Living in New Hampshire means that you have a unique set of options to choose from when it comes to purchasing qualifying major medical coverage – or an alternative. But which option is right for you and your family? Some options may cost more than others, but not provide you with the same set of benefits or consumer protections. Getting the right health care coverage is a bit of a give-and-take. But in order to know which one to choose, you have to know the differences between the policies and products which are available to you. This article is going to go into what those are, and how they can help you and your loved ones get the coverage you need.
Major Medical Insurance in New Hampshire
When we talk about major medical insurance coverage, we’re talking about the ACA, AKA Obamacare, AKA the federal Health Insurance Marketplace. The Affordable Care Act was passed back in 2010. The Health Insurance Marketplace was set up in 2014 in order to help people connect with insurance companies who were complying and cooperating with laws designed to offer them the most comprehensive and cost-effective coverage possible.
Applying for coverage is a little more convoluted in New Hampshire than it is in other states, but it’s not as difficult as you might think. Yes, it’s true that New Hampshire does run their own state exchange; but they do it through a partnership with the federal government. This means that you still have to apply at HealthCare.gov and fill out the federal application for insurance if you want to be approved for and be able to shop around your state exchange. The application is fairly simple, it only takes minutes to fill it out, and you can usually get results the same day and start shopping for plans right away.
If you’re wondering what’s so great about major medical coverage, the answer is: lots of things. First and foremost is the fact that every single policy approved for sale on the exchange is guaranteed issue. If you apply for coverage for a policy you found on the exchange, you will never be rejected for coverage. You also won’t be charged an arm and a leg for your monthly premiums if you have pre-existing conditions; major medical coverage through the ACA is one of the only ways you can be protected against this type of price discrimination in the healthcare industry today. You may still have to pay a higher monthly premium, though, if any of these four factors make you a riskier customer to provide Insurance to:
- Your age
- Your location
- Your use of tobacco products
- Whether you are applying for an individual policy or a family policy
Another advantage of major medical coverage are the 10 guaranteed Essential Health and Wellness Benefits that are very difficult to find outside of the ACA. Most companies don’t want to sell you that much coverage because it is very expensive for them to provide it, and it cuts into their profit margins to do so. But even hard to get coverage like mental health counseling is guaranteed with every insurance policy sold in the ACA. The full list of benefits is available below:
- 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)
Last – but certainly not least – are the tax subsidies which make major medical coverage affordable for the average family, in spite of the expensive list of benefits and consumer protections they are required by law to offer. But it largely depends on whether or not you fall above or below 138% of the federal poverty limit. If you, based on your household size and income, fall above that threshold, then there’s good news – you will qualify for a federal subsidy which can make your monthly insurance premiums cost a fraction of their full retail price. This makes healthcare marketplace insurance affordable for the vast majority of Americans. If your income Falls below that threshold, however, you might want to try applying for Medicaid instead. The useful chart below can help you figure out which side of the income threshold you fall on.
|Household Size||Annual Income (138% of FPL)|
The good news is that New Hampshire has been accepting federal funds and providing expanded access to Medicaid for qualifying residents for several years now. On the downside, however, qualifying for Medicaid depends on more than just your income. Your age, disability status, and number of qualifying children in your household will also factor into whether or not you qualify for this type of healthcare coverage. For more information on Medicaid in New Hampshire, you should visit the official New Hampshire Medicaid website.
Short Term Health Insurance in New Hampshire
New Hampshire has done a good job with using their federal partnership to boost the state exchange and with expanding access to Medicaid to the needy – however, this doesn’t mean everyone will be eligible for a subsidized major medical policy through HealthCare.gov. Some people may not qualify at all, while others may not be able to afford it, even with a subsidy. In this event, you have alternative options to consider. The first alternative option to think about is short-term health insurance. In the state of New Hampshire, you can only apply for short-term health insurance for a maximum of six months with no option for renewal. This is one of the most important things to keep in mind when shopping around for short-term health care coverage in your state.
Another important thing is the fact that short-term health insurance companies require medical underwriting and are therefore not guaranteed coverage policies. So if you have a pre-existing condition, it can count against you. This can raise your monthly premium, or it could make you ineligible for coverage in the first place. But you at least have consumer protections on your side when it comes to short-term health insurance. You will have plenty of legal recourse and may even be able to take your provider to court if you feel like they have denied you benefits and refused to pay out claims unjustly – not many other ACA Alternatives can say this.
The costs are bound to be a little bit higher with short-term health care coverage. Most plans start with a substantial deductible as high as $5,000 or more. You won’t have any caps on your total out-of-pocket costs, but your provider will likely enforce caps on annual and lifetime benefits for your policy. Still, short-term health insurance has the potential to be up to 33% less expensive than the monthly premiums for an unsubsidized ACA major medical policy. And if you don’t require too much medical care, purchasing one of these plans can be very cost-effective in the long run. You can also supplement short-term health insurance with an indemnity plan, a medical discount card, and more in order to help keep your out-of-pocket cost and deductible charges under control.
Christian Health Plans/Health-Sharing Plans in New Hampshire
The biggest appeal of a Christian Health Plan – also known as a health share plan – actually went away at the beginning of 2019. Before then, the individual mandate was still in place, and there were still tax penalties every year for Americans who chose not to purchase qualifying major medical coverage through the ACA. Back then, most people chose a Christian health plan because it offered a cheaper alternative to major medical – despite the fact that, legally, these plans do not offer equivalent or qualifying coverage.
Even though the individual mandate is no longer a legal requirement in New Hampshire, this doesn’t negate the potential usefulness of a Christian health plan. But this can be a little confusing for some people, so let’s start by talking about all of the things that Christian health plans have in common with the other major ACA alternative, short-term health insurance:
- These plans are NOT guaranteed issue
- They have unlimited out-of-pocket costs
- They have lifetime and annual benefit caps
- They likely won’t have all of the guaranteed essential health benefits
Now we should talk about the major differences between short-term health insurance and Christian health plans so that you get a better idea what these have to offer you. In order to become a member of a Christian Health Plan, you have to agree to certain participation guidelines. You will likely have to declare a specific faith, And quit any unhealthy habits (such as tobacco use). there are other religion-based stipulations you may have to agree to or comply with depending on your provider and your plan. You must also agree to pay a “monthly share amount” which takes the place of a monthly premium, as well as certain “unshared amounts” or “personal responsibility amounts” in place of deductibles, co-pays, and coinsurance. Lastly, you should know that unlike short-term health insurance, any disputes over claims, benefits, and payouts can only be settled between you and your plan provider. You won’t have any legal recourse to seek arbitration or take them to court if you feel you have been unfairly denied your benefits.
Fixed Indemnity Plans in New Hampshire
A fixed indemnity plan could definitely help you manage your healthcare costs – but it’s unlikely to do so if you’re trying to purchase one in order to replace major medical coverage. Indemnity plans actually work better as a health supplements alongside something like short-term health insurance in order to help you manage your out-of-pocket costs. By itself, fixed indemnity plans cover a far smaller share have your medical expenses compared to things like short-term health insurance or a Christian health plan. They also have some of the same drawbacks (such as annual and lifetime benefit caps, as well as medical underwriting) which can be problematic for people who have pre-existing conditions.
When you use a fixed indemnity plan, it will pay out your benefits on a per day, per week, per month, per incident, or per visit basis, regardless of whether or not you already have coverage. Those payouts are usually a small fraction of your medical costs, and they are a fixed amount – hence the “fixed” part of the name – instead of a percentage of your total bill, the way a major medical policy divides the costs. Still, if you’re having trouble finding short-term health insurance or a Christian health plan, but you manage to find an indemnity plan to help with your medical expenses, it’s still better than nothing. This is especially true if you are relatively healthy but you are particularly concerned with the financial fallout of a sudden and unexpected medical emergency.
Discount Cards in New Hampshire
Medical discount cards are available for sale in New Hampshire, or you can find free services like the New Hampshire Rx card which basically provides free coupons online to help reduce your prescription drug costs. If you decide to purchase a membership with a medical discount card company, you will be asked to pay a membership fee (either on a monthly or an annual basis) and you will be sent a card in the mail. Once you get that card, you can present it at providers, pharmacies, and whenever purchasing medical supplies to get a small discount on your products and services. Sometimes, the amount of money you spend on membership fees ends up being less than the amount you would have paid in medical costs without the discounts. In the event that you get lucky with a scenario like this, a medical discount card is a great way to help reduce your out-of-pocket costs with regard to your health care.
But not many people end up getting lucky with medical discount cards. As a matter of fact, there are many less-than-reputable companies out there exaggerating or outright lying about the discounts you can receive through their medical discount card programs. Some will even go as far as to say that their medical discount card is a form of insurance, when the reality is that such claims couldn’t be further from the truth. Medical discount cards don’t involve filing claims or waiting for reimbursements. And they certainly do not come anywhere close to replacing major medical coverage through the ACA. If you’re concerned about major medical cards in your area or their potential scams, visit the Federal Trade Commission’s web page fo tips and advice on how to deal with medical discount cards in New Hampshire.