A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
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Medicare & Medicaid

Medicare & Medicaid

Featured

Featured
How sunsetting ARP’s subsidy enhancements would affect ACA subsidy amounts
What will happen to Marketplace health insurance subsidy availability and size when the subsidy enhancements instituted under the American Rescue Plan sunset after 2025?

Featured

Featured
Where do I find my 1095 tax form?
The 1095 tax forms are used by exchanges, employers, and health insurance companies to report health insurance coverage to the IRS. Learn about each type of tax form and where to find it.

medical discount plan

Infographic regarding medical discount plans

What is a medical discount plan?

Medical discount plans are much less expensive than health insurance, but they do not provide any of the protections of a health insurance policy. Instead, they simply give members a discount on medical services — as long as the member receives care from a provider who participates in the discount program.

The discounts are not guaranteed and can vary significantly depending on the provider and the treatment involved. There is no cap on out-of-pocket costs with a discount plan, and they are not regulated by the ACA; regulation is left to the states instead.

Discount plans are not suitable to be a person's only medical coverage, and they aren't necessary if you have major medical health insurance, as one of the benefits of health insurance is the built-in discount resulting from the network negotiated rates. A dental/vision discount card can still be useful in addition to regular major medical health insurance, however, as adult dental and vision services are rarely covered by health insurance plans.

Having a discount plan (if it's your only coverage) does not satisfy the shared responsibility provision. Although there is no longer a federal penalty for not having health insurance, there are still five states that impose a shared responsibility penalty for people who don't maintain coverage. In those states, relying on a discount plan would mean that you're subject to a penalty when you file your state tax return, unless you qualify for an exemption.

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