open enrollment
Affordable Care Act General Health

What You Need to Do Now During Open Enrollment

In just a few short weeks, we’ll ring in a New Year—and a new decade. But before then, you have big games to watch, holiday celebrations to attend, gifts to buy, and winter weather to prepare for.

Oh—and health insurance to think about.

In fact, the choices you make in the next few weeks could affect your health and your wallet for all of 2020 and beyond.

Why? Well:

  • If you have Medicare coverage, you have until December 7 to review and change your coverage for 2020.
  • If you get insurance through your job, you may have already chosen your plan for 2020, but now’s the time to plan ahead for what costs you’ll face—because they may go up.
  • If you buy your own insurance on healthcare.gov or another site, you have until December 15 to review your options and change plans if you want.
  • If you have coverage through a Medicaid expansion program for low-income people, you should get familiar with new requirements that might affect you next year.
  • If you don’t have health insurance right now, this is the time to find out what you qualify for, to avoid being caught uncovered if your health changes next year.

What to do now if you have Medicare:

Even if you like your coverage, Open Enrollment is a good time to check out all your options.

Some costs will go up for 2020; some will go down. Take a minute to visit https://www.medicare.gov/ and have your list of medications and regular doctors ready so you can check if you can save money by switching plans.

You can find professional help through your Area Agency on Aging, which is a free public service organization supported by the federal government to help people over 65 and their caregivers. Find your local Area Agency on Aging office, and other resources and information, through the national Eldercare Locator website.

What to do now if you have insurance through your job:

Even if you’ve had health coverage for years, this is the time to look at the fine print of the plan or plans available to you during your employer’s Open Enrollment. Even if your enrollment period already ended, you should make sure you understand the plan you’ll be in.

More and more employers now ask employees to share a bigger chunk of the cost of their health care. Even if your monthly premium cost didn’t change much, you may discover that you now have a bigger deductible that you have to pay before your insurance coverage kicks in.

Related:
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You may have higher co-payments for drugs and doctor visits, or restrictions on which clinics, hospitals and pharmacies you can go to. And you may be able to start socking away cash in a Health Savings Account to prepare for out-of-pocket costs in 2020. If your employer offers a Health Savings Account, be sure to set it up!

If you already have doctor appointments, operations, procedures or scans scheduled for 2020, now is the time to double-check that the clinic or hospital will still take your insurance at the time you arrive, and that all the providers who will care for you actually participate in your insurance plan. If they don’t, you should find a different site or provider that’s “in network.”

What to do if you need to buy your own insurance:

The Open Enrollment period for plans listed on Healthcare.gov, and for other sites that sell health insurance plans directly to the public, ends December 15. (Some states extend the deadline for their residents a few weeks beyond this.) These are the plans offered under the Affordable Care Act, also referred to as Obamacare. Plans for the ACA come in different levels, called Catastrophic, Bronze, Silver, Gold and Platinum.

If you’ve bought insurance this way before, you can just allow it to renew. But experts recommend checking all of your options every year because plans change, as do the subsidies that help pay insurance for 89% of people who get their coverage through these plans.

You could save money, or be able to afford a better plan for not much more money, if you take time to look through all of your health insurance options. Also, this year there are changes for people over 30 who want to buy a bare-bones Catastrophic ACA plan.

You can find a trained local counselor to help you understand your coverage options, based on your unique health situation, for free by visiting https://localhelp.healthcare.gov.

Everybody should pull together some information before sitting down to look at their health care options. This includes:

  • A list of medications you take and doctors you see regularly. Not all hospitals and doctors accept all of the plans available in your state.
  • Information about people in your household, whether or not they need health insurance through the ACA Marketplace. This includes Social Security numbers, mailing addresses, and their relationship to you, as well as whether you file taxes with any of them as a joint filer or dependent. If anyone on your application is a lawful immigrant, you’ll need information from their immigration documents.
  • A recent tax return or other documents that list wages, other kinds of income, and things like Social Security and retirement account income, unemployment and alimony. You will need this information for anyone in your household, even if you aren’t seeking insurance coverage for them.
  • Your best estimate of what your household’s income will be in 2020—it can be a ballpark figure.
  • If anyone in your household gets health insurance from their job, the government (such as Medicaid, CHIP, Medicare, or the VA) or another source, you’ll need to have their insurance policy numbers ready. (Even though you won’t be seeking insurance for them, the healthcare.gov site asks for them.)
  • For each person in your house who has an employer, have contact information for those employers ready, as well as information about any insurance the employer offers. Fill out this form in advance: https://www.healthcare.gov/downloads/employer-coverage-tool.pdf
Related:
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If you don’t have insurance:

Even though the federal tax penalty for going without insurance has ended, it’s still an extremely good idea to get some form of health insurance. Health care costs are a top reason for personal bankruptcy in the United States. And even young, healthy people can get injured or ill.

The healthcare.gov site has information on bare-bones Catastrophic plans that kick in after you pay the first $8,000 or so of your health costs in a year. These are available to people under age 30 for any reason, and to people over age 30 who qualify for having financial hardships.

You may also have access to “skinny” or “short term” insurance plans in your area. These offer much less actual coverage – if you are looking at them because of their low premium costs, be sure to read the details carefully. The cost to you if you need to actually use any healthcare benefits in 2020 may be much higher than if you bought a plan with higher monthly costs but more coverage.

From Michigan Health

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