ACA WITH PRIVATE SUPPLEMENTAL WRAP HYBRID PLAN INFORMATION

A wrap plan is a combination of two or more plans to create overlapping and complete coverage, typically creating a reduced monthly premium amount with increased coverage by eliminating non-essential coverage items (such as maternity for a single male). An ACA/private wrap plan is using the two main insurance avenues to get the best of both worlds. ACA is the marketplace (also known as Obamacare) and has low to no cost monthly insurance options, they are typically underwritten via private insurance company and partially paid for with government funding. These plans must accept everyone, no matter what the pre-existing conditions. Due to this increased risk (cost) to the insurance companies that write these plans, they will have very high deductibles, copayments, coinsurance, and out of pocket max costs. They are designed to cover wellness visits (annuals physicals, immunizations, etc - routine visits) and will cover major medical with a very large deductible typically in the tens of thousands of dollars (heart attack, stroke, cancer, etc.). This leaves minor injuries and accidents vulnerable to out of pocket costs, such as broken bone, urgent care visits, minor illness, etc. 

A wrap plan address this gap in coverage by adding private supplemental accident and MedGuard coverage to the plan. an example with costs would be as follows:

39 YEAR OLD SMOKER WITH $54,000 ANNUAL INCOME IN 33760 ZIPCODE

Sample ACA plan: $0 monthly premium, primary care visits covered 100% with specialists, doctor visits, ER and hospital stays, urgent care, etc subject to a $9450 deductible. Private UCH supplemental only accident coverage $500 deductible with $10,000 max coverage and MedGuard at $10,000 at $121 per month with an optional $39 dental/vision plan

The ACA portion of the plan covers daily wellness visits, the private plan kicks in for accidents and illness up to $10,000 (covering the ACA deductible and max out of pocket) with a one time $500 deductible and the ACA covers anything above $10,000 to an unlimited top end cost. This plan cost the client $121 a month with $500 max deductible. If this coverage was ACA only, the client would be liable for up to $9,450 in out of pocket expenses. 

NOTE: ACA plans are subject to open enrollment periods without a qualifying life experience event which is November, if appying for ACA out of open enrollment period, a life qualifying event includes items such as loss of current insurance, denied for medicaid, change in family size, and moving which results in loss of insurance coverage. a short term bridge plan is available if needed for those who do not qualify but please keep in mind open enrollment period is very busy and it can be difficult to get coverage due to the system being overwhelmed so it is best to set everything up ahead of time to be ready when the time comes. 

Please email, call, or text to receive more information on this type of plan to see if it is right for you or your family.