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Channel 13 Short Term Insurance Story

Channel 13 WTHR Investigates recently reported on a controversial story about Short-Term Health insurance and asked me to be a part of it being a health care professional.

The story is about a family that had been using short-term health insurance and the women was diagnosed with breast cancer. The policy she had purchased was good for 90 days.  Upon the initial diagnosis, the insurance company denied the claims.  At the end after a formal appeal, hiring an attorney and having channel 13 investigate, the insurance company agreed to pay the claim.

With short-term health insurance, companies will conduct Post-Claim Underwriting. This is the practice of researching previous medical records to determine if the condition had been previously diagnosed or had signs or symptoms. If the company finds evidence that the situation was pre-existing, then they will deny the claim.   One of the issues with Post Claim Underwriting is it delays the process of paying the claims, which can lead to delayed treatment. 

With individual health insurance becoming more and more unaffordable in Indiana, short-term health insurance has become a solution for some.

Guide to short-term policies.

1.    These policies are not for everyone. You need to be in good health, not being treated for any conditions.

2.    Look at the term of the policy. Most policies are for 90 days, but there are new products called 4×3 which provides coverage for 12 months. The 4×3 is four short-term policies but underwritten with one application.  In this arrangement, the policy will restart every 90 days. 

3.    Confirm you are purchasing short-term plan. We are seeing more and more Hoosier who are buying indemnity products thinking they are short-term policies.  The indemnity plan may pay a set amount per claim occurrence which ideally should be purchased in conjunction with a health insurance policy to offset the out of pocket.

4.    Look at the network and confirm that it’s a PPO network and it’s a recognized in your community.

5.    Read the brochure or at least the last page they address exclusions.

6.    Purchase the short-term policy from a local broker. Work with an agent that cares about the products they represent like Nefouse & Associates.

Tony Nefouse

https://www.wthr.com/article/fighting-for-coverage-short-term-health-insurance-may-result-in-long-term-trouble