Not Yet 65, But Don’t Have Healthcare Insurance? Hurry- Open Enrollment Is Shorter This Year

Coming Soon… How to Buy a Medigap Policy

November 1, 2017 — Today is the opening day of the abbreviated Open Enrollment period for Obamacare/aka the Affordable Care Act. We know many of our younger Members are retired before they wanted to be, or work for companies that don’t offer health insurance. If you don’t have health care insurance, and you are not yet 65 or otherwise ineligible for Medicare, you have until Dec. 15 to do something about it.

In this article we will try to outline the basic facts about how to sign up for Obamacare. Many people assume, incorrectly, that Obamacare is dead. To the contrary, although wounded by Congress’s umpteen unsuccessful attempts to repeal it and the President’s recent executive actions, the reports of the ACA’s death are greatly exaggerated, to paraphrase Mark Twain. It is still the law of the land and the vehicle for over 10 million Americans to get affordable health insurance. You can still sign up for (or change) health care insurance for you and your family without worrying about having to pay extra or be declined for pre-existing conditions. And if your income is under $50,000, you are probably eligible for tax credits and subsidies that will make that coverage relatively affordable.

Nine Questions
1. Can I still sign up for Obamacare?
Yes you can. Obamacare is the law of the land. Although anything could happen down the road, at the very worst you can get coverage through 2018.

2. Where can I sign up?
Go to www.Healthcare.gov. If you enter a zip code for a state that has its own exchange, you will get a link to it. At the Healthcare.gov the budget for the website and its Navigators has been drastically cut, so it will be harder to get personal assistance than it was in previous years. In fact, in a thumb in the eye gesture to Obamacare, the Administration is even shutting down the website for much of every Sunday, when many people might want to use it. But the rest of the time the website is pretty straightforward so you can probably work through it on your own, or find a volunteer to help you sort out your options.

3. Can I get a subsidy to help with premiums and out of pocket expenses?
Yes, if your income is within certain limits.

4. How much might that subsidy be? And how do I compare plans and signup?
Your subsidy, if eligible, will vary depending on your income and family situation. About 85% of the people who buy through the exchanges receive a subsidy. As one example we went to www.healthcare.gov and entered our zip code and chose Male, single, non-tobacco user, and an annual income of $45,000. The response from the site was that we were eligible for a monthly premium tax credit of $1996.

Comparing plans at Healthcare.gov and signing up for them seemed quite easy, although we didn’t actually go all the way through the signup process. The relative amount of the subsidy we were to receive in the example we made up resulted in some pretty affordable insurance, at least at the Bronze and Silver levels. We used the “Simple Plans” option to compare. In our sample case the monthly premium would be $0 for a Bronze plan and $428.61/month for a Silver FL Blue plan. Both have out of pocket expenses and co-pays. You can figure out what would happen in your case by going to the site and plugging in your basic information.

5. How long is the open enrollment period?
The enrollment period is from Nov. 1 to Dec. 15 (half what it used to be). Eight states and Washington, D.C., which have their own marketplaces, have longer sign up periods that range up to Jan. 31 (New York). The others are CA, CO, CT, MA, RI, MN, and WA.

6. Health insurance prices are skyrocketing, and the Trump administration stopped paying subsidies to the insurance companies. Won’t that mean my monthly premiums will go up?
Probably not. One reason is that insurance companies are obligated to reimburse certain low income policy holders for out of pocket expenses – the hit is to the companies. Another is that tax credits paid to eligible lower income folks will increase to make up for any higher premiums. Insurance companies will have to raise prices in other areas to make up for their lost subsidies, which probably means individuals whose incomes are too high to be eligible for a subsidy or tax credit, and companies that offer health care to their employees, will see their premiums rise.

7. Can I change or renew my health care insurance policy in this enrollment period?
Yes. Although you can simply renew your existing ACA policy, it is always a good idea to go in and compare to make sure you have the best plan for you and your family. The companies offering these plans keep changing their prices in different ways; for example in some cases prices on Silver plans have gone up so much that a Gold plan might be a better deal.

8. What happens if I don’t get any health insurance?
Several things, none of them good. For one, if you are struck with a serious illness or injury you will be thrown upon the mercy of your local hospital, with little choice in how you are treated. You could end up seriously indebted. And you will have to pay an annual penalty to the IRS for not having coverage. For 2017 that penalty is 2.5% of your income or $695 per person, whichever is higher.

9. If I don’t want to or are ineligible for Obamacare what are my options?
You have some options. You can always go into the private marketplace to buy or compare policies. In some cases a policy available on the open market might be a better deal. Here is some information on private insurance. You probably need to go to an independent insurance agent to get one of these plans – use your family and friends to get some recommendations.

For further research:
Healthcare.gov
Medicare Open Enrollment Period Opens: Which is Better, Orginal Medicare or Medicare Advantage?
Confusion Reigns As Obamacare Open Enrollment Period Opens (NY Times)
Shopping for Affordable Care Health Plan? Read This (WSJ, A Gold Plan Might Be Cheaper Than a Silver Plan)

Comments? Are you getting insurance through Obamacare? Please share your experiences in the Comments section below.