Last year, more than 8.7 million Americans enrolled in a Health Insurance Marketplace plan on healthcare.gov. On Nov. 1, the marketplace opens for 2019 enrollment. Whether you plan to sign up for the first time or renew last year’s plan, here are some things you’ll want to know.
1. You have 45 days to choose a plan. Open enrollment begins Nov. 1 and ends Dec. 15. To have 2019 health insurance coverage that starts on Jan. 1, you must enroll in a marketplace plan by Dec. 15. If you already have a plan under the Patient Protection and Affordable Care Act (ACA) and do nothing, on Dec. 16 you will be auto-enrolled in the same plan – but it will be too late to change your plan.
2. Do your homework. Marketplace plan options can change from year to year, so it’s important to review all 2019 plans available to make sure you find one that meets your needs. Before you buy, ask or check online to see which doctors and hospitals are included in the plan. If you already have a regular doctor, check to see if that doctor is part of the plan. If you are a returning customer, you will be defaulted into a plan if you do not make a choice.
“It’s also important to recognize that there are health insurance plans available off the marketplace, like short-term or association plans. These plans are not equivalent to the health insurance plans available for purchase on healthcare.gov,” said Bob Seehausen, senior vice president of business development and sales for Novant Health. “They may have fewer benefits or a number of exclusions. Consumers should be very wary of these new plans – don’t just buy based on price. Consumers should also check the health care network your plan allows so you can continue using your current provider and keep your out-of-pocket costs down.” To see a list of participating plans that include Novant Health providers, visit NovantHealth.org/healthmarketplace.
3. You may be eligible for a lower premium. What you pay for insurance depends on your income. Depending on your income and household size, you may be eligible for a subsidy that lowers your premium. “The majority of people who buy insurance on the health exchange qualify for subsidies, which can make a policy very affordable,” Seehausen said. “It’s important to do your research. Go to healthcare.gov and put in your income information to see what your actual premium will be. It could be a lot less than you expect.” In 2018, 87 percent of all marketplace enrollees received tax credits to cover a share of their premium and 53 percent received cost-sharing reductions, according to Kaiser Health News. Learn if you qualify for savings by reviewing the health care savings chart on healthcare.gov. You can also get personalized help at this healthcare.gov link.
Some health insurance carriers have also lowered their premiums for 2019, like BlueCross and BlueShield NC, which announced that overall premiums in its ACA plans would be reduced.
4. Preventive care like vaccines and screenings are free. All health insurance plans offered on the marketplace must cover preventive care services without charging a copayment or coinsurance.
5. Using urgent and express care clinics, as well as MyChart, can help save you money. You can lower your health care costs by knowing when to access the right type of care. Find yourself sick or injured when your doctor’s office is closed? Instead of heading to the emergency room, look for a nearby express care or urgent care clinic. They can provide treatment after hours for many non-life-threatening health needs and are less expensive than hospital emergency rooms. There may be times when what you need does not require going into the doctor’s office at all. By signing up for MyChart, an online patient tool, you can send a message to your provider, schedule appointments, request prescription refills, pay bills, view laboratory test results and download your medical records.
Novant Health offers additional resources at NovantHealth.org/healthmarketplace. If you're new to buying health insurance -- or just have questions -- this story may help.