How to Get Health Insurance This Year
Believe it or not, the Affordable Care Act is still in effect. Most people who do not have work coverage can buy a plan on the Marketplace (called “Obamacare plans”) for $ 100 a month or less starting November 1st. Signing up is harder this year, however, so we’ve put together a guide that brings together the most important information.
Do I need to take care of open enrollment?
Open enrollment is a time when anyone can enroll in a health plan for any reason. It is open to everyone, do you understand? Another type of enrollment is special enrollment, which is applied during the rest of the year. Life events such as a wedding or the birth of a child only open the registration window for your family. Loss of insurance coverage and relocation of your home are also eligible; read here to learn more about qualifying events.
If you are getting work insurance, you will have to ask your HR staff about the timing of enrollment. (They probably also have an open recruitment at this time of year.) Employer-provided insurance is pretty simple: you have options that they say you have, and the price is what your employer says. you pay. Usually, your employer takes over part of the bill, so your out-of-pocket costs are lower than if you bought the plan yourself.
If you don’t like your employer’s insurance, you might want to take a closer look at it. However, this is rarely successful . You will almost always pay full price because your employer does not interfere and you are usually not eligible for subsidies if you opt out of the employer’s plan.
If you do not have employer-provided coverage, or if you still want to explore other options, the rest of this guide is for you.
Can’t I just ignore this and get the same plan as last year?
In theory, yes. But it’s always a good idea to compare purchases, and it’s especially risky this year to leave your insurance coverage at the mercy of automatic enrollment. Here are two big caveats:
- Your old plan may no longer exist. The system will try to enroll you in a similar plan, but it may end up with something completely different from what you have now. For example, a new plan might not include your favorite doctor in its network.
- It will be too late to change your mind. This year, when the automatic registration occurs, the open registration will end. So if you don’t like the new plan, you are stuck on it.
When should I register?
Open registrations in most states run from November 1 to December 15, 2018. This is a much shorter period than last year when you could register any time before the end of January. Some states have extended their open admissions period this year. They all still start on November 1st, and here are the end dates.
- California : January 31.
- Colorado : January 12.
- Connecticut : January 22
- District of Columbia : January 31.
- Massachusetts : January 23
- Minnesota : January 14
- New York : January 31.
- Rhode Island : December 31.
- Washington : January 15.
Most people haven’t gotten a date reminder , so tell your friends. You can also find a shared Information map with these dates in English and Spanish here .
So, anytime in this window?
No. Register early. There is usually a spike in signups at the end of open signups, so you need to surpass the crowd.
If you need free personal assistance with registration, it is especially important to arrive early. Funding for these “navigation” services has been cut, plus the shorter registration period also means they are probably already flooded. Therefore, if you or a family member might need help, make an appointment as soon as possible. (You can find local helpers and brokers here . Community organizations will also run their own outreach programs, so ask around – your local library will be a good place to start.)
One final caveat: The computer systems behind open check-in require weekly maintenance, and this service is scheduled from midnight to noon almost every Sunday morning. If you are concerned about this, check out last year’s downtime schedule. Downtime was similar, but sometimes it ended ahead of schedule. On the other hand, there should have been no downtime on one Sunday, but it still ended up with seven hours. As we said – register early.
How much will it cost me?
This is good news! Most people receive a substantial subsidy when they buy insurance from the Marketplace ( healthcare.gov or your state equivalent). Exact rates may vary, but there are two different types of subsidies that can help keep your costs down. Many people buy on the stock exchange or are not insured at all because they do not realize that they have the right to do so. Here are two types of subsidies
Advance premium tax credits reduce your monthly payment. They are available to people who represent 100 to 400 percent of the federal poverty level. This cap is a modified adjusted gross income of $ 48,240 if you are single and $ 98,400 for a family of four. (Numbers are different for Alaska and Hawaii; check here .) Here is the range for different family sizes:
A lower cost share means you can buy the Silver plan, but pay fewer deductibles and co-payments than the Silver plan usually offers. You are eligible for these if your income is between 100 and 250 percent of the federal poverty level, so the cap here is $ 30,150 if you are single and $ 61,500 for a family of four. Again, these numbers are different for Alaska and Hawaii. Here’s a chart of that range if you live in the continental United States:
If you fall within these upper limits, you can get cheaper insurance than you probably think. Visit healthcare.gov or a similar website in your state to find out how much you are willing to pay. Most eligible people pay less than $ 100 a month, and in some cases, insurance may even be free.
Silver plans this year are strange
So, you might remember that the White House announced that they … no, they won’t … no, they … wait, HAHA, they won’t! pay the CSR payouts that make these low deduction silver plans possible . So we all screwed up, right? Surprising … maybe not.
This is because insurers are required by law to provide these low-deductible plans whether they receive the money or not. (They may decide to leave the market altogether if they really want to avoid offering these plans, but they don’t seem to be doing it yet.) Now the question is whether your monthly payments will rise because of this.
If you’re eligible for upfront tax credits (which most people who buy on the Marketplace do), your monthly payments probably won’t change much because the subsidy will rise to make up the difference.
What if you are not eligible for these subsidies? Well, what happens now depends on how your state decides to handle the situation. Charles Gaba of ACASignups.net , who does an amazing amount of computation and policy analysis on things like this, has compiled the lists below:
- In Alaska, Arkansas, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New York, North Carolina, Oregon, South Dakota and Tennessee , all silver prices have been increased … plans. If you are not getting a subsidy and were hoping to buy the Silver plan, look out for Bronze and Gold. That’s right – gold can be cheaper than silver.
- In Alabama, California, Connecticut, Florida, Hawaii, Illinois, Idaho, Maine, Maryland, Minnesota, Nevada, Ohio, Pennsylvania, Rhode Island, South Carolina, Utah, Virginia, Washington, Wisconsin and Wyoming, prices are only higher on Silver plans. offered on the Marketplace . If you are not eligible for the subsidy, search the insurer’s website and see if they sell you the silver plan directly. It will be cheaper than the Marketplace version of this plan.
- In Colorado, Delaware, Indiana, Oklahoma and West Virginia, premiums will be higher overall. Sorry.
- There is no premium increase in DC, North Dakota, and Vermont to accommodate the lack of CSR payments. This is where insurance companies take the hit, not consumers or the federal government. Be careful: this is where insurers can exit the market. On the other hand, government regulators may change their minds and implement one of the above strategies.
But what happens to politics?
A lot, but it doesn’t matter now. There is a bipartisan bill to permanently reinstate CSR payments; then there is a Republican-led bill that will fund the CSR and also overturn some parts of the ACA. In addition, there is a tax reform law that may include elements of the cancellation of the ACA.
Whatever happens, it is too late to influence how much you pay for insurance for 2018 or what conditions you get in return. Any changes in legislation will only apply until 2019 and later. Fingers crossed.