Living in Kansas shouldn’t mean going without affordable health care coverage for you and your immediate family. But thousands of Kansas residents are still searching for a healthcare plan that meets their needs at an affordable cost. Odds are good that if you’re reading this right now, you’re one of them. But after reading this article, you probably won’t be for much longer. We will discuss all of your options below, how they relate to you as a resident of the state of Kansas, and what you can do to get an affordable and comprehensive health plan to meet your health care needs.
Major Medical Insurance in Kansas
The law which is responsible for the majority of affordable plans available today is formally known as The Patient Protection and Affordable Care Act. It became law in March of 2010, and has been helping millions of Americans get affordable and life-saving health insurance for the past several years. But the law that existed on day one is very different from the law which exists today, and you need to know about these important, recent changes (like the discontinuation of the individual mandate) if you want to get covered for an affordable price.
Getting an affordable major medical health insurance plan through the ACA – which is pretty much the gold standard as far as health insurance goes these days – is a very simple and straightforward process. You start by going to HealthCare.gov during the Open Enrollment period between November 1st and December 15th each year. Once you create an account and log in, you can fill out an application and receive notice of eligibility – as well as any subsidies you may qualify for – that same day. The application itself contains a short list of simple, straightforward questions that makes the process virtually effortless.
So why are these major medical plans the gold standard of healthcare today? What is so special about them that makes them so popular? It starts with the fact that these plans are guaranteed issue. When you apply for coverage under a guaranteed issue policy through the ACA, you’re applying for a health insurance plan from a provider who cannot reject you for coverage, no matter how “high risk” of an investment you may seem to be. And you can’t be charged astronomically higher monthly premiums due to any pre-existing conditions you may have. In fact, only these four factors are allowed to determine whether or not your insurance provider charges you a higher premium in the first place:
- Your age
- Your location
- Your use of tobacco products
- Whether you are applying for an individual policy or a family policy
ACA plans also have the 10 guaranteed Essential Health and Wellness benefits which are a mandatory part of qualifying for sale on the exchange. According to leading medical experts, insurance policies which offer these 10 benefits are the most effective at providing low-cost, preventative medical care which keeps costs down over the long-term. Here are the Essential Health Benefits you can expect with an ACA plan:
- 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)
The third reason why ACA insurance is the most popular out of all the available options is because of the federal subsidies. But qualifying for a subsidy is a little tricky in Kansas. If you make between 138% and 400% of the federal poverty level, it is highly likely that you will qualify for a federal subsidy to make your monthly premiums for an ACA plan affordably inexpensive. If you make less than that, you might qualify for Medicaid instead – but qualifying for Medicaid in Kansas is based on more than just your income, so being low income in and of itself does not automatically qualify you.
The handy chart below illustrates the income threshold for 138% of the poverty level based on household size. If you are at or above the threshold, then you can qualify for a government subsidy. Otherwise, you may have to look for help if your insurance costs through other means.
|Household Size||Annual Income|
There is an income gap somewhere between 138% of the federal poverty level and the ever-moving goalpost that is the poverty threshold to qualify for KanCare (the Medicaid Program in Kansas). This income gap exists because, for whatever reason, government officials in Kansas have decided not to accept free federal funding to expand Medicaid for certain low-income individuals in Kansas. in order to find out if your income and other personal circumstances qualify you for Medicaid instead of an ACA plan, you should visit the KanCare website and fill out an application. If you still can’t qualify for a subsidized, low cost plan through either the ACA or KanCare, then you have a few other options to consider.
Short Term Health Insurance in Kansas
It’s harder to qualify for a low cost major medical health plan in Kansas then it is in most other states. For this reason, short-term health insurance is a popular alternative – albeit not quite as comprehensive as health insurance through the Health Insurance Marketplace. But the rules are a little bit different in Kansas compared to other states. You’re only allowed a maximum of two years on short-term health insurance before you either have to switch providers or register for a different type of qualifying health insurance plan. Other than that, short-term health insurance in Kansas follows many of the same rules that a dozen other states.
Here are a few of the selling points which makes short-term health insurance a popular choice among some people: it starts with the fact that the monthly premiums for these plans are usually one third less costly than an unsubsidized ACA plan. You’ll also be able to negotiate with your insurance provider and add certain coverages to your policy that you might not otherwise get – unfortunately, you may fall short of getting all of the Essential Health Benefits guaranteed by the ACA. Best of all, unlike some other ACA alternatives, you have a fair amount of consumer protection laws on your side. This means that if you ever get into a dispute with your insurance company, you can take them to court if you think you have a legally justifiable reason.
But there are some downsides to these plans that you should know about before you go any further. There is medical underwriting involved with short-term health insurance, which means these policies are not guaranteed issue. You can be rejected for coverage if your insurance company thinks you have too many expensive pre-existing conditions, and you could be charged a substantially higher monthly insurance premium to compensate for your high risk status. Furthermore, there are some benefits which most short-term health insurance companies simply will not sell you, no matter how much you want them – preventative care and mental health counseling services are two of the most notoriously rejected benefits – which means that you can’t get the level of comprehensive coverage you would with an ACA plan.
Lastly, you should know that there are limits and caps on the level of benefits you will receive – both on an annual basis, and over the lifetime of your policy. But the sky’s the limit when it comes to the out-of-pocket costs you might incur with short-term health insurance. This is an important factor to consider because many of these plans are as affordable as they are due to their very high deductibles – usually starting around $5,000 or more. After you pay the deductible out-of-pocket for your medical care, then your short-term health insurance company will start contributing toward your medical costs.
Christian Health Plans/Health Share Plans in Kansas
A couple of years ago, the individual mandate from the federal government created a lot of big business for Christian health plans. Consumers who couldn’t afford or didn’t want an ACA plan started to take advantage of the religious exemption associated with health share plans like these. But now that the federal mandate is no more – and since the state of Kansas has decided not to enforce a statewide mandate of their own – there’s no legal requirement for anyone to purchase health insurance coverage of any kind. But many Americans still choose to try and procure some sort of coverage because the financial consequences of being struck with a medical emergency without one are much more devastating.
You may be surprised to learn that there are quite a few similarities between a Christian health plan and a short-term health insurance policy. Just take a look at all the things they have in common:
- No guaranteed issue status
- 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, don’t make the mistake of assuming that these two types of health care coverage are identical. They certainly have some very stark differences. For starters, the agreement you get into with your healthcare plan provider is not contractually obligated; this means that if you ever have a dispute over a claim with your provider, you can’t take them to court or seek any other means of legal resolution the way you could with a short-term health insurance policy. Next, you should know that there are specific “participation guidelines” that most Christian health plans will ask you to follow. Sometimes that’s as simple as ending any current tobacco usage, but that could extend into declaring a specific faith, attending a specific church on a regular basis, and pledging to make certain biblical lifestyle changes. Lastly, you should be familiar with the terminology used with these plans. Instead of paying a deductible, coinsurance, or co-payment, you will likely be asked to play a “shared responsibility amount” or an “unshared amount”. Along that same line, you don’t pay a monthly premium for health share plan; you pay a “monthly share amount”.
Fixed Indemnity Plans in Kansas
For the longest time, fixed indemnity plans were sold as supplements for major medical insurance policies. These days, however, people are increasingly turning to fixed indemnity hospital and doctor plans in order to help with a more substantial portion of their medical expenses. While most insurance experts would not advise trying to replace major medical coverage with a fixed indemnity plan, they may be able to help you keep your medical costs under control if you are struggling without any type of major insurance coverage.
With a fixed indemnity plan, you’ll have to deal with the same hassle of lifetime and annual benefit caps, as well as no limit to your out-of-pocket costs. Fixed indemnity plans pay a fixed amount usually determined per day, per week, per month, per incident, or per visit. And they don’t come anywhere close to providing the 10 guaranteed Essential Health and Wellness Benefits that you could get with an ACA plan. But they can still help you avoid a substantial amount of medical debt if the premiums are within your budget and you cannot afford or acquire an ACA plan.
Discount Cards in Kansas
Medical discount cards are a different way of supplementing your need to reduce your medical costs. But they work very differently from a fixed Indemnity plan. If it is a legally operating, reputable company, it works somewhat similarly to the AARP or AAA: you pay an annual or monthly membership fee, they mail you a card, and you present that card whenever you get care at a participating provider. You won’t be filing claims, and you won’t be sitting around waiting for any reimbursements; you’ll just get an upfront discount whenever you purchase medical supplies, prescription drugs, or get the care you need.
Unfortunately, there are some dishonest companies out there who may try to use the discount card system in order to scam innocent people. If you run across a company who claims that their medical discount card is a form of insurance, if you find that the discounts they advertise or the list of providers they claim to work with is too good to be true, or if they are not maintaining a surety bond with the Kansas Secretary of State’s office, then it might be a scam. If you think you have found a scam or if you believe yourself to be the victim of a scam, be sure to contact the Secretary of State’s office. Otherwise, if you find a medical discount program that makes good on its promises, feel free to sign up and enjoy the savings either in tandem with a major medical health insurance policy, or as a way to reduce your out-of-pocket costs.