Help Choosing Health Insurance for 2018

m_armstrong_nov17-01_webIf you are buying individual or family health insurance for 2018 under the Affordable Care Act (ACA), you have until Dec. 15, 2017 to enroll in a plan that will go into effect Jan. 1, 2018. With this year’s abbreviated enrollment period, there is a sense of urgency for residents to complete the process as soon as possible.

“Nothing will help you more when renewing your health insurance than becoming an informed consumer,” advises Marsha Armstrong, an ACA Certified Application Counselor who serves residents in the greater Hickory area at Catawba Family Care located at 133 1st Ave SE. To become informed, here are some facts to keep in mind when considering your options for health insurance in 2018:

The ACA is Still the Law of the Land – This means if you don’t get insurance through your job or a government program, you will still be able to get coverage for a set of comprehensive benefits regardless of whether you have pre-existing conditions through the Marketplace (also known as “the exchange”). It also means that if you meet income eligibility requirements, you will be able to get help from the federal government to afford the premiums, and, possibly, deductibles and other out-of-pocket costs in the form of subsidies.

Consider Options Carefully – By assessing your health needs and budget now, you will be better prepared to make health insurance decisions that work for you and your family. When it comes to deciding what health insurance plan is best for you, one of the first things you probably think about is cost. However, cost should not be the sole basis for choosing medical coverage. Shopping around to consider the options that best meet your personal needs is more crucial than ever. You want to compare and pick a plan yourself so that the marketplace doesn’t automatically enroll you for 2018 coverage. That’s because the auto-renewal date this year is expected to be Dec. 16, the day after the open-enrollment period ends. So, if you are assigned a plan you don’t like, you won’t be able to change it until the 2019 open-enrollment season.

Think About What You Value in a Plan – Although cost is an important issue, there are other factors to consider when selecting a plan. The lowest cost plan may not always be the best choice. For example, in addition to premium costs, you should also think about which providers and facilities are “in network”, each plan’s overall deductible, out-of-pocket limits, prescription drug coverage, co-pays for primary and specialty care, mental health benefits, urgent care and emergency room costs. Just like physician networks, insurance plans have certain hospitals that are included in their networks. Knowing whether or not your facility of choice is included in your insurance company’s network could save you hundreds of dollars. Refer to Catawba Valley Medical Center and Catawba Valley Medical Group‘s online list of insurance plans currently in network.

Buyers Beware – Outside of the official marketplaces there may be more insurers selling lower-cost, short-term policies. While less expensive, these plans may not cover all benefits and might exclude coverage of pre-existing conditions or medications. Those plans may not meet ACA requirements for “minimum essential coverage,” so policyholders would still be liable for paying a tax penalty. Make sure you consult with a reputable broker when comparing your options.

Be Resourceful – There are free local resources available to help determine if you and your family members qualify for help paying for healthcare based upon your income, age, health conditions, and/or insurance status.

  • NC Trained ACA & Medicare Assister: Marsha Armstrong, Catawba Family Care – 828-624-0538
  • NC Appointment Scheduling: 855-733-3711 or NCnavigator.net
  • Medicaid/CHIP: Medicaid is available for certain populations (children, elderly, blind, or disabled people) who meet program qualifications. CHIP is available to eligible children whose family income is above the Medicaid guidelines. Each county’s Department of Social Services is responsible for determining Medicaid/CHIP eligibility, processing Medicaid/CHIP applications, and processing Medicaid/CHIP enrollment. To contact the local Department of Social Services, call (888) 877-1615 or visit http://www.ncdhhs.gov/dma/medicaid/apply.htm for more information.
  • Medicare: Medicare is available for those age 65+ and specific populations who meet eligibility guidelines. Enrollment dates go along with a person’s birthdate; however, each year people can review their existing Medicare plans and make changes if they choose. Medicare open enrollment ends December 7, 2017; new enrollees begin 3 months before they turn 65. To make an appointment with a trained assister contact the Senior Health Insurance Information Program (SHIIP) at 855-408-1212. You may also go to http://www.ncdoi.com/SHIIP/Search_For_a_Counselor_By_County.aspx to find contact information for the SHIIP counselors in your county.

Reminder: Open enrollment began Nov. 1, 2017, and will end on Dec. 15, 2017. For coverage to start on Jan. 1, 2018, you must renew by Dec. 15, 2017. To enroll  in health insurance without assistance, review plans and prices at Healthcare.gov. If you buy health insurance through your workplace, your employer will inform you about its open enrollment period. The information contained in this article is for people buying health insurance outside of group plans.

 

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