We are continuing our advocacy blog series meant to help youtake care当涉及到重要的关节炎保健和覆盖问题时。If you’re just now tuning into this series, check out our previous advocacy blog postshere. In August, we kicked off a focus on health insurance benefits as we approachopen enrollmentthis fall. This week, we take a closer look at association health plans.
What are association health plans?
As the term indicates, association health plans (AHPs) are a specific type of health plan that an employer group or an association can offer to their employees. A key feature of an AHP is that small employers can band together to purchase health care for their employees. By pooling resources, these groups are theoretically able to purchase health coverage that rivals significantly larger employers and keeps premiums lower for employees.
为什么新闻里会有协会健康计划?
Likeshort-term health plans, AHPs are not new; they’ve been around since the 1970s. AHPs received renewed attention this year due to a regulation issued by the administration over the summer that expanded their availability. Over 90 percent of health care stakeholders strongly opposed this action, but the administration decided to move forward with its proposal.
What is changing with association health plans?
Beginning in September, small employers now have increased flexibility to form an association if they are in the same geographic area. This was not true before: Under the old rules, only small businesses in the same industry could form associations and purchase health coverage (for example, a bakery and a deli). The new rules are broader: A local bakery and a hardware store in the same region, for instance, can now theoretically form an association to obtain coverage for their employees. The new regulation also includes sole proprietors, or those individuals who exclusively own and operate a business and report income and losses on their personal income tax return.
What kind of issues would someone with arthritis face if they enrolled in an association health plan?
尽管最终条例禁止层次分析法基于任何一项健康因素对资格、保费或福利进行歧视，但它们可以根据年龄、行业、性别、职业或相关人口因素改变保费。此外，这些计划不需要覆盖《平价医疗法案》(Affordable Care Act)的所有基本健康福利，如处方药覆盖或医院护理。由于这些原因，ahp可能不是关节炎或其他慢性疾病患者的理想选择。
Is there anything else I should be aware of about association health plans during open enrollment?
Likeshort-term health plans,AHPs have a history of fraud. These plans have also been financially unstable in the past. The expansion of AHPs could also contribute to health insurance market instability as healthy patients leave the individual market due to the promise of lower premiums in these plans. While lower premiums might sound attractive, AHPs are not required to cover essential health benefits like prescription drugs. This means a patient with arthritis may not be able to appropriately manage his or her disease if enrolled in an AHP. Unexpected illness is another important consideration due to the limited scope of benefits offered through an AHP.
What resources are available from the Arthritis Foundation?
The Arthritis Foundation has already kicked off the open enrollment season to raise awareness of your health care choices for 2019. Revisit our Take Care blogpostsor get started with ourYour Coverage, Your Care toolkit. The toolkit is a great resource to help you understand your insurance options, the claims process and tips to overcome barriers. Additionally, if you have any questions about your health care, we have licensed clinical social workers on staff who can talk with you 24 hours a day for your convenience. You can reach the Arthritis Foundation toll-free Helpline at844-571-HELP (4357).
If you’d like to stay informed of federal and state-based health care issues, considersigning up to be an Advocate. Becoming a part of our advocacy grassroots network is an easy way to get involved and stay updated.
Related Resources:
- Read More Posts from the Take Care Series
- Get Involved! Sign Up to Be an Advocate
- Visit Our “Your Coverage, Your Care” Toolkit to Prepare for Open Enrollment