2024 Health Insurance State of the Union

I teach health insurance to clients, which is much different than selling products!  Once my new client understands how the insurance company makes money, it’s amazing to see what I call “the Visine effect!”  This occurs when the eye-glazing lifts and it “gets the red out,” so to speak, meaning they get it!

Are you either unhappy with your agent or unhappy with your current health plan?  If yes, keep reading as there are many upcoming 2024 health insurance changes ahead that your agent/broker should be telling you about!

There are 2 worlds, Traditional (Obamacare) and Non-traditional health insurance!  In traditional, there are what I call the main 5.  See below what’s in store for most of you for 2024:

1. Emblem Health: Used to be called GHI (Government Health Ins). They are removing ALL group policyholders from their “Prime Network” and forcing them into their, what we call SKINNY “Select Network” where it’s hard to find doctors.  NO MORE BROKER Commissions!  Good Luck getting service directly from Emblem from mostly non-licensed staff.
2. Health First: The least expensive of the main 5 in terms of monthly premium.  They are forcing ALL group policyholders to take their platinum plan which is expensive and NO MORE Broker commissions on new business.  Good Luck getting advice and service from mostly non-licensed service persons!
3. Oxford: They are changing their prescription plan in the “Liberty Network” to Broad RX and rates are going up 4.7% over the current bloated premiums for their middle network. 
4. Aetna: They are reclassifying many of their drugs (in a 12-page memo) to non-formulary or not accepted!  What this means is if you have Aetna and are on prescription drugs every month, there’s a chance you will be paying a higher co-pay, or they might no longer be covered at all!
5. Empire Blue Cross: They have changed their name to “Anthem” after their parent company and are quietly raising co-pays on many of their plans which are going up 6.8% in January 2024!

The definition of insanity is doing the same thing (such as renewing your same health plan year after year) and expecting a different result!!!

There is a whole other world called “Non-Traditional” insurance which offers access to additional networks (through partnerships, associations, and unions) such as Cigna PPO, Empire “Blue Card” network, PHCS Multiplan network, Magnacare and HIP, etc. on a discounted basis. 

It is no secret that the U.S. healthcare system is broken!  See below for my top 6 reasons for this:

1. The USA spends over $12,000 per person per year on health-related issues: This is by far the most in the world.  Other than Germany at $7,500 per person per year, the rest of the world is under $6,000, meaning we spend twice as much as the rest of the world!
2. Obamacare Rules and Regulations: Obamacare is a “guaranteed issue” meaning everyone who applies is accepted.  Many persons who had no health insurance for years (and accumulated health issues) were able to secure subsidized plans and “buy a claim!”  Buying a claim is when one has no insurance, buys new insurance, and immediately gets that surgery they have needed for years. 
3. Dependency on Prescription Drugs: Having been in the life, disability, and long-term care insurance business for over 25 years, it is rare to find someone who is NOT taking prescription drugs.  Because these drugs are expensive, there is a cost share between the insurance company and the policyholder, further driving up costs.
4. The Juvenile Diabetes and Obesity Epidemic: A recent report from the CDC (Centers for Disease Control) projects a 700% increase in Type 2 diabetes for juveniles under age 20 by 2060!
5. Processed Food Label Rules and Bad Habits: We have a national problem with misleading food labels that must be remedied.  There are more than 60 synonyms for sugar, which is found in most baby foods starting the sugar addiction early.  In fact, a NEW WARNING is out from the AAP (American Academy of Pediatrics) on ALL products labeled “Toddler Formula,” saying “Products MAY Contain Too Much Sugar and MAY NOT Provide Adequate Nutrition!”  “Toddler Formula” labeled food sales are UP 158% in the last year!
6. No Market for Individuals: In the current state of health insurance, individuals are doomed!  If one doesn’t work for a company that offers group insurance or owns a corporation, there are VERY few options with traditional health insurance.

Because of these 6 reasons, health insurance premiums will continue to outpace inflation!

One potential solution is to look at Non-Traditional insurance offered through groups, associations, unions, and partnerships!  Some of these plans are medically underwritten, meaning one needs to qualify to get onto the plan.  The benefit is having a much healthier pool of policyholders; hence, reducing claims and future premium increases.

To learn more or get quotes, feel free to email me at Rob@InsuranceDoctor.us.  Let’s hope you never need to use this insurance!