Health Insurance Matters: Self Introduction

HEALTH INSURANCE MATTERS / Harry P. Thal

It was sometime back in 2004 when I was unloading my (oversized) post office box that I met Dolly Ogawa. As my box, really a drawer, was full of mail, Dolly introduced herself and inquired what I did to warrant such a large mail receptacle. I responded that I was an insurance agent who specialized in health insurance. I was nationally known as an expert in Medicare and spoke and lectured on a national basis, training other agents about Medicare. Dolly told me that she was the publisher and founder of the Kern River Courier. She invited me to write a column about health insurance for her readers. I agreed, and with a few missed deadlines, have been contributing to the Courier ever since.

I am certain most of the residents of the valley, as well as regular tourists ,will miss the paper from the free newsstands. But life must go on, and the Kern Valley Sun has graciously made available space so I may continue providing our valley with the latest of health insurance news.

Happy New Year 2018. 2017 was a tumultuous time for health insurance. On the Federal side, Congress was unable to unravel Obamacare, the promise of many of the Congressmen/Congresswomen running for office. It seems that whatever direction the President turned, there was political interference.

One major component of the “Affordable Care Act” is the penalty if you do not have health insurance. Personally, I feel this is a good thing, just poorly done, and with a penalty too small to make a difference. Keep in mind, that if every person, healthy or not, participated, the cost of healthcare would have been shared. This would lower the cost to all. With the premiums regulated, there is not an insurance company getting rich on this program. In fact, many companies stopped selling individual plans as they were losing money. Here in the Kern Valley, and throughout most of California, Anthem Blue Cross not only stopped selling individual and family plans, they discontinued most plans previously issued.

The penalty part of the ACA will be ending, but not until 2019. Therefore, there will be tax consequences for people who do not have health insurance in this new year. Policies purchased prior to January 15 will be effective February 1. The open enrollment period runs through the end of January, so those people who enroll in the later part of January will have a March effective date, and will be faced by a one-month penalty.

I am astounded by the number of phone calls we have received from people on Medicare wanting to enroll in a Medicare Advantage plan. I need to screen these people before having a conversation. If they are just turning 65, great. If they are over 65 and just now retiring and had employer sponsored group insurance, fine. If they are on Medi-Cal and want the enhanced benefits of specialized HMO plans, wonderful. If they have certain heart problems or Diabetes, they can enroll year-round as well. BUT, there are many people who just pop in thinking that after the doctor diagnoses their problem they can run out and get somebody (or a company) to take responsibility and pay their bills…forget it.

How many of our locals did not have fire insurance on their homes? They couldn’t run out and buy coverage after the fire. They were stuck. Lost everything. Health insurance is becoming like the homeowners or car insurance. It is needed, in proper amount and coverage BEFORE the problem arises. You will pay until you are broke. When all is lost (spent), then, perhaps, you can get treatment.

Well, I hope we all have a HAPPY NEW YEAR, and I will continue to brighten your minds with relevant information to make your life easier in the complicated world of health insurance.

Harry P. Thal, MA, is a licensed insurance broker in California (0621106) and 24 other states. His offices are in Kernville. He is a member of the Society of Certified Senior Advisors and Past-President of the Kern Association of Health Underwriters. He may be reached at 760-376-2100, e-mail harrythal@aol.com or visit him on the web at www.harrythal.com.