Beware when buying health insurance

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ACA Health Insurance open enrollment has ended. The next open enrollment will begin Nov. 1 for 2021 plans.

However, certain changes in an individual’s life can make them eligible for a special enrollment period (SEP) and allow them to enroll at any time during the year. Examples of qualifying-life events include: Loss of employer-based coverage, moving to Nevada from another state, being dropped from your parents’ coverage when you turn 26, and changes in family size through marriage, divorce or the birth/adoption of a child. If you have a qualifying life event contact Nevada Health Link at 1-800-547-2927.

Now, that open enrollment has ended, don’t be fooled by claims of ACA-compliant “look-alike” health insurance products. Some consumers may find themselves falling for misleading marketing practices from entities mimicking health insurance, such as plans offered by health care sharing programs or ministries (HCSM).

Consumers should be careful of purchasing plans from HCSMs; they may seem enticing because they may be cheap, look and sound like they are in compliance with the Affordable Care Act (ACA), when in reality these plans are not even insurance products. These plans are from organizations whose members share a common set of ethical or religious beliefs and have shared medical expenses in accordance with those beliefs.

Consumers should be aware of the following regarding health care sharing programs or ministries:

• They do NOT comply with the Affordable Care Act (ACA), even if their materials say they do. If you come across any advertising or statements by a sharing program or ministry stating that it is ACA-compliant (or similar language), please report this to the Division of Insurance.

• Many sharing ministries specifically state that they do not guarantee payment for any health care and the member is ultimately responsible for anything the ministry does not pay. This language might be buried in the fine print, but it is an important notification.

• They typically have restrictions or exclusions on pre-existing conditions, leaving the member responsible for the health care costs for those conditions.

If you believe someone is trying to sell you a health care sharing program or ministry by telling you that “it complies with the ACA,” or “is just as good as ACA plans,” contact the Division of Insurance. Contact the Division by calling 775-687- 0700 or 888-872-3234 or by visiting the website at http://doi.nv.gov/.

Mel H Bell has been a licensed insurance/ investment professional for over 25 years. He is also Affordable Care Act (ACA) and Nevada Health Link certified.

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