You’re under pressure to make decisions on a year-long commitment to what could potentially be a bad healthcare plan, so we’ll get straight to the 6.4 things you should know before Open Enrollment ends.
If you got stuck with a high deductible plan last year, or paid too much on your monthly premium, or chose a plan that didn’t fit your health, now’s the time to make changes to your health insurance plan for 2019.
Here are the 6.4 Things You Need to Know:
#1 – December 15.
That’s the last day to enroll for health insurance and it falls on a Saturday. If you don’t enroll by this date, you won’t be able to get health insurance and apply during Open Enrollment for 2020, unless you have a qualifying event such as losing a job, having a baby, getting married, or experience a drastic decrease in income.
#2 – Where do you start this late in the game? You might have noticed this 2 years ago as we rolled into Open Enrollment for 2017: there were less programs and public access resources to help you decipher the health insurance application maze. With changes and moving pieces around The Affordable Care Act, it was especially hard to know what was required. Today’s no different.
You will definitely find some general answers online, but you may not get the full scope of how health insurance works with your entire financial health. It’s more helpful to have someone (a licensed advisor) prod you with questions so you cover all your bases.
#3 – There is no longer a penalty for not getting a health insurance plan for 2019.
From 2014 through 2018, you were subject to tax penalty for not getting an eligible health insurance plan. In most cases, this was up 2.5% of your income, or $695 per adult in each household.
Even though this penalty has been lifted, you might think more prudently about having health coverage.
#4 – There are 3 main ways we get health insurance:
1 – Through employee sponsored plans
If you purchased your health insurance plan through your employer in 2018, chances are your coverage for 2019 will continue through your comployee benefits so long as you’re still employed with that same company. Your deadline to submit changes, or decline your options would have already happened. If you’re not happy with any of the options your employer offers, check to see if it’s too late to decline coverage and take action fast to see what other plans you can buy in the open marketplace.
2 – By directly purchasing a plan from the Affordable Care Act market exchange, or from a private insurance plan.
If you purchased individual plans last year (either privately or through the Affordable Care Act-compliant marketplace) you must still choose a plan for 2019. If you don’t elect any changes, you will be re-enrolled into the same plan offered to you last year. If you didn’t like your plan, you can change it by December 15.
If you’re a contractor/entrepreneur, or work for a small business who doesn’t offer health insurance benefits, the good news is, you still have time to enroll.
3 – Through government sponsored programs like Medicaid and Medical for low/no income earners.
You now have more options for health insurance coverage. As more insurance companies are signing back up for the exchange, insurance premiums (the cost you pay for insurance) are also expected to stabilize in 2019.
#6 – Health insurance terms you need to know
Understanding how health insurance coverage works will allow you find the right plan for your particular circumstance. Don’t hesitate to speak with a licensed insurance advisor to get the widest range of options and consultation. Or if you choose to start the research yourself, you can click here: https://localhelp.healthcare.gov/#/.
As you quickly choose between your options before the December 15 Open Enrollment deadline, you’ll see these key terms that affect your coverage. Become familiar with these terms so you can study your options quicker:
– 6.1 Deductible
A deductible is the amount you pay for costs related to your health care service before your insurance starts to pay.
Example: If your plan’s deductible is $2,000, you’ll pay 100 percent of eligible health care expenses until your bill reaches $2,000. After that, you either share the cost with your insurance company by paying coinsurance. Your coinsurance can then be 20-80, at which point you would pay 20% of the rest of the bill while your insurance company pays the rest of the 80%, or you could be fully covered after the deductible.
– 6.2 Coinsurance
Coinsurance is just as it sounds–the way you and your insurance company share the cost of healthcare services. It’s usually shown as a percentage between what you pay and what your insurance company pays. Coinsurance kicks in after you’ve paid your plan’s deductible.
Example: You’ve paid $2,000 in health care expenses and met your deductible. When you go to the doctor, instead of paying all costs, you and your plan share the cost. For example, your plan pays 80%. The 20 % you pay is your coinsurance.
– 6.3 Copay
A copay is a fixed amount you pay for a health care service, usually at the time of the service. Your copay can vary by type of service, whether it’s for lab work, or a preventative care visit. Your insurance company determines what your copay is and when you have one.
You insurance premium is the amount you pay for having an insurance plan. This is what you pay monthly to have coverage in place.
It’s not too late to get your application in. Don’t hesitate to consult with a licensed insurance advisor and get the attention you need. You have until December 15 to enroll in a health insurance plan that’s right for you.
About Travis Etheridge
Travis, the co-owner of The Insurance Alliance, joined the insurance industry in 2011. He is married to his lovely wife Anica, and has an amazing son Henry. Travis is passionate about helping people, so the insurance industry is a natural fit. The thing he loves most about the industry is being there for his clients at their most trying times. He believes everyone is an individual and they deserve an individual plan best suited for their situation.