Open enrollment begins: What you need to know about health insurance

by Ray Hanley (rhanley@afmc.org) 580 views 

At AFMC, we know how important it is to have health insurance. If you need medical attention, insurance protects you against expensive costs and you can focus on getting well.

We know from research that people who have health insurance throughout their lives are healthier and less likely to develop chronic conditions like heart disease or diabetes. Insurance also provides valuable preventive services to help keep you well, most are at no cost to you.

Now is the time to spend a little effort insuring your health. Open enrollment for health insurance begins Nov. 1 and ends Dec. 15, 2019. If you get your health insurance from the health insurance Marketplace, also called the state Exchange, you can enroll (or re-enroll) during open enrollment. You must not be eligible for any group health insurance (through your employer or Medicaid) in order to use the Marketplace.

If your employer offers health insurance, your employer will provide instructions specific to your workplace to renew your health coverage.

If you have health insurance from Medicaid, Arkansas Works, or your children are insured with ARKids, you do NOT use the Marketplace. People with Medicaid or ARKids First do not have an enrollment period. They can enroll as soon as they become eligible, based on income and assets.

People on Arkansas Works have coverage from private insurance companies that are paid with Arkansas Medicaid funds. Arkansas Works beneficiaries can change private plans during the Nov. 1 to Dec. 15 open enrollment period.

During Medicare’s Open Enrollment – Oct. 15 to Dec. 7, 2019 – older or disabled people can shop for or change Part D Medicare drug plans, supplemental coverage (“medigap”) or Medicare Advantage plans.

Comparison shop and save
During open enrollment you can enroll for the first time, renew current coverage, re-evaluate plan prices and services, and either renew or choose a different plan. Even if you are happy with your current coverage, smart shoppers can benefit by comparing plan prices, benefits and services covered. Plans can and do change from year to year, and your health needs can change, too.

Arkansans can choose from more than 60 options including Obamacare plans (Affordable Care Act), health maintenance organizations (HMOs), preferred provider plans (PPOs), Medicare options and even short-term plans that provide next-day coverage. All plans available in Arkansas are listed on the Marketplace website. You can complete an application on-line. Plan prices and services for 2020 will be available by late October. After Nov. 1, visit HealthCare.gov. or arkansas.health-exchange.com and you will be guided through the process.

Sign up before Dec. 15
You must complete your new or renewal application before 11:59 p.m., Dec. 15, for your health insurance coverage to begin Jan. 1, 2020. If you miss this deadline, you will not be able to sign up for a Marketplace health plan until Nov. 1, 2020, a full year from now. Once you sign up with a plan, you must stay with that plan for 12 months.

However, if you had certain changes in your life (new job, marriage or divorce, gaining/losing a dependent, moving or losing COBRA coverage) during the year, you may qualify for a Special Enrollment Period. If you cannot afford COBRA coverage from a previous job, you can sign up for Marketplace coverage and then drop your COBRA coverage.

Subsidies for most Arkansans
Most people shopping on the Marketplace qualify for a subsidy. The website will show the full cost of the plan, any cost-sharing or premium tax credits you’re eligible for and what your monthly premium will be. You can use your subsidy to reduce your monthly premiums or pay the premiums and get a tax credit when you file your income tax return. You must reapply for your subsidy every year because it is based on your past year’s income.

Editor’s note: Ray Hanley is Arkansas Foundation for Medical Care’s CEO and President and Mandy Palmer is AFMC’s manager of outreach quality. The opinions expressed are those of the author.

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