It may be open enrollment season for many of you at work, but for millions of Americans it will be the official open enrollment for Obamacare started Wednesday, November 1st. Amidst all the adjustment surrounding federal subsidies, there is a plethora of information to digest for those of you who are considering the federal marketplace for your health insurance. Sometimes, it may feel like you need an engineering degree to choose your health insurance. Here are my five-smart money moves Q & A to help you get an initial start to understanding the open enrollment period beginning this week.
Question 1: When does open enrollment start/end and how many people are expected to sign up this year?
- Starts November 1, 2017 and ends December 15, 2017
- You must apply by December 15th if you want your coverage to begin January 1st.
- There are no other enrollment periods unless you qualify for a special enrollment for life events such as marriage, divorce, birth of new child, etc.
- The CBO expects 11 million people to sign up this year (source vox.com).
* The most popular plans are expected to go up by 34% according to CNBC. You should analyze the plans carefully to ask yourself not only a) what will your premium be, but also b) what will you be paying out of pocket potentially for deductibles.
Question 2: Is the Government selling health insurance?
- No, there is no Government agency- it is a federal marketplace you can access through www.healthcare.gov.
- You can get the same options from independent private companies (go to www.hlnobamacare.com and we can get a quote for you).
- You have 5 categories of coverage – bronze, silver, gold, platinum, and catastrophic. The bronze health plan will pick up roughly 60% of the costs and you will pay 40% of the costs. The platinum plan is 90%/10%. The key here is to closely review your medical history or your expected medical procedures you may need in 2018.
Question 3: Do you have to carry insurance?
- Yes or you can get fined. I will discuss the fine in question five.
- All market place plans have 10 essential health benefits. ‘Essential health benefits’ are benefits such as trips to the emergency room, lab tests, prescription drugs, etc.
- Depending on your income and people in your household, you can potentially get federal subsidies to pay for your health insurance.
* With the impending alterations from Trump, there are some unknowns now as it pertains to overall subsidies and we know that health care reform is up in the air.
Question 4: Why are premiums rising so high?
- Because this is GUARANTEED coverage.
- You cannot be denied – pre-existing conditions, pregnancy, etc.
- It is also why you can’t just drop and pick up coverage. For example, you can’t enroll in July, have $100,000 of costs, and then drop in August. Rates are increasing due to the actual costs and unknowns about federal subsidies.
For someone like me – if I applied as a 48-year-old single male. A silver plan with a $6,800 deductible is about $473 a month versus a gold plan with a $500 deductible which would cost more than $717 per month.
Question 5: What are the fines if you don’t take on health insurance?
- 2.5% of your household modified adjusted gross income (OR)
- There have been no 2018 adjustments mentioned as of yet, but the current fee is $695 per adult/$347.50 per child to a maximum of $2,058 whichever is more for your household
- You should be listing your fine on your tax return under the clause of ‘shared responsibility’.
- IRS holds back from future refunds if you don’t pay on the honor code.
- No liens, levies, or criminal penalties for not paying according to www.healthcare.gov
This isn’t a full and complete list of everything you need to know. To get more information, go to www.hlnobamacare.com or you can go to the Government website at www.healthcare.gov. Get smart about your health insurance so you can make the best moves for your family profit and loss statement.