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Frequently Asked Questions

Community Healthcare Plan from HomePort Healthcare Services
Community Healthcare Plan from HomePort Healthcare Services

You have Questions. We have Answers.

Let's face it, healthcare is confusing. You have questions. That's understandable and it is also good, because that means you are taking your healthcare seriously.

Starting below are the questions we are frequently asked. Simply select the question and you will see our answer. If you have any question that is not answered here, please send us your question by using our contact form below.

Community Healthcare Plan from HomePort Healthcare Services

Healthcare Plan Question

Please click on the question you have to get your answer

1 What types of healthcare plans are offered by HomePort?

Answer: There are four types of Healthcare plans in the marketplace:

Community Healthcare Plans are not insurance. Rather, CHP brings individuals, families and employers together to become more self-reliant, and to "Self-Insure" against medical costs. CHP plans are the lowest cost, most flexible plans available in the marketplace. CHP plans are available at any time, and only through HomePort. CHP plans are not available on state exchanges.

The federal Affordable Care Act - ACA (Obamacare) is insurance generally for persons who have major medical issues. ACA plans are very expensive and have a very high Max Out-of-Pocket. ACA plans are available on state healthcare exchanges and through HomePort.

Medicaid Plans are provided by the state for individuals with lower income.
Neither HomePort nor CHP offer Medicaid plans.

Medicare is a federal medical program for people over the age of 65.
Neither HomePort or CHP offer Medicare plans. We do have a very experienced affiliate who manages our Medicare clients. We would be happy to refer you to our affiliate.

2 How should I go about choosing a Healthcare plan?

Answer: The most important considerations are affordability and coverages:

First, can you afford to pay both the plan's monthly cost AND the plan's Max Out-of-Pocket cost.

If you can't afford to pay either cost, you should not purchase that plan. If you purchase an un-affordable plan, you could have a significant financial hardship or even a medical bankruptcy. CHP offers the most affordable plans, with the lowest Max Out-of-Pocket costs in the marketplace.

Second, coverages should be considered. CHP offers better coverages and more flexibility than any other plan in the marketplace.

3 What exactly are the Max Out-of-Pocket, Deductible, Co-insurance, and Co-pay costs?

Answer: Most people have heard of a plan's deductible. A plan's Max Out-of-Pocket is less known, but actually more important. The Max Out-of-Pocket cost is the total of the plan's Deductible plus the Co-Insurance cost. These are the costs you must pay when you use your major medical insurance plan.

The Deductible: Every insurance company charges a "Deductible". You must first pay 100% of the plan's Deductible cost. The Deductible payment goes to the medical providers. Not to the insurance company. The lower the Deductible, the higher the monthly cost.

The Co-Insurance: After the Deductible is paid by you, then you and the insurance company share in the remaining costs. This is called "Co-Insurance". The Co-Insurance cost is frequently shown as a percentage, 80/20, for example. This means the insurance company pays 80% of the remaining costs. You pay 20%. However, your 20% is capped at a specific maximum amount. This cap is usually hard to find in your plan. The cap is included in the plan's Max Out-of-Pocket cost.

The Max Out-of-Pocket: The Max Out-of-Pocket (MOOP) is the total of your Deductible cost plus your Co-Insurance cost. The MOOP is the most important cost for you to know.
If your Deductible is $2,500 and your 20% Co-Insurance cap is $5,000, your MOOP is $7,500.
When you have a major medical event and need to use your insurance, you will have to pay the plan's MOOP. Not just the Deductible!

After Paying the MOOP: Once the MOOP is paid, the insurance company pays the remainder of your medical costs. For example, if your medical costs are $50,000, you pay a $7,500 MOOP, insurance pays $42,500.

Most Insurance Plans: Almost every insurance plan's Max Out-of-Pocket costs range from $6,000 to over $7,500 for an individual and twice for a family. The deductible may vary from $0 to $6,000. Whichever way you look at it, the insurance company wants your $7,500.

The Co-Pay: The Co-Pay is what you pay when you visit the doctor. Co-Pays are usually around $50 per visit. However, almost all lower cost major medical plans don't include or have limited office visits.

4 What is a Community Healthcare Plan?

Answer: Community Healthcare Plans (CHP) offer a new approach for managing and paying your medical bills. Church and fellowship organizations have been offering CHPs for many years.

CHPs are not insurance. CHP brings individuals, families and employers together to "Self-Insure". Instead of sending money to an insurance company, you and other Members contribute a fixed monthly amount to a "Community Healthcare Pool". Like a "Community" Health Savings Account (HSA).

When a Member has a Medical Event the Pool pays the medical bills. For additional information on CHPs read "Plan Details" and other FAQs.

5 What is the Community Healthcare Pool?

Answer: The Community Healthcare Pool (the "Pool") is used to hold deposits received from your Contributions, and Contributions from other CHP Members. These deposits are called "Pool Credits" and are used to pay approved medical bills.

The Pool resides in multiple banks and credit unions. Separate Pools are created to stay within FDIC or NCUA insurance limits. Each separate Pool is collectively called the "Pool". Deposits received by the Pool do not pay interest. CHP manages the Pool.

6 Do I have to qualify to use the Pool?

Answer: No. Your credit rating will not be used to grant you access to the Pool. There is no charge for use of the Pool. You will not pay any interest on the Pool Advances. Your obligation is to repay your Pool Advances made to pay your medical bills as provided in your CHP Agreement.

7 What is a Pool Credit?

Answer: Pool Credits are cash equivalents that accumulate monthly, and are added to your CHP Pool Credit Account Balance. You receive Pool Credits as follows:

From CHP Contributions: Usually about 50%of your monthly Contribution is designated a "Pool Credit". Pool Credits are deposited into the Community Healthcare Pool (Pool). Pool Credits accrue to your CHP Pool Credit Account Balance. Note, no insurance plan gives you any credit for your monthly payment. CHP does!

Third-Party Stop-loss Payments: Pool Credits can also be earned with payments received by CHP from Third-Party Stop-loss Insurance providers. CHP purchases supplemental insurance from these providers to reduce the Pool's General Capital Account risk. When you have a Medical Event that is covered by Third-Party Stop-loss Insurance, the cash proceeds received by CHP are used to increase your CHP Pool Account Balance and pay your medical bills.

Sponsoring Pool Credits: Pool Credits can also be earned by Sponsoring new CHP members. You will receive $10 per month as a Sponsoring Credit for each person you send to us who becomes a CHP Member.

8 What is a Pool Credit Account Balance?

Answer:: Your Pool Credit Account Balance is the total of your accumulated Pool Credits, less Pool Advances. A Pool Account statement is available from CHP at any time upon request.

Example: Your Pool Credit Account Balance is $2,400. You have an accident and Third-Party Supplemental Insurance providers pay CHP $15,000. You now have a $17,400 Pool Credit Account Balance.

9 What are Pool Advances?

Answer: Pool Advances are the monies withdrawn from the Pool to pay your approved medical bills, and medical costs.

10 Do I have to pay back the Pool Advances used to pay my medical bills?

Answer: Yes. You are obligated to repay any monies withdrawn from the Pool's General Capital Account to pay your medical bills. You are not obligated to pay back money advanced from your personal Pool Credit Account.

11 Does CHP charge me interest on the Pool Advances?

Answer: No.

12 Can I request more than one Pool Advance?

Answer: Yes. Pool Advances are tied to a Medical Event. A Medical Event likely will have medical bills from multiple medical providers. In this case CHP will make multiple Pool Advances. However, these Pool Advances are treated as one Pool Advance.

In another case, you could have two or more Medical Events throughout the year. As long as you meet the terms of your CHP Membership and Policy Agreement then the Pool Advances will be made.

13 What is the Pool Advance Limit?

Answer: Your Pool Advance Limit is the total of your Pool Credit Account Balance plus your CHP Line of Credit. The Pool Advance Limit is the maximum amount CHP will advance to pay your approved medical bills during the term of your Agreement. Any medical bill, collection of medical bills or Medical Events that exceed the Pool Advance Limit will not be processed and remain your responsibility for payment.

Example 1: If your Pool Credit Account Balance is $2,000 and your CHP Line of Credit is $15,000, your Pool Advance Limit is $17,000.

Example 2: If your Pool Advance Limit is $17,000 and your approved medical bills total $20,000, you are responsible to pay the remaining $3,000.

14 What is the CHP Line of Credit? When can it be used?

Answer: Your CHP Line of Credit is provided by CHP and is linked to the Pool's General Capital Account. Your CHP Line of Credit may be used to pay your approved medical bills after your Pool Credit Account Balance has been depleted. Your credit rating is not used to grant you access to your CHP Line of Credit. You will not pay any interest on advances made from your CHP Line of Credit. Your obligation is to repay advances made from your CHP Line of Credit to pay your approved medical bills.

15 How are my medical bills paid?

Answer: First, your medical bills are reviewed by the CHP Concierge. The Concierge will then attempt to negotiate a reduction in your medical bills and to establish a payment program, if needed.

Second, payments to the Medical Providers are withdrawn from your Pool Credit Account. If your Pool Credit Account balance is not sufficient to pay your medical bills, the payments are then made from the Pool's General Capital Account until paid or your payments reach Your Pool Advance Limit.

Your monthly CHP Contribution and Pool Credits continue as payments continue to be made to the Medical Providers. During this period, there is no increase in your CHP Contribution.

16 How do CHP, ACA and Group plans compare in cost?

Answer: CHP plans are the least expensive. CHP plans will save you about 50% compared to the cost of an ACA or Group plan. For example, the monthly CHP cost for a 25 year-old is about $95. An ACA plan's monthly cost can range from about $200 to over $350.

Your employer's Group plan's monthly cost is usually about 5% to 15% higher than a traditional ACA Individual plan. In many cases your employer subsidizes the monthly cost to make the Group plan more affordable for you. Even with an employer subsidy, CHP plans are usually less expensive for you and are considerably less expensive for your employer.

Another major consideration is the ACA / Group plan's Max Out-of-Pocket cost. Max Out-of-Pocket, "MOOP", is the plan's deductible plus co-insurance cost. ACA and Group plans have a MOOP between $6,550 and $14,000. The CHP MOOP options range from $250 to $2,000. CHP plans do not have co-insurance costs.

17 What are the healthcare coverages for these plans?

Answer: CHP plans are flexible and can be customized to meet your needs and budget. CHP plans can include coverages not available with an ACA plan. Just about any medical treatment can be included that is necessary for your health and well-being. You only select the coverages you want.

For example, ACA plans are required by federal law to include wellness visits, maternity, drug treatment and others. These coverages add cost and may not be needed by you.

18 What are each Plan's Deductible options?

Answer: With CHP, $250 to $2,000. ACA plans $1,500 to $7,000.

19 How is the CHP Deductible different from an insurance plan's deductible?

Answer: When you have a Medical Event, an insurance deductible must be paid. Then you pay the insurance plan's co-insurance. The total of these two is known as the plan's Max Out-of-Pocket (MOOP). ACA and Group plans have a MOOP between $6,550 and $14,000. The CHP MOOP options range from $250 to $2,000.

With CHP, the deductible is paid each time you have a Medical Event. For example, if you have a Medical Event early in the year, you would pay the CHP deductible at that time. If later that year you have another, separate and unrelated Medical Event, you would pay another CHP deductible.

Here is why the CHP deductible is much better than an insurance plan's deductible. With traditional insurance, a single Medical Event will likely require you to pay the MOOP; $6,000 to $7,500 or more. With CHP, the same Medical Event would cost you only the deductible amount you selected, $250 to $2,000. So, if you had a $1,000 CHP deductible, it would take 6 Medical Events to equal the cost of one insurance Medical Event. CHP could save you $5,000 or more in deductible costs.

20 Can I use my doctor or any other doctor?

Answer: With very few exceptions, you may use any primary care doctor you choose. Your office co-pay is limited to only $50. You will frequently receive priority appointments and discounts.

With an ACA plan, your doctor may not be affiliated (In-Network) with your insurance plan. Most of the lower cost ACA plans include an annual wellness exam, but not doctor visits.

Other medical providers can also be registered. Medical Providers are defined as any person performing a medical treatment such as doctors, nurses and other persons meeting the requirements of their professional organizations affiliation. If you want to use other medical providers that are not your Primary Care Physician, simply register your Primary Care Physician (PCP) before scheduling an appointment. If you need to see a specialist, you can also register the specialist. You do not need a referral from your PCP. Then register any other medical providers. To register, go to the "HomePort Resource Center" and then to "Register your Doctor".

21 Do psychologists and life coaches qualify as medical providers?

Answer: Yes. Psychologists and life coaches do qualify if medically prescribed. Prior certification is required in each case.

22 Does CHP negotiate rates with the providers relating to Labs, X-Rays and other tests?

Answer: Yes provided the medical providers are registered with CHP.

23 Are prescription medications included?

Answer: Yes. There is no co-pay and you do not have to wait until you pay your deductible, as with most major medical plans. Medications can be purchased at a significant discount from over 60,000 pharmacies, via the Internet, or by mail order.

Most major medical plans do not include prescription medications, until you pay the plan's deductible cost.

24 How about Dental and Vision Coverages?

Answer: With CHP they can be included as an option. ACA plans do not include dental or vision.

25 How about preexisting medical conditions?

Answer: With CHP most pre-existing conditions are accepted. ACA plans are required by law to accept people with pre-existing conditions.

26 How about annual wellness exams?

Answer: With both CHP and ACA plans they are included just like any other doctor visit.

27 How about Labs, X-Rays and other tests?

Answer: These costs are usually covered by CHP. Many with no-co-pays or additional out-of-pocket costs. All tests over $250 require pre-certification for coverage. ACA plans may cover such tests but usually require you to first pay the plan's deductible and co-insurance costs.

28 How about Maternity and Alternative Treatments?

Answer: With CHP, each can be an included coverage on a case by case basis. ACA plans cover maternity but not alternative treatments. Unlike insurance, CHP generally approves all types of recognized medical treatments. Contact us before scheduling your treatment to confirm with us the coverage. You can also go to the "HomePort Resource Center" and then to "Register a Medical Event" to request a confirmation of coverage.

29 CHP refers to me as a "Member" rather than an "Insured". Why?

Answer: People who sign up with CHP are called Members because they become members of the Community Healthcare Plan. CHP is not insurance, which is why CHP Members are not referred to as "Insureds".

30 CHP monthly payments are called "Contributions". Why?

Answer: Your payments are called "Contributions" because they are contributions to a Community Healthcare Pool.

31 How does CHP determine my Contribution amount?

Answer: Your age, overall health, chosen deductible, benefits and coverages, and your Pool Advance Limit determine your monthly CHP Contribution.

32 Who receives my Contributions?

Answer: Contributions are received by CHP, which then makes a cash deposit into the Community Healthcare Pool (Pool). These deposits are called "Pool Credits".

33 What is the difference between the Contribution amount and the Plan Effective Cost?

Answer:The Contribution amount is what you pay monthly. The Plan Effective Cost is your Contribution amount less Pool Credits and Plan Discounts.

For Example, if your Contribution amount is $200, your Pool Credit is $100 and you receive a $20 per month "New Member Discount", your credits total $120. You Plan Effective Cost is $80 ($200 less $100 less $20).

For comparison, consider if you paid $200 for a TV. When you purchased the TV you also received a $120 pre-filled credit card, what was your TV's actual cost? The answer is $80.

With an ACA Plan, your total monthly payment goes to the insurance company to pay their administrative costs. With CHP, approximately 50% of your Contribution Contribution is used to manage the plan, with the other 50% deposited into your Pool Account as Pool Credits to be used to pay your medical bills.

34 What is a Medical Event?

Answer: A Medical Event is generally defined as any medical treatment or consult for a medical issue by or with a medical provider such as for an Accident, Critical Illness or a Non-Critical Illness.

35 What is a Medical Event Registration Form?

Answer: A Medical Event Registration form is used to inform CHP about a Medical Event. A Medical Event Registration is required when you have a Medical Event. Once your Medical Event is registered, your CHP Concierge will begin to help you with your Medical Event; Medical bills, payment terms, Pool Advances and much more.

36 What are Assisted Managed Care Services?

Answer: Assisted Managed Care helps you manage many aspects of your healthcare and financial wellbeing. Once your Medical Event is registered, your CHP Concierge will begin to help you with your Medical Event; Medical bills, payment terms, Pool Advances and much more.

Your CHP Concierge provides you with the following services:
    Helps you locate cost effective medical services.
    Review your medical bills to discover charges that should be questioned.
    Negotiate cost reductions of your medical bills.
    Negotiate payment terms for your medical bills.
    Authorize Pool Advances to pay your medical bills.

37 What is and why do I need a HomePort Concierge Service?

Answer: Healthcare is too complex to manage by yourself, leave to your employer or purchase through a broker or the state healthcare exchange. You need a professional with the knowledge to answer your questions and guide you through any healthcare process or issue.

Your HomePort Concierge Service will help remove the hassle, uncertainty and complications when you have to deal with healthcare issues. Your Concierge will:

    Help you locate cost effective medical services.
    Review your medical bills to discover charges that should be questioned.
    Negotiate cost reductions of your medical bills.
    Negotiate payment terms for your medical bills.
    Authorize Pool Advances and pay your medical bills.

38 If one of my family members drops off the plan, how will my Agreement quote be changed?

Answer: Your monthly Contribution is recalculated. You should use this change as an opportunity to review your entire plan, make other changes or add other benefits.

39 My employer offers a "Group" healthcare plan. Should I purchase it?

Answer: It depends. Group plans are more expensive types of ACA plans, typically by about 5% to 15%. Most Group plans are more expensive than Non-Group Individual plans. Group plans are standardized and cannot be tailored to your specific needs. Individual plans are always less expensive, and can be personalized for you and your family. Compare your employer's Group plan to other plans available in the marketplace.
We'll help you with this process.

40 If I have either an ACA plan or an employer "Group" plan, can I also become a CHP Member?

Answer: Yes. ACA and Group plans do not offer the range of medical services you have with CHP. CHP can be used for doctor visits, dental and vision, and many other medical services not covered by ACA or "Group" plans. The most important reason for adding CHP to an ACA or Group plan is to lower your deductible and out-of-pocket costs. For example, if your ACA or Group plan has a $7,000 Max Out-of-Pocket cost, you would want to purchase a CHP plan with a $1,000 deductible. When you have a Medical Event, you would pay the $1,000 CHP deductible and CHP would advance $6,000 to pay your ACA or Group plan's deductible cost.
CHP could save you from having a major financial crisis!

41 The ACA allows dependents to stay on their parent's insurance until age 26. Same with CHP?

Answer: Yes.

42 What happens if I have a CHP plan and I'm diagnosed with a very serious, long term illness?

Answer: CHP would move you to an ACA plan. ACA plans are required to take all person with pre-existing medical conditions. There will likely be requirements to meet such has having a Qualifying Life Event or being inside the "Open-Enrollment" period. Contact us for further answers to this question.

43 Can I change my CHP benefits and coverages after I become a CHP Member?

Answer: Usually Yes. It depends on the benefits you want to add or change and your current medical condition.

44 How can I lower my Deductible, Co-insurance and Max Out-of-Pocket costs?

Answer: With CHP your Deductible choices are from $250 to $2,000. ACA plans are usually from about $1,500 to $6,000.

To limit your Max Out-of-Pocket cost with an ACA or Group plan, you can purchase CHP with TOPS (Total Out-of-Pocket Solution). TOPS limits your Max Out-of-Pocket cost to only $1,000. TOPS is very affordable and can be used with any major medical plan. TOPS is included with all the CHP plans.
Call for details and a quote.

45 How can I lower my monthly premium cost?

Answer: Choose a CHP over an ACA plan.

Deductible: Choose a higher deductible.

Coverage Limits: With CHP, lower the plan's Coverage Benefit Limits. ACA plans don't allow you to select different coverage limits.

Split Policies: If one family member has a significant medical issue, purchase an ACA plan for that family member. Purchase CHP for the other family members. The combined cost will always be lower than having all family members on an ACA plan.

Sponsor other CHP Members. CHP will credit your Contribution $10.00 for each new CHP member you Sponsor.

Use Medical Financing: A $200 monthly premium payment can be reduced to only $69.95. Your payment is locked in for five years.
Contact us for details.

46 How can I lower my CHP Contribution?

Answer: The easiest way is to "Sponsor" new CHP Members and we'll lower your monthly CHP Contribution $10 each month for each new member. No limit to the number of new members. Sponsoring CHP Members can eliminate your monthly contributions and add to your Pool Credits.

You can also increase your deductible, lower your Line of Credit, or adjust your benefits.

47 How do I Sponsor a CHP Member?

Answer:: First, tell you friends, relatives and neighbors about your CHP experience. If they are interested and want to know more, you go to the HomePort Resource Center. Select "Sponsoring CHP Members" follow the directions, complete the form and submit. We'll follow-up with your referral and keep you posted.
Thanks in advance.

48 Can my CHP Contribution be deducted on my taxes?

Answer: Yes. Call for details.

49 If I want to use Medical Financing, what do I need to do?

Answer: Use a cash-out refinance, a new first mortgage loan or a home equity loan. A $200 monthly premium payment can be reduced to only $69.95.
Contact us for details and assistance.

50 What is Third-party Stop-loss insurance and how does it work?

Answer: CHP routinely purchases stop-loss insurance from third-party insurance companies for accident and critical illness Medical Events. When such a Medical Event occurs, CHP receives a cash payment from the stop-loss insurance providers. This payment is deposited into the Pool's General Capital Account. Third-party Stop-loss insurance is used by CHP to lower your, and the Pool's, financial risk when paying medical bills for a Medical Event.

51 What is the definition for an "Accident"?

Answer: The general definition of an accident is an event that occurs unintentionally and usually results in harm or injury. An accident is not an illness and an illness is not an accident.

52 What is the definition of a "Critical Illness"?

Answer: The general definition of a Critical Illness is a Heart Attack, Stroke, Serious Coronary Artery Disease, Kidney Failure, Aplastic Anemia, Blindness (Loss of Sight), End Stage Lung or Liver Failure Disease, Coma, Major Burns, Paralysis, Alzheimer's Disease/Severe Dementia, and any Terminal Illness. However, a specific medical condition may or may not be a critical illness as defined by the medical insurance industry.

53 What is the definition of a "Non-Critical Illness"?

Answer: The general definition of a Non-Critical Illness is not being an accident or having a critical illness. A Non-Critical Illness is a non-life threatening condition and a non-long term illness. The list of Non-Critical Illness or procedures is too long to list here. However, here are some examples; gallbladder or hernia surgery, or orthopedic and general out-patient surgical procedures.

54 My doctor is recommending an expensive series of tests and medical treatments. What should I do?

Answer: Go to the "HomePort Resource Center" and then to "Register a Medical Event". When we receive your form, we will check pricing and make recommendations. You can then decide to proceed with treatment or contact your doctor for other options.

Note: We are not challenging any medical treatment recommended by your doctor. We are only reviewing the price and where you might receive treatment.

55 My doctor has not heard of HomePort or CHP. What should I do?

Answer: This is not uncommon. Most medical providers are only familiar with the larger insurance companies. If you are talking to the medical provider on the telephone before a visit, give the medical provider our telephone number and email. Ask them to contact us.

If you are at the medical provider's office, be sure to give them your ID card. Our contact information is on the back of the ID card. The medical provider can call us for certification.

56 If the medical provider requires that I pay at the time of service, what should I do?

Answer: Pay the bill and request a copy of both the billing and physician's statement describing the services performed. Send them to us and we will process a refund to you. Please go to the "HomePort Resource Center" and then to the "Medical Event Registration".

57 What about the ACA Penalty Tax?

Answer: We believe the government is going to eliminate this tax. If not, CHP will reimburse you any Penalty Tax you pay. Do not voluntarily pay the ACA tax. Let the government compute the tax and inform you of the amount.
Row 61 on your form 1040 income tax return.

58 How and where should I buy my healthcare plan?

Answer: CHP plans are available from HomePort Healthcare Services.

You can purchase traditional healthcare insurance, ACA plans, directly from the insurance company or through a state healthcare exchange. Both methods have about the same plan cost. However, to get a federal subsidy you must use a state healthcare exchange. To get a federal subsidy you must have a low income. For an individual, this is usually less than $40,000 per year.