EXTRA! EXTRA!

In response to the Covid-19 Public Health Emergency, President Biden issued an Executive Order last week providing a Special Election Period (SEP) February 15^th thru May 15^th. This will allow individuals and families experiencing new health problems during the pandemic, to update an existing health plan or acquire new coverage. (CMS press release here.)

Enter Blackstone.

Bill and his family are covered by a grandfathered plan; one with a $12,000 deductible and certain exclusions, neither of which are permitted under Obamacare.

That plan design however - and a premium much lower than anything in the current market - served them well for years.

But now his daughter needs a surgical procedure specifically excluded by this plan under any circumstances. He’s facing out of pocket charges of $30K or more.

Reviewing the policy provisions of carriers offering individual plans in 2021 (here), most will cover the procedure if “medically necessary.” The surgeon contends it is and, in similar situations, has had no trouble pre-certifying for payment.

Bill might even consider a low deductible ‘Platinum’ plan for just the rest of this calendar year.

While he can never go back to the grandfathered plan, he can review coverage again for 1/1/2022.

Abracadabra!

EXTRA! EXTRA! EXTRA!  We moved just two miles north. New address below.