Now’s the time to check your health care coverage for 2017 or sign up for the first time. Open enrollment through the Health Insurance Marketplace began on Nov. 1 and runs until Jan. 31.
Here are six key facts to know about this year’s enrollment season.
Your actual premium costs probably aren’t as high as you’ve heard.
More than eight in 10 Oklahomans with coverage through the marketplace will be able to find a health plan for less than $75 per month, thanks to financial assistance.
If your income falls below 400 percent of the federal poverty level – that’s $48,000 for one person or $97,000 for a family of four – you’ll qualify for federal tax credits that will help make your coverage affordable. About eight in 10 marketplace consumers in Oklahoma are eligible. Because the tax credits increase dollar for dollar with the cost of a benchmark health plan, most consumers are protected from rate increases.
Also, if you’re buying an individual health plan but not through the marketplace, you’d be wise to visit healthcare.gov and recheck your eligibility for the tax credits. An estimated 33,000 Oklahomans who purchased coverage outside the marketplace and paid full price for it last year have incomes low enough to qualify for assistance.
All consumers still have choices.
Even consumers served by a single insurer will be able to select from a range of plans. Oklahomans can choose from an average of 13 health plans, though the exact number will vary from county to county. Rural areas are likely to have fewer. You can view all of the plans for sale in your area at healthcare.gov.
If you haven’t purchased a health plan through the marketplace before, you should know that all plans cover a comprehensive set of benefits, including doctor visits, hospital stays, preventive care, pregnancy and prescription drugs. The plans must treat you fairly. Insurers can’t deny you coverage because you have a medical issue, such as cancer or diabetes. Nor can they charge you more than they would someone who’s in good health.
It pays to shop and check out your options.
If your health plan from this past year is continuing into 2017, you may be automatically re-enrolled. But you’ll still want to review it to make sure it meets your needs.
Every year, insurers adjust premiums, out-of-pocket costs and benefits. You should have received a letter from your insurance company explaining the changes for 2017.
Even if you’re satisfied with your current coverage, it’ll be smart to log into your marketplace account at healthcare.gov and update your information on household income and family size.
Updating your personal information is important, because you may be eligible for lower costs than last year.
Comparing plans at healthcare.gov is easier than ever.
The marketplace simplifies your shopping for coverage by letting you make convenient comparisons of health plans.
The process is faster and more streamlined this year. You can even shop and enroll from a smartphone or tablet.
Healthcare.gov helps you put together the full picture of your health care costs, including premiums, deductibles, copayments and coinsurance. An “out-of-pocket calculator” will give you an estimate of your total yearly costs for each health plan, based on factors like your age, gender, income, ZIP code and how much health care you expect to use.
You can also check out a plan’s list of covered drugs and find out which doctors and hospitals participate in the plan you’re considering.
Deductibles can often be made more manageable.
Most marketplace consumers qualify for financial assistance that lowers their deductibles -- the median marketplace deductible is now $850.
All plans cover some preventive services, such as cancer screenings, vaccines and well-child visits, without a deductible. And eight in 10 marketplace consumers select plans that cover common health services, such as primary care visits, generic drugs and some specialist visits, before meeting the deductible. Instead of bearing the full cost of your doctor visit, you may have just a copayment.
There are places to turn for help with signing up.
Besides relying on healthcare.gov, you can call 1-800-318-2596 and visit with a marketplace customer service representative. You can also visit localhelp.healthcare.gov to locate the organizations in your community that will assist you in signing up for coverage.
Open enrollment runs until Jan. 31. But you must act by Dec. 15 if you want any changes in your coverage to take effect on Jan. 1.
Don’t risk paying a penalty of $695 or more because you go uninsured next year. Check out your options at healthcare.gov. Plans may be more affordable than you think.