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URGENT: Sign your name to tell lawmakers to keep mandates and pharmaceutical giveaways out of the new "omnibus" healthcare bill.

ACA Open Enrollment is Now: What to Look For and What to Avoid

November 27, 2018

Open enrollment started November 1, and goes on until December 15. Make sure to sign up for a plan as soon as you can if you do not already have health insurance.

First, the good news: you may be able to get a break in premium costs during open enrollment. That means you could be seeing cheaper premiums for the first time since the Affordable Care Act (ACA) was passed. On average, prices are expected to drop between 1.5% and 4.1% for silver or middle range plans, which tend to be the most popular option across the board.

There will also be more insurers joining the exchanges for the first time since 2015 according to the Department of Health and Human Services (HHS). This is especially good news for people who don’t qualify for government subsidies that help with the cost of the premiums. However, despite these improvements, consumers must still be very wary when it comes to shopping. Here are some other useful tips:

1. If you’re considering new short term, non-ACA alternatives, ASK QUESTIONS.

  • The past few months have seen new, alternative types of insurance under President Trump, alternatives that are not subject to the same regulations and standards as ACA policies.
  • These are cheaper than plans on the exchange, but they also exclude people with preexisting conditions.
  • These short-term plans don’t offer maternity coverage and you could be turned down for coverage if you have ever been diagnosed with cancer, HIV/AIDS, hepatitis, substance abuse disorders, etc.
  • If you get sick while enrolled in a short term plan, you likely will not be able to extend or renew coverage. More importantly: If you lose coverage under a short-term plan during the year, you are not eligible to enroll during the special enrollment period for an ACA plan.
  • The benefits of a short-term plan are very limited, so make sure to read the fine print and what limits are going to be imposed on your access to healthcare.
  • Under a short-term plan, doctors and hospitals may not have negotiated with insurers on how much they can charge for medical services. Click here for more information.
  • Marketing efforts to push these short-term alternatives are well under way. Make sure to read and reread what you are signing up for if you choose to go with this alternative. These should come with a prominent notice to consumers to let them know that they are signing up for a non-ACA policy, but sometimes it may not be obvious right away.
  • If you are considering this option, you can find more information on healthcare.gov.

2. Pre-deductible - If you are going for the option with the lowest premium and the highest deductible, make sure to review your options for pre-deductibles. Pre-deductibles are treatments that are required to be covered by law before you meet your deductible. Some policies may even include primary care visits and medicines before your deductible is met. 

 

3. Pick carefully - If you qualify for a government subsidy on your premium, carefully go over the various plans provided by an insurer. In some cases, higher-tiered options may make more sense than what you usually get.

Now that Open Enrollment is here, there are several newcomer policies in the scene to look out  for. Please read the fine print of everything you are considering because things have changed this year due to the Trump administration’s new policies. Even more changes to the U.S. healthcare system are on the horizon as we look to the new year. That’s why the NC Coalition for Fiscal Health is always on the lookout for how these changes will affect North Carolinians.

 

Have the sky-high costs of healthcare in our state impacted you and/or your family’s lives? Do you want to do something about it? Join the Coalition now to receive updates about new legislation and policies that will affect YOUR healthcare. Sign up now!


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