November 4th, 2019 BY HealthNetwork
As the holidays arrive, your first thoughts are likely more family, presents and parties! than health insurance. If you don’t have coverage through work, though, this would be a good time to move insurance to the top of your holiday to-do list. Feeling secure about your health insurance for next year will help you enjoy the holidays more, especially as you drive on icy roads, attend parties where germs circulate as freely as drinks, and think about your friends, family and loved ones.
What makes the timing of this so important is that the open enrollment period for major medical insurance sold on and off ACA exchanges runs during the holiday season, and if you miss it, you might miss out on coverage for 2019. Ready to add health insurance to your shopping list? Make sure you know what to look for.
Health Insurance Options
Health insurance is offered through government programs and private insurance companies. Just as holiday gifts range from economical to extravagant, so health insurance plans range from free or inexpensive plans available to people who qualify for various subsidies to private insurance plans that are designed for a wider range of budgets.
Comparison shopping is just as important for health insurance as for presents. If you’ve ever bought flat pack furniture, batteries-not-included devices, or anything that requires masses of expensive accessories or add-ons to function, then you know that it’s important to look at ease of use issues (such as number or providers for a health plan) and what’s not included as well as what’s being promoted. In short? It’s easy to miss the details when you’re blinded by a low monthly price. Do some digging to find the kind of coverage you really need.
Recent regulatory changes and weakening of consumer protections make it especially important to read through the fine print and pick your insurance plan carefully. On a positive note, along with having a plethora of insurance options to choose from these days, you can shop for them conveniently online or by phone, avoiding holiday crowds and traffic.
Affordable Care Act (ACA or Obamacare)
The ACA, a landmark piece of legislation signed into law by former President Obama on March 23, 2010, created a network of health insurance “marketplaces” or “exchanges” that enable people to buy insurance offering a wide range of essential health benefits, regardless of pre-existing conditions. Under the ACA, people who earn up to 400 percent of the federal poverty level may be eligible for subsidies. These reduce the monthly premium cost, making insurance more affordable. About 83 percent of the people who shop on the exchanges qualify for these subsidies.
Many private insurance companies offer plans under the ACA federal or state exchanges. These plans are organized in tiers, from bronze to platinum, with some having higher premiums but lower deductibles and copayments and others having higher premiums and lower deductibles and copayments. There are even “catastrophic” plans designed for people under 30 or those dealing with financial hardship with very affordable premiums.
The exchanges aren’t the only place to buy an ACA-compliant plan, though. Private marketplaces also exist – and existed before the ACA – to help people find coverage that still meets the standards and requirements of Obamacare. (You’re on one right now.) You can even apply for subsidies for Obamacare policies without having to apply directly on the ACA exchanges, but you’ll need some assistance from an agent or broker to do it.
And of course, you can always go to an individual insurance company and sign up for a plan that way. The downside to this method is that you won’t get to compare any other plans against the company’s own offerings, which means you could lose out on a better deal (and you won’t get those subsidies we mentioned). But if you like a certain company, this is an option.
Bottom line? The private health insurance market is wide open for consumers, and it’s getting even better. More insurers are participating on the exchanges for 2019, giving people better access to more options than they had last year. Plus, average nationwide premiums dropped slightly for next year (a first since the ACA took effect), so you’ll have a good chance of finding affordable coverage in 2019.
Medicare is a program available to senior citizens, people who qualify for Social Security disability payments and those with end-stage renal disease. If you qualify, you can choose between original Medicare, a program run by the government, or Medicare Advantage plans offered by private insurers.
While Medicare Advantage plans typically include a lot of benefits that original Medicare doesn’t, such as prescription drugs and hearing and vision benefits. With original Medicare, you may also need to add a private Part D (prescription drug) plan and supplemental Medigap coverage for things not included in original Medicare (Parts A and B).
As choosing Medicare coverage is very complex, one of the best gifts you can give seniors on your holiday list is help with sorting through all the options and calculating the costs of various plans. If you’ve got friends or family nearing Medicare eligibility, check out our sister site for more information on this affordable health insurance program for seniors
Medicaid and CHIP
Part of the social safety net and created at the same time as Medicare, Medicaid was designed for people living in poverty. If your modified adjusted gross income is below 100 or 138 percent of the federal poverty level (depending on your state) for your household, you’re eligible for Medicaid. Enrollment is open year round, but if you are eligible, don’t wait until after the holidays. Gift yourself with peace of mind so you don’t need to be worrying about medical care when you should be enjoying time with friends and family.
If you don’t qualify for Medicaid but you can’t afford health insurance, see if you can enroll your child into the Children’s Health Insurance Program (CHIP). This program was specifically created for children of families who can’t afford coverage but can’t qualify for Medicaid. As with Medicaid, you can apply for CHIP at any point in the year.
Veterans Health Administration (VA)
VA health insurance is designed for those who have served in the U.S. armed forces. If you or your spouse is an honorably discharged veteran, you may be eligible for free VA health insurance and other benefits. Check in with your local VA office for more information about programs available to you.
Short Term Health Insurance
Insurance companies offer a wide range of products, including short term health insurance. If you miss the open enrollment period, you still have the option of investing in a short term health insurance plan that can protect you in case of emergencies. And this time of year is packed with unexpected mishaps – from falling off your ladder as you string lights outside to burning yourself while pulling another batch of Grandma’s classic shortbreads out of the oven.
There are lots of benefits to short term coverage. And while it’s true that this kind of protection isn’t good for long-term health problems or to replace major medical, it can be a good alternative as a safety net. It’s much less expensive than major medical, it protects you in cases of emergencies or unexpected illnesses, and you can buy it anytime of the year. Plus, new rules under the Trump administration make it so you can buy these plans for up to 364 days in most states, and they can be renewed for up to 36 months.
Don’t rule short term out. If you don’t want or can’t afford major medical, adding short term health plans to your shopping list can give you adequate protection this holiday season (and beyond).
Happier Holidays with the Right Coverage
No matter what your individual circumstances, you and your family will be happier and safer during the holidays if you move health insurance to the top of your holiday list. The best present anyone can enjoy is good health or good care in case of illness or accidents, without worries about unanticipated healthcare costs.