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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 General: How should I go about choosing a Healthcare plan?

Answer: The most important consideration is your answer to a simple question: "Can your 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.

2 General: 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 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.

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 cost 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 to $15,000.

The Co-Pay: Finally, a 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.

3 General: What types of healthcare plans are offered by HomePort?

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

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.

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

Medicaid Plans are provided by the state for low income people.
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.

4 General: My employer offers a "Group" healthcare plan. Should I purchase it?

Answer: It depends. Group Plans are a more expensive type of ACA plans by about 5% to 15%. Most employer plans are more expensive than other "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 plan to other plans available in the marketplace.
We'll help you with this process.

5 General: How do CHP, ACA and Group plans compare in cost?

Answer: CHP plans are the least expensive. CHP plans will save you over 50% compared to the cost of an ACA plan. For example, the CHP cost for a 25 year-old is about $95.

An ACA plan can range from about $200 to over $350.

Your Group plan's price is usually determined by how much your employer subsidizes your healthcare cost. In most cases, an employee's monthly cost is higher than what can be purchased direct from an insurance company or CHP. Group plans usually add about 5% to 15% additional cost to a traditional ACA individual plan.

There is another cost to be considered with these plans; the Deductible, Co-Insurance and Max Out-of-Pocket (MOOP). The ACA and Group plan's MOOP range between $6,550 and $10,000. The CHP MOOP options range between $250 and $2,000.

6 General: What are each Plan's Deductible options?

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

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

Answer: When you have a single Medical Event, an insurance deductible must be paid. Then you pay the insurance plan's Co-Insurance. The total of these two is called the Plan's Max Out-of-Pocket (MOOP). This cost is usually $6,000 or more.

With CHP, the deductible is paid each time you have a Medical Event. You choose your CHP deductible, which range from $250 to $2,000.

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 insurance, a single Medical Event will likely cause you to pay the MOOP; $6,000. With CHP, the same Medical Event would only cost you the $250 or $2,000 amount you selected. So, if you had a $1,000 CHP deductible, you would need to have 6 Medical Events to equal 1 insurance Medical Event. CHP could save you $5,000 or more in deductible costs.

8 General: 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 wellbeing. 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 are not needed or wanted by most people.

9 General: Can I use my doctor or any other doctor?

Answer: With CHP, you can use any primary care doctor you choose. Your office co-pay is limited to only $50. You also receive priority appointments and discounts.

With an ACA plan it is likely your doctor is not affiliated (In-Network) with your insurance plan. We recommend you check to see if your doctor is "In-Network". Most of the lower cost ACA plans do not include doctor visits. Just an annual wellness exam.

10 General: Are prescription medications included?

Answer: With CHP, prescription medications are included. There is no-co-pay. 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.

11 General: How and where should I buy my healthcare plan?

Answer: You can purchase healthcare insurance 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 about $40,000 per year.

CHP plans are available through HomePort from HomePort Healthcare Services.

12 General: 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.

13 General: 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.

14 General: What is the definition for 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.

15 General: What is the definition for a "Non-Critical Illness"?

Answer: The general definition of a Non-Critical Illness is not being an accident or a critical illness. A Non-Critical Illness is also 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.

16 General: 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;

    (a) interpret insurance policies and coverages,
    (b) negotiate medical costs and payment terms,
    (c) answer questions concerning medical situations and
    (d) help you communicate with your insurance companies to get your questions answered and issues resolved.

Your Concierge will also help you file a claim to receive the medical cash reimbursements. The HomePort Concierge will save you time, money and your sanity.

17 General: 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.

18 Coverages: How about annual wellness exams?

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

19 Coverages: How about Labs, X-Rays and other tests?

Answer: These costs are usually covered by CHP with no-co-pays and no additional out-of-pocket costs. ACA plans do cover such tests after you pay the plan's deductible or Max Out-of-Pocket.

20 Coverages: Dental and Vision Coverages?

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

21 Coverages: 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.

22 Coverages: 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.

23 Financial: 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 the optional Max Out-of-Pocket limiter called TOPS (Total Out-of-Pocket Solution). TOPS limits your 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.

24 Financial: 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.

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.

25 Financial: 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. Your payment is locked in for five years.
Contact us for details.

26 CHP: 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 along with other people. CHP is not insurance. That's why CHP Members are not referred to as "Insureds".

27 CHP: CHP monthly payments are called "Contributions". Why?

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

28 CHP: How does CHP determine my Contribution amount?

Answer: Your chosen Deductible plus your Maximum Benefit Limit result in your base monthly CHP Contribution. To this you can add other coverages to further personalize your healthcare plan.

29 CHP: 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 the actual plan cost. 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.

30 CHP: What is the CHP Maximum Benefit Limit?

Answer: The CHP Maximum Benefit Limit is the amount of costs covered when you have a Medical Event. A Medical Event could be from an Accident, Critical Illness and Non-Critical Illness. CHP Maximum Benefit Limit are from $5,000 to $250,000. The lower the Healthcare Benefit, the lower the monthly Contribution.

31 CHP: How do I choose the plan's Maximum Benefit Limit for me?

Answer: First, statistics show that most Medical Events cost less than $10,000.

A non-critical illness could range from a $10,000 to about $50,000.

Additionally, a critical illness could range from a $10,000 to over $100,000. Statistics show that a seven day stay in the hospital could cost about $50,000.

If you are on a limited budget, choose a Maximum Benefit Limit from $5,000 to $10,000. If your budget allows, choose a higher Maximum Benefit Limit. CHP has options from $25,000 to $250,000.

32 CHP: 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 ACHP for further answers to this question.

33 CHP: How can I lower my CHP Contribution?

Answer: 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.

34 CHP: Can my CHP Contribution be deducted on my taxes?

Answer: Yes. Call for details.

35 CHP: Who receives my Contributions?

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

36 CHP: What is the Community Healthcare Pool?

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

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

37 CHP: What is a Pool Credit?

Answer: Pool Credits are cash equivalents that increase your CHP Pool Account Balance. You receive Pool Credits as follows:

From CHP Contributions: With each CHP Contribution and specific amount is designated a "Pool Credit", usually about 50% of your Contribution. Your Pool Credit is deposited into the Community Healthcare Pool (Pool) and adds to your CHP Account Balance. Note, no insurance plan gives back to you 50% of your monthly payment. CHP does!

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

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 various third-parties 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 to pay your medical bills.

38 CHP: What are Pool Advances?

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

39 CHP: How are my medical bills paid?

Answer: First, your medical bills are reviewed by the CHP Concierge. The Concierge will attempt to negotiate a reduction in your bill and establish a payment program. Then, the approved medical payments will be made from the Pool to the medical providers.

Second, the payments are withdrawn from your Pool Account Balance. Then, from Third-Party Stop-loss insurance payments. Finally, if these resources are not sufficient to pay your medical bills, the payments are made from the Pool's General Capital Account until paid.

Your monthly CHP Contributions continue to be applied as payments are being made. There is no increase in your CHP Contribution or decrease in your monthly Pool Credit Amount.

40 CHP: 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.

41 CHP: Do I have to pay back the Pool Advances used to pay my medical bills?

Answer: No and Yes. You do not have to repay any money received by CHP from Third-party Stop-loss insurance providers. You are obligated to repay any monies withdrawn from the Pool's General Capital Account to pay your medical bills.

Third-Party Stop-loss insurance payments are first applied to pay your approved medical costs, then to repay any negative balance in your Pool Account. Any remainder will be credited to the Pool's General Capital Account.

42 CHP: Does CHP charge me interest on the Pool Advances?

Answer: No.

43 CHP: Do I have to qualify for Pool Advances?

Answer: No. But Pool Advances may be limited or denied based on several factors. Ask for details.

44 CHP: 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 this Agreement.

45 CHP: What is the Pool Account Balance?

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

46 CHP: What is a Medical Event Registration?

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 and desire to use the CHP Assisted Managed Care Services (AMC Services). Once your Medical Event is registered, your CHP Concierge Service will begin to help you with your Medical Event; medical bill repricing of medical bills, payment terms and Pool Advances.

47 CHP: What are the Assisted Managed Care Services?

Answer: AMC Services helps you manage many aspects of your healthcare and financial wellbeing.

CHP Concierge Service: Your CHP Concierge Service provides you with the following services:
  1. Where to receive medical treatment: When you have a Medical Event, we'll help you locate cost effective medical services.
  2. Review your medical bills: We'll attempt to discover charges that should be questioned.
  3. Price Negotiations: We'll attempt to negotiate a cost reduction of your medical bills.
  4. Payment Terms: We'll attempt to negotiate payment terms for your medical bills.
  5. Pool Advances: Paying medical bills.

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

Answer: Yes

49 CHP: The ACA allows kids to stay on their parent's insurance until age 26. Same with CHP?

Answer: Yes. Each Member is priced separately.

50 CHP: If one of the CHP Members drops off the plan, how is the quote recalculated?

Answer: Re-quoted again with a decrease in the monthly Contribution amount.

51 CHP: Do psychologists and life coaches qualify as medical providers? Does CHP cover costs associated with those types of treatments?

Answer: Yes, if medically required. Prior certification is required in each case.

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

Answer: Yes. However, you only need to cover your plan's Max Out-of-Pocket. For example, if your plan has a $6,000 Max Out-of-Pocket you would purchase a CHP membership with a $5,000 Maximum Benefit Limit. When you have a Medical Event, you pay the deductible and CHP advances the $5,000. As with all CHP plans, doctor visits and medications can be included.