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The complexity and ever-changing nature of today's US health insurance market makes a strong case for talking to a professional health insurance agent each year before making a final decision (that you can't reverse for a year).
A health insurance agent can alert you to important changes and remind you of the basics to help you find, select, and successfully sign up for a new plan you'll love or keep your current plan.
You can get started on your own too, by learning these 4 key facts about today's ACA-compliant health insurance market:
1. Rates Will Be Lower In Most States
Although some states saw premium increases over 2018, rates have fallen in 19 states, and by 10% or more in 8 states. Overall, health insurance got a little cheaper this year, so be sure to check if a better plan is now available to you.
As always, balance your likely health care costs for the approaching year against premiums, deductibles, and copays to decide on whether a Bronze, Silver, Gold, or Platinum plan will save you the most money.
And take note of whether you will qualify for subsidies or not, and for how much. Based on income and household size, the limit for subsidies is 400% of the federal poverty level for the previous year. Estimate your income with care because if you underestimate, you will have to repay some of the subsidy funds come tax-time in 2020.
2. The Mandate Remains But Is "Toothless"
For 2018, you can still get hit with the tax penalty for not having health insurance. But for 2019, not so. Technically, the individual mandate requiring you to buy health insurance remains in force, but since the penalty has been canceled, it's a law with the teeth taken out of it.
That said, it's probably wise to buy a health plan even if there is no tax penalty for not doing so. Paying more for health care is "penalty" enough. Or, you might want to consider a lower-cost short term plan as an alternative.
3. Beware Of Auto-Renewal Of Your Plan
If you do nothing, chances are your 2018 plan will simply auto-renew going into 2019. That may or may not be a good thing. The fact is, important features of your plan may change, such as premium amount, deductible, prescription drug coverage, or network coverage. Also, if you don’t reapply for your subsidy, it may not recalculate based on the 2019 poverty level adjustments.
Your current insurer must send you a notice of any changes for 2019, and you can check which drugs are covered by clicking the plan's online link to view the prescription drug formulary.
4. Understand Open Enrollment Deadlines
Nothing will cause more dismay than accessing the marketplace only to find you've missed open enrollment for your state and can't get the plan you would like and can't get federal subsidies. Open enrollment for 2019 plans usually falls from November 1st through December 15th. .
In some states, enrollment continues well into January. In such cases, coverage would start later too, either in February or March. Open enrollment periods for insurance gotten through work may also vary. You should also inquire if you qualify for a special enrollment period due to life events such as marriage, divorce, childbirth, adoption, or loss of job/insurance.
For assistance in navigating the ins and outs of today's health insurance marketplace, and in finding your "perfect" plan, contact Summerlin Benefits Consulting today!