Health Insurance 2018: Exploring Your Options
*This article was originally published on Bedsider.org
Open Enrollment Starts Now
Good news: Affordable Care Act (ACA, a.k.a. ObamaCare), it is still law, and the chance to get coverage is approaching. ACA has helped make health insurance more affordable and accessible to millions of people, and it covers birth control for women without any out-of-pocket costs. Whether you already have insurance or are one of the millions of Americans who are eligible for coverage but haven’t signed up yet, it’s time to head to the health insurance marketplace to explore your options.
Save the Date
The open enrollment period for 2018 health coverage goes from November 1, 2017 to December 15, 2017. So you only have six weeks to sign up for a new plan. An added complication is that every Sunday during open enrollment, the HealthCare.gov website will be down for maintenance from midnight (12 am) to noon (12 pm). The only exception is December 10, 2017—the last Sunday before open enrollment ends.
There are 12 states that have their own healthcare exchange, and they have slightly longer enrollment periods. But you’ll need to register by December 15th to have coverage on January 1st. You can find the states with extended enrollment (and their websites) below:
1. California: Nov. 1, 2017 to Jan. 31, 2018, Covered California
2. Colorado: Nov. 1, 2017 to Jan. 12, 2018, Connect for Health Co
3. Connecticut: Nov. 1, 2017 to December 22, 2017 (enrolling by December 22, 2017 will allow coverage to begin on Jan. 1, 2018), Access Health CT
4. District of Columbia: December 16, 2017 to January 31, 2018, DC Health Link
5. Idaho: Nov. 1, 2017 to December 15, 2017, Your Idaho Health
6. Maryland: Nov. 1, 2017 to December 15, 2017, Maryland Health Connection
7. Massachusetts: November 1, 2017 to January 23, 2018 (enroll by Dec. 23rd for coverage that begins on January 1st), Massachusetts Health Connector
8. Minnesota: November 1, 2017 to January 14, 2018, MN Sure
9. New York: November 1, 2017 to January 31, 2018, New York State of Health
10. Rhode Island: November 1, 2017 to Dec 31, 2017 (enroll by Dec 23 for coverage that begins on Jan. 1, 2018), Healthsource RI
11. Vermont: Nov. 1, 2017 to December 15, 2017, Vermont Health Connect
12. Washington: November 1, 2017 to January 15, 2018, Washington Health Benefit Connector
Given the short enrollment period and news that the federal government has cut funding to advertise, it’s important for us all to spread the word. Make sure your friends and family know about open enrollment, and check in with them about signing up.
Shop for the Perfect Plan
Depending on your insurance situation, you may want to check out HealthCare.gov or your state’s exchange. The health insurance marketplace allows you to compare different plans to select the one that’s the best fit for you. You can sort plans by the cost of premiums, or by how much you might expect to pay in deductibles before coverage kicks in. It may also be possible for you to qualify for premium assistance to lower what you pay for coverage, and help with deductibles and copayments to reduce your costs even further, however this assistance is still being debated in Congress.
Ready to visit the marketplace? Here are some tips:
- Get your paperwork ready: To sign up for coverage, you’ll need: income information, a form of ID, proof of citizenship/immigration status, a social security number, and your zip code.
- Use a computer: The healthcare marketplace is not mobile-friendly. If you don’t have a computer, head over to your local library to enroll.
- There’s help if you need it: If you need language help or other assistance, the Healthcare.gov website has a directory that can help connect you to local resources. Depending on what you’re looking for, it might be most helpful to type in your state to see what statewide resources are available.
- Don’t wait until the last minute: Six weeks can go by quickly, but enrolling at the last minute increases your chances of overwhelming the system and experiencing technical difficulties.
Already Have Coverage?
If you already have marketplace health insurance, it’s a good idea to make sure all of your information is accurate and up to date. If you’ve had major life changes in the past year (having a baby, change of income, etc.), your eligibility for financial assistance might have changed. Even if nothing has changed and your current plan is set to automatically reenroll you, it’s a good idea to browse in case there’s a plan that better meets your current needs. The plan you have this year may not be the best value available for next year, so it pays to shop around.
Uninsured, but thinking about signing up?
About 10.7 million uninsured Americans are eligible for health coverage during this enrollment period, and almost half of them are between the ages of 18 and 34. If you’re one of those people, head over to HealthCare.gov and fill out an application. Through the marketplace, you can also find out if you qualify for financial help to make your plan more affordable.
A note about the cost of being uninsured: You are now required by law to have health insurance. You won’t go to jail for not having coverage, but when you file your 2017 taxes in early 2018, you’ll have to pay a fine to the tune of $695 for each uninsured person in your household or 2.5% of your yearly household income, whichever amount is higher. Factor that in when you’re thinking about the cost of insurance premiums.
You shouldn’t have to break the bank to get insured. If your income is below a certain level, you may be eligible for financial assistance to help you get covered and stay covered.
- Subsidies (a.k.a. premium tax credits) will lower your monthly payments (called premiums) for your health plan if you qualify.
- Cost-sharing reductions allow you to pay less out-of-pocket for deductibles, coinsurance, and copayments.
- Medicaid is a health insurance program for low-income individuals and families. Eligibility generally depends on your income and household size and [varies a lot from state to state] ((http://kff.org/medicaid/fact-sheet/where-are-states-today-medicaid-and-chip/). Under health reform, states were encouraged to expand Medicaid to cover more people, but not all states have done so. As of October 2015, 31 states (and DC) have opted to expand their Medicaid eligibility. If your state is one of them and your income is below 138% of the Federal Poverty Level, you should be covered.
Birth Control Included?
Plans sold through the health insurance marketplace must cover all FDA-approved birth control methods for women without copays or deductibles and provide at least one option for each method. These rules apply to all Marketplace plans, so your 2018 plan should cover your preferred birth control method without any out-of-pocket expenses. So when you go to the pharmacy to pick up your pill pack or to your health care provider to have an IUD put in, the cost to you should be $0.
The FDA-approved methods include both hormonal and non-hormonal IUDs, the implant, the pill, the patch, the shot, the ring, diaphragms, cervical caps, and sterilization procedures. Birth control that you can buy over-the-counter—like the sponge, internal condoms, and some emergency contraceptives—is also included, but to get it covered your plan might require you to have a prescription from your provider.
Note that your insurance company has to cover all methods, but not necessarily all brands of birth control. If you and your provider agree that a certain brand-name birth control is best for you, your insurance company should allow your provider to notify them and explain that you need to use that particular brand. After you take those steps, your insurance is required to cover your preferred brand.
Keep in mind: there are still special rules for employers or schools with religious objections to providing birth control coverage. Find out more about those rules here.
Know Your Benefits
Beyond birth control, the ACA ensures that a bunch of other women’s preventive health services are covered in all new plans without out-of-pocket expenses. There’s a long list of covered benefits, but here are a few highlights:
- well-woman visits;
- counseling on sexually transmitted infections (STIs), including HIV;
- the HPV vaccine, as well as the flu and Hepatitis vaccines;
- depression screening;
- intimate partner violence screening and counseling;
- a wide range of prenatal screenings and tests; and
- breastfeeding counseling and supplies.
Whether you’re buying insurance for the first time or shopping around to see if there’s a better option for you, you can feel good about staying on top of your health. You’re worth it.