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Hypothetical medical situations. 09/08/09

Note-This post is under major construction and is 20% etched in stone.

HYPOTHETICAL SITUATION #1.
-Lets say that their is a man named Dennis who has just received a letter from the government in 2009 telling him he will automatically be included into the government's new UPP Care health plan starting Jan 2010. He is told that he has the right to reject this plan if he desires.

Dennis has his own private insurance he's been happy with called Guysinger Health Insurance. The Guysinger plan later in 2009 announces that it's plan will include the same identical coverage as UPP Care by adopting the UPP Care's legal policy language so that their is no question that it is identical to UPP Care.

Dennis is fine with that but is realizing that if he gets sick he may not afford his private plan premiums as his income is likely to be effected by his illness and time missed at work.

So, Dennis decided to continue as an ACTIVE PARTICIPANT in UPP Care but decide to inform the government that he will continue to pay on his own for his Gusinger health plan and lists it as the ALTERNATE PRIMARY PAYEE-PLAN B. The PLAN B means Guysinger will not be able to use the UPP Care reduced rates through Dennis's account because of his account status.

During the year of 2010 Dennis is an ACTIVE PARTICIPANT in the UPP Care plan and also continues to pay the premium in full out of his pocket for the Gusinger health plan.

During that year he only has a few claims for physicals & check-ups and they are paid DIRECTLY out of his Guysinger plan. Their is no claims paid buy the UPP Care plan and their reduced rates where not used through Dennis's account.

In Jan of 2011 Dennis can file for a TAX VOUCHER request for almost all of the taxes he paid into the UPP Care plan. This would include any tax that is taken out of his check or taxes he has receipts showing he paid a HEALTH RISK TAX.

Dennis's insurance would certainly qualify as an ALTERNATE INSURANCE and Dennis should get almost all of his taxes back because he had paid for and maintained a private insurance of his choice.

However, Dennis won't get back ALL of his taxes because he remained and ACTIVE PARTICIPANT in the UPP Care plan which allowed him the POSSIBILITY to change his ALTERNATE PAYEE status at anytime to have the UPP Care program pay for a medical bill should Guysinger not pay or be cancelled. In effect UPP Care was the back-up plan if Dennis could not keep paying his private plan.

If Dennis rejected the UPP Care plan it would put Dennis in a possible situation where he may have to cancelled his plan due to lack of money while he was sick in bed and then be uninsured. But Dennis was able to afford both paying taxes on UPP Care and continue his Guysinger plan. Not all will be able to do as Dennis did, however, it remains an option.

One advantage to UPP Care is that as Dennis's income falls he may qualify for assistance to help pay for UPP Care. But this could effect a final tax voucher distribution if qualified.