Good morning —
It is now December 14th.
ACA open enrollment is still ongoing. There is a short term deadline coming up soon. If you want coverage to start on January 1, 2022, you must pick your plan by 11:59PM local time December 15,2021.
Open Enrollment goes goes through January 15th on healthcare.gov. It goes at least that long on the state based marketplaces with the exception of Idaho which shuts off open enrollment on Wednesday December 22, 2021. Open enrollment is the time when you can sign up for a health insurance plan for any reason at all. You can choose a new plan if you’re already in the market. If you’re currently uninsured, you can pick an ACA plan without a special reason. But the late December and January period is for insurance that starts on February 1, 2022.
So what are the big things to remember:
- Get on it today — A significant chunk of all enrollment happens on the 15th. There is likely to be a long line for help.
- Know what are your core constraints — what hospitals/doctors do you have to have, what drugs do you take, how much can you afford each month and what is the maximum oh-shit amount you can pay?
- Accept that insurance is confusing and complex
- Accept that your goal is to get good enough instead of perfect where good enough is often, for people without significant medical history, avoiding the really bad and hideous.
If there are questions, leave them in comments, and I’ll be monitoring throughout the day.
WaterGirl
Thanks for this, Dave!
I hope everyone who tweets will tweet this out to help spread the word.
Mary G
O/T IT IS FINALLY RAINING AT MY HOUSE!
I am personally responsible for ending the SoCal drought. I have earthquake retrofitting and junk hauling guys coming today and my new roof was finally supposed to be started on Thursday. Plus I have no raincoat.
And I don’t care. Even my neighbor who I thought I was going to war with for his sprinklers overflowing our wall and rotting out my garage had drip installed.
laura
I was locked out of my covered ca account yesterday due to my password and so I had to stop before hurling the laptop out into the stormy street. Grrr. It would’ve been nice to have a W-2 in advance of the open enrollment, but no, and so the UI that spouse received -qualifying for a $0.0 plan now just looks like income. Le sigh. When I followed the instructions to contact covered ca, I was 57 in the queue. Much swearing ensued, or should I say enlied.
Lobo
Your suggestions are what I think are the best we can do with the present system. Given that, how can we start improving upon it?
David Anderson
@Lobo: Whiskey, lots of whiskey.
Realistically, I think getting meaningful difference to mean something is important to reduce the complexity of the choice space would be useful. I lean towards a rule of an insurer can offer whatever it wants as long as there is a 3% premium difference from any other plan it offers. In addition to that, enhanced decision support is likely helpful.
David Anderson
@laura: There are a couple of things happening with unemployment insurance —
For 2021, that made the spouse eligible for $0 premium silver plans. That function goes away in 2022.
For the purpose of estimating your income for 2022 (and yes, this is a pain in the ass in all circumstances and worse in yours) the system defaults to current year income including the UI to calculate the initial projected subsidy amount. If your spouse is actively seeking work, then upping your income estimate is probably a good idea.
La Nonna
I’m sorry to say that every time I read one of David’s posts I am so very grateful for universal healthcare in Italy, and happily pay a bit more in taxes here vs our US tax rates to help pay for it. I wish America could wake up, but the entrenched $$ in the existing system makes it unlikely.
laura
@David Anderson: spouse is not actively looking, and I was considering drawing ss, but I’ll hold off for a year to see what shakes out of the Congress.
Wyatt Salamanca
OT
Cheney Reads More Panicked Texts Meadows Received From GOP Lawmakers Urging Trump to Call Off Rioters
h/t https://www.mediaite.com/news/fix-this-now-cheney-reads-more-panicked-texts-meadows-received-from-gop-lawmakers-urging-trump-to-call-off-rioters/
Meanwhile, Mark Meadows continues singing the Ralph Kramden Homina Homina Blues
https://www.youtube.com/watch?v=wK9odsWwfIo
Barbara
@David Anderson: Meaningful difference got a bad reputation with Medicare Advantage plans because the agency administered the concept in a way that made it seem like it was trying to micromanage benefits. Having a broad rule based on the cost of the plan seems like a good way to avoid that kind of accusation.
David Anderson
@Barbara: I agree… and I am not going to say that I’m smart enough as a regulator to say what is meaningful in the details, but I know people buy on price, so that is probably worthwhile to create notable gapping.
Mary G
I do need to thank you, Dave, for getting me to look at my Part D plan a month. The one I had bought in 2006 was awesome then and I just kept renewing. “How different could they be?” I naively asked myself.
They changed me a $480 deductible for the first time this year and still haven’t paid out anything because TFG showed me I didn’t need the HCQ I had taken for years and my rheumatologist and I have eliminated several more prescription drugs as well. The ones I’m still on are old generics not yet plundered by hedge funds.
I went to the .gov site, put in all my drugs and found a whole list of plans almost all with the same deductible but charging substantially lower premiums. I switched and am saving $43 a month. Thanks, D!
J R in WV
Hi Dave,
I just want to thank you for your assistance to the world via Balloon-Juice regarding health insurance!
Very Sincerely,
J R in WV
JoyceH
@Wyatt Salamanca: What I loved about that, though, was the reading of the day AFTER text from the Congressman who was all apologetic because ‘nothing worked’ in their attempt to overturn the election. I’m sure more people than that one Congressman are sweating bullets today. Anyone who ever texted Mark Meadows – the 1/6 committee’s got your texts! (And I’m as certain as I can be that was precisely the point they were making by reading that text in open hearing.)
Parmenides
I swear there must be a reason but I can’t see it for the pricing.
Kaiser DC.
Bronze 320 premium with 7000 deductable
Platinum 520 Premium with 0 deductable.
Obviously the chronic high spending person pick is the platinum. I know someone who takes enbrel and the listed prices of that stuff make the the Platinum plan a deal. But the 520 premium person pays 6840 with copayment for biologic while the bronze could pay with a car accident 10840.
Clearly there is something I’m missing. I get one is 90 percent and the other is probably 70, but I’m not working out the price difference.
David Anderson
@Parmenides: The premium difference between Bronze and Platinum is usually relevant for a fairly small band of medical expenses if someone is paying full premium.
Bronze is great if you know you’re a train wreck with $100,000+ claims or have very little to no medical expenses. But it exposes you to big shocks of medium expenses. Platinum and Gold reduce the scope and scale of those shocks.
No name
@David Anderson: I was unemployed this year and didn’t know about the $0 silver plan option. Been paying for a bronze plan all year, not very expensive but not zero! How do people find out about things like this?
David Anderson
@No name: it was in the newspaper as part of the ARP
David Anderson
@No name: you should get the premium back when you file your taxes
No name
@David Anderson: Thanks! I spent most of this year in a panic so I’m not surprised I missed this. Think I’ll not do my own taxes next year.