Open Enrollment: What You Need to Know Now About Health Coverage
(LANSING) Over 706,000 Michigan consumers are now buying their own health coverage either through the Marketplace or directly from an insurance company. The Michigan Department of Insurance and Financial Services (DIFS) is reminding consumers that, barring certain qualifying events, open enrollment is the only opportunity they have to get coverage for 2018. Open enrollment for 2018 private health insurance coverage begins today, November 1, 2017.
“It is important for Michigan citizens to know that private health coverage can only be purchased during the open enrollment period regardless of whether they purchase their coverage on the Marketplace or directly through an insurance company.” said DIFS Director Patrick McPharlin. “Regardless of which path you choose, if you don't enroll in a health insurance plan by December 15, 2017, you can't enroll in a health insurance plan for 2018 unless you qualify for a Special Enrollment Period.”
Consumers shopping for coverage through the Marketplace can apply online at www.healthcare.gov, by mail, over the phone at 800-318-2596 or in person with the help of a local assister. Consumers shopping for coverage outside of the Marketplace can do so by contacting insurance companies directly or by utilizing the assistance of a licensed insurance agent. A list of companies that sell major medical coverage can be found through the DIFS website.
Consumers should also be aware of these key points this year:
Those who qualify for premium subsidies, also known as advanced premium tax credits (APTCs) will still receive them in 2018, and those who qualify for cost-sharing reductions (CSRs) will still receive them.
- Even though premium rates are increasing, individuals and families eligible for an APTC will likely see their rates off-set by increases in premium tax credits.
- The insurance companies must still provide CSR benefits to low-income individuals and families who qualify and who purchase a Silver plan through the Marketplace.
Those without subsidies are advised to avoid inadvertently purchasing a higher priced Silver plan.
- To cover the loss of CSR payments to the insurers, Marketplace Silver plans are priced higher for the 2018 plan year.
- Any plan offered on the Marketplace must also be offered off the Marketplace; therefore, those who do not qualify for tax credits may find more savings with an off Marketplace plan.
- Individuals without subsidies who currently have a Silver plan will want to guard against being automatically re-enrolled into a high-priced Silver plan, by actively shopping for other options.
Those with subsidies may find that Bronze and Gold plans are more affordable than in the past.
- Those who qualify for a CSR will still only qualify for them by purchasing an on Marketplace Silver plan.
- However, because the cost of Silver plans on the Marketplace have increased disproportionately compared to Bronze and Gold plans, a premium subsidy applied to a Bronze plan will stretch further (though cost-sharing will be higher); and a subsidized Gold plan may not cost much more than a subsidized Silver plan (and cost-sharing will be lower).
Compare all costs, not just the premiums, as well as networks, providers and drug formularies.
- Look at deductibles, co-insurance, copays and maximum out-of-pocket amounts to determine the total cost of a plan, based on your health and anticipated use of services, not just the monthly premium.
- Make sure your preferred providers and medications are covered by the specific plan you are considering. There is local help available to guide you through this process.
Don’t wait until the last minute - start now. Open Enrollment is just six weeks - November 1 through December 15, 2017.
- New plans must be purchased by December 15 to have coverage for 2018 and to avoid a tax penalty. Look at your options, ask questions, choose a plan, complete an application and (if applicable) update financial and household information on healthcare.gov soon, to avoid encountering a bottleneck as enrollment comes to a close.
Consumers who purchased health insurance through the Marketplace last year will be auto-enrolled in the same plan unless they select a different plan by December 15. If an insurer is discontinuing a plan, those currently in the plan will be auto-enrolled into a similar plan by the same insurer. Individuals whose current health insurer is not offering coverage through the Marketplace for 2018 will need to select a plan from a different insurer by December 15, 2017. Those not doing so will be automatically enrolled into a similar plan with a different insurer unless they opt out of the coverage.
DIFS offers tools, guides, and resources on their website which is available for use 24 hours a day, seven days a week on the DIFS Health Insurance Consumer Assistance Program’s (HICAP) website, www.michigan.gov/hicap. This site contains information on the Marketplace and the Affordable Care Act. HICAP also has a toll-free number, 877-999-6442, for consumers who wish to speak to someone about their questions or concerns.
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