This is the time to get out your paperwork and choose a 2020 health insurance plan. HealthCare.gov, as well as the other state exchanges, is now open for enrollment for those who are looking for their own plans.
Despite the rhetoric about the implosion of the Affordable Care Act, the individual mandate going away, and other attempts to hobble the law, the marketplaces are still alive and well. Many people can get subsidies to help lower their costs.
In fact, HealthCare.gov has gotten sleeker and easier to use over the years (after a famously rocky start). There are new bells and whistles to make shopping for a plan easier this year. It can be difficult to find the right plan for you, balance your deductibles and premiums.
Charlene Wong knows this from experience. She and her husband chose the wrong plan a few years back, even though she is a Duke University academic and doctor who studies how people choose their health insurance.
She says that she spent several days researching and calling around to check if the doctors she wanted were in network. After she became pregnant, she discovered that her OB was not in network.
She explains that there was a tiered network in her health insurance plan, and my OB was Tier 3 of network providers. She thought she had done everything correctly, but she ended up switching doctors to lower her medical costs.
Take heart, it’s not easy to get health insurance. These are some tips to help you choose the right plan.
Find out when and where you should enroll
Depending on where you live, there are two options: either the federal exchanges at HealthCare.gov (or your state’s market place) to find insurance. Twelve states and the District of Columbia run their own exchanges. Open enrollment for federal exchanges is open until mid-December. However, you may have more time if your state has its own marketplace.
Even if your current plan isn’t working for you, it is worth looking at other options
Charles Gaba advises people who have enrolled in ACA plans to log in to see if there is a better deal, even if they are happy with their current plan. Gaba runs the website ACAsignups.net, where he does health care data and policy analysis, focused primarily on the Affordable Care Act.
It’s tempting to just skip the entire enrollment process, especially considering that you’ll only be rolled into the same or similar plan if nothing is done during open enrollment.
Gaba states that many people believe that simply because they have not had any changes in their lives, such as their income or household, nothing will affect their policy or their premiums.
There are many changes each year that can affect the types of plans and their costs. For instance, this year new insurers have entered the marketplace, and premiums have gone down in some states. It is worth checking in to see what has changed and whether switching to a different plan makes sense.
Compare the estimated annual costs and not only monthly premiums
While it’s easy to concentrate on the monthly premium when comparing plans Wong at Duke suggests that you also consider other costs.
“A lot of people — we know from past research — become overly focused on the monthly premium and may not pay as much attention to things like the deductible or how much the co-payments are,” Wong says.
While the premium price is often highlighted when looking at plans, it’s important to consider other costs. The tool on HealthCare.gov or some state marketplaces can calculate your “estimated total annual costs”. This includes the plan’s copays and deductible. It also considers how much you will use for health care in the next year.
Wong suggests that the yearly cost estimate is a useful tool for selecting a plan. It can be difficult to work out the math, especially for those who aren’t as familiar with insurance. She says.
Take into account how much you spend on health care
The best insurance plans will depend on how many health problems you are likely to have in the next year. This could impact the cost of your plan. Although your age is a good indicator, there are always unknowns such as unexpected cancer diagnoses or car accidents.
Wong points out that there are some basic tradeoffs you should consider. You might think about whether you are willing to pay more for a monthly premium, knowing that it would result in lower out-of-pocket costs if you need more medical attention. She says. “Versus — The other way around — “Let me pay less monthly because I don’t anticipate needing much care but I know that I would have this insurance in the event of something very catastrophic.” “
These unknowns are not the only thing you need to know about your health. Look for plans that cover you if you already have a doctor or know you will be taking a particular prescription drug. HealthCare.gov lets you add your doctor and prescription drugs to your plan to check if they are covered. Wong suggests calling your doctor to ask about their plans.
Beware too-good-to-be-true plans
If you see a good deal online, make sure you’re looking at an ACA plan, warns health policy writer and insurance broker Louise Norris. You may find short-term plans with lower monthly premiums that don’t offer the ACA’s ten essential benefits if you search the internet for health insurance. These benefits include important stuff such as prenatal care and mental healthcare treatment.
Norris states that there are times when people can get good premiums in both the state and federal marketplaces. But if one plan seems too good to be true then read the fine print.
She says that she did notice some new plans in certain areas for 2020, which will have a $0 deductible. Scroll down and you will see that there is a $1,000 per day copay for hospitalization. Although you hope to not spend too much time in the hospital’s emergency room, it could add up quickly.
Norris identifies a new tool to help you sort good plans from poor. It is a star rating. This is similar to the Yelp and Amazon ratings that consumers use (recalling Obama’s original vision). Star ratings are based upon information that insurers submit about cost and enrollee feedback.
Star ratings are one way to see what other customers think about a plan. ” Norris says. She says that not all plans have them, as some are still new. However, for those plans with stars, they “give you some red flags if there are any concerns.”
Receive free assistance from the professionals
Trump’s administration cut federal funding for open enrollment advertising and the navigator program. However, those programs still exist. There are still people in the country who can sign people up for free.
Wong states, “My best advice to people — especially those who are less knowledgeable about insurance is to see how you can get some help.” You can call for help, but she recommends trying to meet in person with “a health insurance navigator or a certified application counselor,” she says. These are people who can help you choose the best health insurance plan for you.
Katie Turner is one of those trained navigators — she’s been signing people up for seven years, and works with the Family Health Care Foundation in the Tampa Bay, Fla., area. She has been busy calling past customers to let them know that open enrollment is near.
She advises people to assemble all the necessary documents, such as Social Security cards, immigration documentation, tax returns, before going into a meeting with a navigator.
She says that most importantly, sign up for coverage if it is necessary.
Turner states that there is “a lot of confusion out here.” Many people are confused about the meaning of a legal challenge to law for the marketplaces (nothing at the moment), open enrollment, and many other things. Turner states that “all we can do” is “continue to be here and offer the same resources we have provided for seven years to help people get coverage.”