Association Health Plan option may be coming to VI

Posted by: @rewired

One of the major concerns for people moving to the VI has been the lack of healthcare options available to small businesses and individuals

While I agree with this completely, I still don’t understand why the USVI didn’t elect to make use of the Affordable Care Act, it only cover half the problem, namely, what services are/aren’t available independent of cost.

As an example, my wife and I have insurance from my current employer, which will transition Medicare after I’m retired and turn 65 in 2021, yet we still see healthcare (and violent crime) as the biggest issues keeping likeminded people from coming to the island.  We’re going to get a medevac insurance policy to increase our options and give us greater peace of mind now that we’ll be here roughly 6 months of the year.

"Three insurance carriers in the USVI were considered – United Healthcare, Cigna, and Elan Insurance Group. Of the three, only Elan Insurance Group could meet the needs of the Associations Health Plan, offering a plan that is more affordable with minimal essential services."

This doesn't make any sense. Elan is not an insurance company like United or Cigna. As far as I know, they're just a broker.

I got a quote from Elan two years ago for my small business. Its just the wife and I, no health issues or pre-existing conditions. I was blown away by the outrageous cost of approx. $35,000 a year. The plan was bloated with services we would or could never use. I was truly shocked.

We decided to stick with Cigna Global who offer a range of coverage at very reasonable rates and covers us worldwide no matter where we travel.

I'm willing to look again, but, if Elan is involved I'm highly skeptical.  

@vicanuck

Interesting, the article also said "Of the three, only Elan Insurance Group could meet the needs of the Associations Health Plan, offering a plan that is more affordable with minimal essential services."

Here's to hoping that they offer a range of plans that people can actually afford...

@jaldeborgh

We're in a similar situation (wife is retiring at the end of this year and we're cleaning out our house near Atlanta now for painters to come next month so we can get it on the market). 

I have health insurance through my retirement, but we're also planning to get med evac insurance at the beginning of the year. Here's a discussion from last year on the subject:

https://www.vimovingcenter.com/talk/generalrelocating/med-evac-insurance/#post-297391

We're leaning toward AeroMed, but still have more research to do.

Back, oh, maybe 17 years ago we had United Healthcare and/or CIGNA, then available to us (through work?) in the Virgin Islands.  I can't recall why, but it transitioned from one to the other.  When I finally dropped it, it was costing us $18,000.00 a year and we were maybe late 40's maybe 50.  I think we had a $5000 deductible.  We weren't using it.  We went without for several years, relocated for awhile Stateside and got GOOD insurance and went back and forth.  The CIGNA/United deal was pure tiefin'.  Because, as I recall, they had a "20% cost charge" for any services.  They believed the facilities here overcharged and weren't going to pay the freight. 

They're only going to come in and bother with 100,000 population, a much smaller percentage of which will engage them vs. Medicaid or Medicare, if they can rake in substantial profits.  That's the nature of the beast standing between you and your Doctor.  

We looked into Tilloglobe Offshore, which a few of my friends had.  It replaced hips, knees, took care of emergency surgeries.  They swore by it.  THEN "someone" decided they "weren't properly licensed" in the Virgin Islands, and, again as I recall, they tried to FORCE them to license and cause their insurance to only go through "select" Virgin Islands brokers.  Tilloglobe said "screw you," since it was obviously a move to enrich someone in particular locally.  

Now got Medicare for one, and one remains on Harvard Pilgrim as domiciliary Stateside.  Figured out the Medicare system and have to say, "Medicare Part C" appears to be a scam designed to enrich insurance brokers and companies, nothing more.  It really doesn't cover anything more than Medicare Parts A, B and D.  It also limits selection of providers.  It is State specific.  Move out of State, might not get services.  I'm in the process of studying Medigap.  

Posted by: @northsidekevin

Back, oh, maybe 17 years ago we had United Healthcare and/or CIGNA, then available to us (through work?) in the Virgin Islands.  I can't recall why, but it transitioned from one to the other.  When I finally dropped it, it was costing us $18,000.00 a year and we were maybe late 40's maybe 50.  I think we had a $5000 deductible.  We weren't using it.  We went without for several years, relocated for awhile Stateside and got GOOD insurance and went back and forth.  The CIGNA/United deal was pure tiefin'.  Because, as I recall, they had a "20% cost charge" for any services.  They believed the facilities here overcharged and weren't going to pay the freight. 

They're only going to come in and bother with 100,000 population, a much smaller percentage of which will engage them vs. Medicaid or Medicare, if they can rake in substantial profits.  That's the nature of the beast standing between you and your Doctor.  

We looked into Tilloglobe Offshore, which a few of my friends had.  It replaced hips, knees, took care of emergency surgeries.  They swore by it.  THEN "someone" decided they "weren't properly licensed" in the Virgin Islands, and, again as I recall, they tried to FORCE them to license and cause their insurance to only go through "select" Virgin Islands brokers.  Tilloglobe said "screw you," since it was obviously a move to enrich someone in particular locally.  

Now got Medicare for one, and one remains on Harvard Pilgrim as domiciliary Stateside.  Figured out the Medicare system and have to say, "Medicare Part C" appears to be a scam designed to enrich insurance brokers and companies, nothing more.  It really doesn't cover anything more than Medicare Parts A, B and D.  It also limits selection of providers.  It is State specific.  Move out of State, might not get services.  I'm in the process of studying Medigap.  

The only Medigap insurance available in the VI is United Health/AARP. It is portable between the VI and stateside. Get a plan that offers international coverage if you plan to travel outside the US.

Posted by: @rewired

We're leaning toward AeroMed, but still have more research to do.

Please let me know what you decide.  I’m just starting to research options, SkyMed looks interesting as they have coverage in the USVI.  I’ll check out AeroMed.

I chose MASA as they were the only ones who responded to my emails, calls and FB messages.  I think Aeromed got back to me like 4 months later.  I figured if they don't want my money, will they answer my calls when I need them.  

An interesting article re: retirees and their Medicare: https://stthomassource.com/content/2020/11/17/government-retirees-transitioning-to-medicare-advantage-plan/

By forcing retirees into a Medicare Advantage plan, the government is going to save a bunch of money. When the retirees find out exactly how Advantage (Part C) works, there will be an uproar. With traditional Medicare, you can go to any doctor who accepts Medicare, not so with Advantage. Virgin Islanders are accustomed to flying to Florida for care, but if the provider is out-of-network they will not be able to do so...

It will be interesting to see if they start to sell this to other Medicare customers. The ads for Advantage are unceasing in the states.

MASA, Tilloglobe for offshore, and NO "Medicare (dis)Advantage."  Wife doesn't qualify for another 2+ years for Medicare, so she's resident elsewhere.  Like I said, Part C is a money making scam for the insurance companies standing between you and your provider.  

Has anyone kept their stateside health plan? We have Cigna in the States and plan to keep it so we can see specialists in the states if needed and use the Online doctors then just pay out of pocket for regular visits. Not sure how long this will work, hope the new local plan works out. We are early 40s with 2 young kids. 

Posted by: @daveb722

I chose MASA as they were the only ones who responded to my emails, calls and FB messages.  I think Aeromed got back to me like 4 months later.  I figured if they don't want my money, will they answer my calls when I need them.  

Actually, MASA or any other evac plan won't answer your calls. They will answer calls from your physician/hospital staff who are trying to arrange for your evacuation and hospital transfer off the island. 

AeroMD uses Bohlke equipment so its available nearby and that can be pretty important.

@gators_mom There is a local rep on island that sells the plans, she has always answered my calls, so not sure what your talking about.

Posted by: @daveb722

@gators_mom There is a local rep on island that sells the plans, she has always answered my calls, so not sure what your talking about.

I wasn't very clear. If you're to be evacuated, you cannot make evac arrangements. Arrangements are made between physicians/medical personnel on STX, the evac company, your health insurance, and the physician/medical facility that will admit you where you are traveling to for care. 

I don't think the same phone numbers are used for sales/service and evacuation planning.

A big issue will be where your trailing spouse will stay and how she will travel - and how you both will get back to STX. Evac insurance helps with this. 

If you have Medicare, Medicare actually pays for most of the flight as far as SJU - and evac insurance can help pay for the balance, for you to travel to FL (or beyond) for care and for spousal accommodations up to limits.

You're only evacuated if your treatment cannot be done on STX - and that is up to local physicians to decide. They're experts at this.