (including oral and vision)
Having a guaranteed issue policy with guaranteed benefits which are essential for health and wellness is important for many people; unfortunately, being able to pay for such a policy is a very different thing. Luckily for Alaskans such as yourself, the state has adopted and implemented the federally recommended Medicaid expansion for anyone whose income is too low to qualify for an ACA federal subsidy. The chart below shows what the poverty level threshold is for Alaska residents based on household size:
|Household Size||Maximum Income Level (Per Year)|
If your annual income is higher than the poverty threshold (based on your household size) in the chart above, then congratulations. You will almost certainly qualify for a federal subsidy so that you can purchase an ACA major medical plan. If you are making less than that per year, then you will have to apply for Medicaid instead. But not everyone below that poverty threshold automatically qualifies for Medicaid. To qualify for aid in the first place, along with having a lower level of income than what is outlined according to the poverty guidelines, one of the following must also apply to you:
- You are under the age of 18
- You are a pregnant woman
- You have a disability or you are the caretaker of a family member in your household with a disability
- You are legally responsible for a child under the age of 19
- You are 65 or older
- You must be a US national, a citizen, permanent resident, or legal alien
- You must be in need of healthcare and/or insurance assistance
Back in the spring of 2018, the Alaska legislature passed a bill with the intention of imposing work requirements for some Alaska residents who qualify for Medicaid. Information on the bill is sparse at the moment, so it’s best to contact your local Medicaid Office to see whether the requirement for part-time employment (or a minimum of 20 hours per week of volunteer service) would be required for you to receive Medicaid benefits.
Short Term Health Insurance in Alaska
If you don’t qualify for a federal subsidy or the Medicaid expansion, or if you do qualify for a subsidy but still can’t afford the monthly premiums, then you may want to consider short-term health insurance instead. These plans operate in a similar manner to that of major medical, but they have some distinct differences which you should know about before you make such an important decision.
There are many benefits to a short-term health insurance plan over a major medical plan, especially given that many of these plans can cost up to 33% less than an unsubsidized health insurance plan through the ACA. The policies offered by short-term health insurance companies are highly customizable depending on your location and the company you purchase from. You can combine them with other forms of coverage such as vision, dental, or hospital indemnity insurance. You can apply directly through the company who is offering you the plan; there’s no need to go through HealthCare.gov or the Health Insurance Marketplace first. Best of all, unlike some of the other non-ACA options out there, you have more consumer protections with short-term health insurance plans. This means that if there is a dispute over a claim you file, you will likely be able to take the insurance company to court in order to get your medical costs covered in a way you deserve.
But there are also some disadvantages you should know about while you are considering a short-term health insurance plan. For starters, none of these plans are guaranteed issue. They can deny you coverage or charge you significantly higher rates based on preexisting conditions, sex, and anything else that their medical underwriting determines would make you a risky investment. Your short-term health insurance company will likely impose both lifetime and annual benefit limits in order to limit their financial liability. There won’t be any caps for you on your out-of-pocket costs, either; and many of these plans come with deductibles in the thousands of dollars. Your deductible is the amount of money you pay out-of-pocket first before your benefits kick in and your insurance company starts paying out on your medical claims. Lastly, there are no essential coverage guarantees for a short-term health insurance policy. This means that many of the major medical benefits listed above (such as preventative care or mental health counseling services, for example) might not be available to you via a short-term health insurance plan – not even if you request to purchase extra coverage.
Christian Health Plans/Health- Share Plans in Alaska
In the first few years after the Affordable Care Act was passed, health share plans (more commonly known as Christian health plans) became very popular. The reason they became so popular is because it offered people who didn’t qualify for a federal subsidy a more affordable health insurance option and it also exempted them from the health insurance mandate that existed at the time. As of January 1st, 2019, the federal mandate disappeared. Since Alaska is one of many states which does not have their own mandate for state citizens, Christian health plans are now much more optional than they were a few years ago.
In many ways, Christian health plans and short-term health insurance plans have several things in common. Some of those attributes include:
- No guaranteed issue
- Unlimited out-of-pocket costs
- Lifetime and annual benefit caps
- No guaranteed Essential Health Benefits
- Plans require a less costly “monthly share amount” than an unsubsidized ACA monthly premium
- Not considered to be a “real” health insurance plan by major organizations and care providers
At the same time, however, there are some stark differences between these plans and short-term health insurance. For starters, people who volunteer to participate in a Christian health insurance plan have fewer consumer protections. There is no official contract between you and your health plan provider, so they technically aren’t legally obligated to make good on any of the promises they make. That being said, many of these organizations do make good on their promises; but you may have little or no legal recourse if you run into an organization that refuses to pay out the benefits they originally promised you. Many organizations also impose “participation guidelines” which require you to cease and desist unhealthy habits such as smoking and adopt certain lifestyle habits which adhere to a (usually) biblical way of life. Lastly, the terminology is different. You don’t pay a monthly premium, you pay a “monthly share amount”; likewise, you don’t pay deductibles, co-pays, or co-insurance; all of these different forms of payment are lumped together and commonly referred to as “personal responsibility amounts” or “unshared amounts”. This is done primarily for legal reasons.
Fixed Indemnity Plans in Alaska
Fixed indemnity plans are actually health insurance supplements – they are not meant to stand alone as your primary form of health care coverage the way a major medical plan, a short-term health insurance plan, or a health share plan is. They usually only pay for hospital expenses, although some of the payouts may apply to very specific types of outpatient care as outlined by your policy. The payments they make may be based on a per day, per week, per month, per visit, or per event basis. The specifics will vary greatly depending on where you live and which company you get your plan from.
Fixed indemnity plans are a far from ideal substitute for major medical coverage. Furthermore, like the other ACA alternatives we’ve discussed thus far, there are both annual and lifetime benefit caps associated with fixed indemnity plans. You also won’t get a guarantee coverage policy because the companies that offer these plans are legally allowed to charge you differently or deny coverage based on pre-existing conditions. On top of everything, the benefits they do pay out only cover a fraction of your total medical costs. It would be misleading to say that this type of coverage is anywhere near as comprehensive as a major medical plan.
Discount Cards in Alaska
Are you familiar with membership discount programs like AAA or AARP? Medical discount cards work in a similar fashion. You pay a monthly fee, the company issues you a medical discount card, and you present that card whenever you get medical care, fill a prescription, or purchase medical goods and services at qualifying providers. These plans can be potentially beneficial if you find a reputable medical discount card provider that offers participants robust discounts at an affordable monthly rate. But keep in mind that you are paying out-of-pocket first, and then getting a discount off of the total price. You are not dealing with an insurance company, you are not filing claims, and you are not being reimbursed for any expenses.
As great as some medical discount card programs are, there are also disreputable companies out there who are trying to game the system in order to take advantage of consumers like you. Some companies exaggerate the amount of money you can save on discounts, while others flat out lie about which providers will honor your discounts. You’ll have to do a little bit of research first, but if you can find an affordable medical discount card provider near you, it can be extremely helpful for bringing your medical costs back down into the realm of possibility.