Just a couple of quick reminders.
Open enrollment for the health insurance Exchanges (HIX) starts tomorrow morning at midnight. Open enrollment will run through February 15th. If you want coverage to start for January 1, 2015, you need to have selected your plan and acknowledged the right of the insurance company to bill you by December 15, 2014.
Open enrollment for Medicare is ongoing right now. It closes out on December 7th. Traditionally the busiest day of open enrollment for Medicare Advantage and Medicare Part D prescription drugs is the Monday after Thanksgiving.
Enrollment is always open for CHIP and Medicaid.
Enrollment is open at the discretion of your employer if you are covered through work.
Now onto the reminders for HIX open enrollment.
I would strongly recommend that everyone who has a current HIX/individual Obamacare policy to go online over the next week or two to look at their choices. They are scheduled to be automatically renewed in the same plan or a near analogue of the same plan if that plan is cancelled by the insurer for 2015. This could be bad news for a variety of reasons. It could be bad because the plan itself could have been the wrong plan for the family. It could be bad because circumstances changed and changing metal bands could be a reasonable response. It could be bad because the post-subsidy costs could change.
Post-subsidy costs will change for a lot of plans. This will happen for a number of reasons. Plan prices will change in and of themselves. Some will go up, some will go down. More importantly, the market mix within a county is often changing. In my region the Silver market went from four insurers and eleven plans last year to six insurers and twenty nine plans this year. The company that had both the cheapest and second cheapest Silver this year issued the same basic plan design as its low cost options. They were a bit aggressive on their 2014 pricing and raised rates by 9% for 2015. The three other insurers from last year (including Mayhew Insurance) massively undercut the 2014 2nd Silver by embracing very narrow networks and HMOs. So the 2014 2nd Silver which sets the benchmark subsidy level is now the 9th Silver. The subsidy benchmark in my region is 3% lower than it was in 2014. That type of undercutting will mean that the people who auto-renew their 2014 2nd Silver plan which had them paying $99/month will now see $200/month premiums in January.
For people who are buying insurance on the Exchanges for the first time this year, I recommend that you spend a couple of hours this week looking at the plans available on the Exchange and ask yourself the following questions:
- How much can I afford to spend every month
- How much can I come up with at once to cover a medium size emergency (say a broken wrist)
- Do I have any pre-exisiting conditions that dictate me seeing a doctor every month/quarter/year with expensive testing etc.
- How comfortable am I with taking medium to large size financial risks?
- Who are the doctors and hospitals that I want to use? Does it matter, or will any doc be good enough?
- How often do I travel out of region so do I want a national network or a local network with national emergency room coverage?
- Am I on the borderline between Medicaid and Cost Sharing Silver and should I manage my finances to land in one of those categories?
- Do I have major life events coming up in the next year (birth of a child, retirement, moving to France for six months etc) and how do I deal with those changes
If I was buying insurance on the Exchange for the first time, I would not buy this week. I would look to find answers to the questions above and figure out what set of plans meet enough of the minimal qualifications and then intensely shop from that short list. I would probably seek to buy right around Thanksgiving for January 1st coverage to give me enough time to make a good decision while getting rid of the stress of making the decision.
Finally, ask for help. There are tons of navigators who will help you. They can lay out choices and options but they can not recommend plans. Brokers can recommend plans but they will often try to enroll people off exchange. That could be fine if you know you are not subsidy eligible, but you must go on the Exchange for subsidy. Ask for help, and people will want to give you good assistance.