December 3, 2023

Prime Electrolite

Transforming Health

Are Florida Health Insurance Rebates Dead?

The creation of the Affordable Care Act by the Obama administration sparked a major battle. One particular mandate that is being contested by Florida republicans is the health care rebate mandate. Governor Rick Scott is seeking a waiver that would potentially cost almost $60 million in rebates alone. Who stands to lose? Health insurance consumers may be out of luck.

What Is The Health Insurance Rebate Mandate?

It is known as the Minimum Loss Ratio (MLR) mandate. It states that insurance companies who fail to spend at least 80 percent of the premiums they collect on individual and small business health insurance plans must issue rebates to policyholders. Almost 340,000 Florida residents would be eligible for those FL health insurance rebates according to Florida’s Office of Insurance Regulation. According to health care reform, insurance companies can keep 20 percent of premiums for admin expenses and profit, but insurance companies are fighting for a bigger share even though some insurers have reported record profits.

While people who really don’t have trouble paying for health insurance decide whether those who do will get help, you can take back some control over your cost for health care. Instead of hoping for a rebate, see what other strategies can help you spend less on health care.

It’s pretty common knowledge that Florida health insurance plans that don’t cover major medical expenses until you have paid a fair amount of medical bills on your own come with some of lowest monthly premiums available. If you’re thinking that’s not for you because you need a doctor to help you manage diabetes or you are taking a ton of prescriptions, the 2011 changes may make those plans more appealing.

Even a $10,000-deductible plan purchased now starts covering health care immediately as long as the service is coded with the right preventive health care codes. Everything from check-ups and tests to detect disease to counseling to help you lose weight or improve the nutrition level of your meals is covered without having to meet a deductible. There is one caveat, though. You’ll need to work with doctors in the plan’s network to avoid out-of-pocket costs.

These covered preventive health care services may not provide all that you need, but you may save so much in premiums with a high-deductible plan that the amount you save will pay for any extras. Seriously, people are switching to drop their annual health insurance bill by hundreds and thousands of dollars.

For any medical care that you pay for yourself, look into ways to bring down those costs, too. Prices on prescriptions are notoriously marked up, more and more pharmacies are offering discount programs. In addition, insurance agents are handing out prescription discount cards. You may also be able to buy your medicine in a higher strength dosage for the same price you are now paying. Pharmacies sell actual pill splitters so you can simply cut pills in half to continue taking the same dosage, just at half the cost.

You may also want to look into PPO plans. This is a form of managed care that gives you substantial discounts for using a provider in the network. PPO networks are known for including a substantial number of providers so they rarely reduce your choice of doctors much. Always check a plan’s provider network before submitting an application, though.