In about three months, I am going to be a low income, not under parents plan, minimal savings, jobless fellow who will have to rely heavily on Healthcare.gov for my health insurance. Peace Corps is offering a “health benefits plan” through IMG where they will cover us the first month as official Returned Peace Corps Volunteers (RPCV) and then we can opt to pay for a 2nd and 3rd month of coverage.
Before I joined Peace Corps, I spent a year as an AmeriCorps volunteer that also provided a “health benefits plan” as part of my service. The plan was serviced by the same company Peace Corps was using right before the switch and so I imagine the plan and coverage was the same or at least similar.
My experience with the AmeriCorps/Seven Corners “health benefits plan” was a nightmare. It was my first time navigating the dark underworld of insurance policies and limits and I had many frustrating calls with insurance agents that led to a few moments of angry hot tears. I just couldn’t wrap my head around why I couldn’t go see a doctor in my neighborhood. Under my parent’s insurance plan in Ohio, I spent my entire life going to the same doctor, dentist and optometrist and never had to pay when I left. As an AmeriCorps volunteer in D.C., I was scrambling to find doctors who could fill out my Peace Corps medical paperwork and also took my insurance but I wasn’t really sure how to answer any questions about my insurance and then the bill would come out and I didn’t know what to do with it – it was all just a confusing mess. In the end, I bitterly paid about $1,000 out-of-pocket.
And to be fair, that’s exactly how much I should have paid under the Seven Corners plan. I know that now but at the time, I felt so cheated.
The RPCV health benefits plan – that I’m going to call IMG for short – was rolled out last week. The premium is $233 per volunteer a month with a $250 deductible in-network/$500 for out of network. The max out-of-pocket costs is $1,000. (Sidenote: I finally know what all this means!)
At first, I thought back to my AmeriCorps days and immediately wrote this plan off as -NOT HAPPENING. But I’ve spent the better part of tonight perusing Healthcare.gov and the options there aren’t that much better.
First off, to make VERY clear, the IMG plan does not meet the current Affordable Care Act minimum requirements so it can’t rightly be called insurance. And for every month you’re not covered by qualified insurance, you have to pay a $50 penalty. That’s a $150 penalty at tax time for being on the IMG plan for three months after service.
However, the first two months you’re not covered is forgiven. So in reality, you will only have to pay a one month penalty on top of the $233/month premium you are paying for the plan. If you’re still under your parents plan when you get home then you don’t have to worry about this penalty at all.
So why would anyone pay for that third month of coverage?
Like I mentioned before, I looked into some insurance plans on Healthcare.gov for Ohio tonight and found that while the premiums are the same (about $200-240/month), the deductibles, coinsurance and out-of-pocket maxes are vastly different. For example, the most you’ll ever have to pay out of pocket on the IMG plan is $1,000. On Healthcare.gov plans, that number is estimated to be in the $6-7,000 range. That means you have to pay $6-7,000 out of pocket first before your insurance pays a cent! (One might be eligible for Medicaid through their state but I couldn’t find any hard numbers on that).
I was also concerned about why the IMG plan didn’t meet minimum ACA requirements. Were they skimping on a really important benefit that would later screw us over? Or was the IMG plan so bare bones that it was basically useless beyond a bro-I’m-about-to-die scenario?
After reading the Essential Health Benefits, I realized that there was a lot on the list that I didn’t need coverage for my immediate future. For example: Pregnancy, maternity, and newborn care; Mental health and substance use disorder services; Rehabilitative and habilitative services and devices; Preventive and wellness services; and pediatric services.
These are definitely health benefits that I need in my life long-term but for three months, I think I will be okay. Instead, right now I need good emergency and urgent care, in-patient stay and some prescription med coverage. I especially need low co-payments and deductibles. I think the IMG plan is exactly what I can both afford and need in terms of coverage which is why I’m planning to buy at least the 2nd month. I’m going to sit a bit longer on whether I want to buy a 3rd month – that $50 penalty is an annoyance. Yet, I suppose it’s better than being saddled with a $7,000 medical bill.
If you have anything to add or think I am missing something important, comment below. Would love to hear from you!