Last Updated March 25, 2019
Do You Need New Health Insurance Coverage? Here’s What to Do
You’ve settled into the new routine, and you think you’re all set when it comes to health insurance – until you realize you forgot to include your spouse and kids when you re-enrolled in your company health plan or signed up for private coverage – or maybe you looked at your medical expenses so far this year and realized that your health insurance plan just isn’t fitting into the budget.
Now that open enrollment season is over nationwide, there’s not much you can do about that mistake when it comes to getting comprehensive benefits. But there may be hope for getting some an alternative type of coverage in place for you and your family.
How to Choose a Plan
First thing’s first: Know what you need. Insurance plans differ in both cost and coverage. Before you choose a plan, consider what you need in terms of coverage. Plans with more comprehensive coverage, greater choice of providers and lower out-of-pocket costs have higher premiums. High-deductible policies tend to cost less, but you’ll pay more out of your own pocket for these plans. And short term health insurance covers less but also costs much less than major medical policies. Other variations include:
- Provider choice: Some plans only cover specific providers. Others offer access to a wider range of providers but may charge more for people and practices outside your policy’s network. If you have a specific doctor that you like, make sure your health plan includes that provider.
- Prescription drugs: Major medical policies cover prescription drugs by law, but not every plan covers the same level of drugs for the same cost. Short term health insurance plans may not cover prescription drugs at all – though some include prescription discount cards that can be used to curb medication costs.
- ACA compliance: While all plans compliant with the Affordable Care Act (ACA) cover the 10 essential health benefits, such as maternity care and preventive services, non-compliant plans – short term health insurance, for example – may not cover essential services.
Weigh the cost of a health plan critically. The total cost of insurance for your family members isn’t a single number but rather a combination of different factors, including:
- Premiums – the monthly fee you pay to have insurance
- Deductible – the threshold you have to meet (out of pocket) before your health insurance company pays its portion of your medical bills
- Copays and coinsurance – your responsibility for your medical bills once you’ve met the deductible
- Out-of-pocket maximum – the limit on how much you’ll have to pay out of pocket in a year for covered services (usually only applies to major medical policies, not short term plans)
- Annual or lifetime cap – the cap on how much an insurer will pay out in covered benefits (only applies to short term health insurance)
Affordable Health Care Act Marketplaces (Exchanges):
We mentioned earlier that the only time to buy a health plan on the Affordable Care Act exchanges is during open enrollment, and that’s true. But there are exceptions if you experience a qualifying life event, such as getting married, adopting a child or losing your job. In these instances, you’ll have access to a special enrollment period, usually about 60 days from the date when your event happened, to sign up for a plan on the private market (on or off an Obamacare exchange).
Outside of the open enrollment period or a special enrollment period if you qualify, you can’t access Obamacare exchanges or private marketplaces for major medical coverage. If you missed enrollment and don’t qualify for a special signup period, you’ll have to find a different plan for your spouse and kids until November, when you can sign up for major medical again.
Other Government Programs
You may have luck trying a government program for health insurance. Medicaid and CHIP allow enrollment all year. Just note that government programs hold different eligibility requirements, not only from state to state but from program to program. Options could include:
- Veterans Health Administration: Families and dependent children of veterans may be eligible for free or subsidized insurance through the VA. Contact your local VA office for more information about this program.
- Medicaid: This joint federal and state program is available to people below a certain income or with certain disabilities. If you have recently married or expanded your family, you may qualify for Medicaid even if your income is unchanged, because the income qualifications are based on household size. Specific guidelines vary by state, but many states expanded their programs under Obamacare, which means you might qualify now even if you never did before.
- Children’s Health Insurance Program (CHIP): Even if you and your spouse are not eligible for Medicaid, your children may still be eligible for CHIP, a program designed to insure children whose parents may otherwise be unable to afford insurance. Eligibility varies by state, so check with your state’s Medicaid office for more information.
Private insurance companies sell health insurance directly to individuals and families, either directly through their own websites and agents or through independent marketplaces, like ours. Private marketplaces offer full ACA-compliant plans similar to the ones offered by employers and on government exchanges. They may also sell short term health insurance.
If you qualify for a special enrollment period and can sign up for major medical, look into an independent marketplace for help. Our site lets you browse plans from a variety of companies, so you might not be limited to just one or two insurers like you could be on an Obamacare exchange.
Short Term Health Insurance
If you don’t qualify for any government program and your family is stuck without coverage until the fall, consider short term health insurance as a viable alternative. These plans get a lot of heat from lawmakers and ACA advocates, but they’re not junk insurance. They’re just a different kind of health plan, one that covers emergencies and unexpected medical crises instead of routine, everyday care.
These plans also cost a fraction of traditional health plans (because they cover less) and can be purchased for terms as little as 30 days and up to just under a year depending on where you live. They’re also renewable for up to 36 months now thanks to expanded regulations under the Trump administration. This gives you plenty of time to keep a policy in place until open enrollment in November.
Note that short term health insurance doesn’t work for everyone. If you have a serious or chronic medical condition or need costly care on a regular basis, short term coverage likely won’t cover it. Because short term policies aren’t regulated like major medical plans, they don’t have to follow the ACA guidelines. This means insurers can deny you coverage or set higher rates if you have a pre-existing condition, and what counts as a pre-existing condition is up to insurers.
Just know upfront that you’re paying for a safety net, not a comprehensive benefits package. Short term plans might not cover everything you need, but they should cover accidents and unexpected illnesses until you can get a more comprehensive plan later.
Protecting Your Family
While you hope that you and your family will never need to use your health insurance for anything other than routine preventive care, people do develop unanticipated medical conditions or have accidents requiring more extensive care. As the consequences of being uninsured can be devastating to your physical and financial health, it’s worth taking the time to investigate all the options for obtaining insurance for your family even if you’ve missed open enrollment this year.
Last Updated December 18, 2018
New State Deadlines to Enroll in ACA Plans Released
A handful of states across the country have extended the deadline to enroll in Obamacare for the 2019 calendar year. Check out if you get a little more time to enroll in a major medical plan by reviewing the graph below.
2019 Open Enrollment Period State Deadline
Obamacare Just Took a Hit – But Nothing’s Final Yet
Late Friday night, December 14, a federal district court judge in Texas ruled that the Affordable Care Act (ACA or Obamacare) was unconstitutional. Earlier this year, 18 state attorneys general and two governors had brought a lawsuit against former President Obama’s signature healthcare law on the grounds that the Tax Cuts and Jobs Act of 2017 rendered the whole thing invalid. We wanted to unpack this big news for you, but first thing’s first: Obamacare is still in effect. Nothing changes immediately. And with an impending appeal from defendants in the case, it’s unlikely that the ACA will meet its demise – at least anytime soon.
That said, the decision alone, permanent or not, could create a bit of chaos in the individual market. For starters, the judge’s decision came in only a day before the open enrollment period for private health insurance ended nationwide. A handful of states with their own exchanges have longer signup periods, but for the most part, open enrollment ended on December 15.
Already, it’s been a tough enrollment season if we’re just looking at the reported tally so far from the Centers for Medicare and Medicaid Services, which oversees the exchanges. As of the latest figure, a little over 4.1 million people had signed up for health insurance since the enrollment period started on November 1. By contrast, at around the same point last year, over 4.6 million people had signed up for coverage, a difference of over 500,000 people. It’s unlikely that the final week of enrollment would see a significant boost, although latecomers could bump the final tally.
This figure includes people using HealthCare.gov, which is the federal platform. Numbers aren’t in for state-based exchanges, and final numbers won’t be in until probably spring.
The Trump administration cut funding for navigators, the organizations and people who help consumers enroll in ACA plans on the exchanges, substantially last year and again this year. There’s also been little push from the current administration for people to seek coverage through the exchanges. Instead, there’s been a shift in focus on short term health insurance, a less expensive alternative to major medical coverage that doesn’t cover the same benefits or guarantee the same protections that consumers have under the Affordable Care Act.
The administration is also encouraging states to seek innovation waivers to design their own state-based health insurance systems. Some states have already implemented reinsurance programs and other measures – like Medicaid work requirements – to save money on healthcare costs.
It’s no secret that President Trump and conservative lawmakers have been doing their best to undermine and weaken Obamacare, with the ultimate goal being to eradicate it altogether. This effort to repeal the ACA predates Trump and in fact goes all the way back to the law’s inception. So far, opponents of the ACA have been unsuccessful in eliminating the healthcare law entirely. But this latest court decision in Texas could hold some weight.
The decision is based on an idea that came about through a separate legal challenge to the ACA in 2012. In that case, the Supreme Court ruled that the ACA was constitutional because the individual mandate, a key component of the law that compelled people to have health insurance or face a penalty fee when they filed their taxes, was considered a tax. As such, the law was constitutional because Congress has the power to levy taxes.
When the individual mandate got zeroed out as part of the Tax Cuts and Jobs Act of 2017, Republicans again brought suit against the ACA, this time asserting that because the tax no longer existed, the law couldn’t stand on its own.
A Texas federal district court judge agreed with plaintiffs, issuing a ruling on December 14 in support of their challenge. Earlier this year, the Justice department said it would not defend the law in this lawsuit, which is an unusual approach from an acting administration.
To add insult to injury, the Trump administration also argued that while it disagreed with the lawsuit on principle – that the ACA couldn’t stand on its own without the mandate – it thought that the law’s guaranteed issue protections should be eliminated on the grounds that they were tied to the mandate. In other words, the current administration will not defend the ACA against the lawsuit and instead argued that protections for people with pre-existing conditions should be eliminated.
California has already said it plans to appeal the decision, which could end up before the Supreme Court, although not anytime soon. Judgment isn’t immediate, and lower courts could still disagree with the federal judge’s decision.
We wanted to highlight this story because it’s relevant to the health insurance industry, but we also wanted to point out that nothing changes for consumers right now. Everything remains the same until we get final word – and a final decision – on the healthcare law.
If you live in Rhode Island, your enrollment period ends December 31. Residents of California, Colorado, D.C., Massachusetts, Minnesota and New York have until various points in January to sign up for health insurance for 2019 – check out our handy chart here.
For most of the country, open enrollment has already ended for next year. Unless you qualify for a special signup period based on a major life event, like moving, losing your job or getting married, you won’t be able to get major medical coverage until next year. But thanks to that individual mandate repeal, you also won’t be charged a penalty because you don’t have health insurance.
2019 Open Enrollment Period Ends Tonight
Unless you live in one of a handful of states, your last day to apply for an Obamacare (Major Medical) plan is midnight tonight – December 15th – local time.
Obamacare Enrollments On Healthcare.gov Are Down Through First Week Of Open-Enrollment
The Centers for Medicare and Medicaid Services (CMS) released its weekly snapshot for open enrollment 2019 this week, an annual tradition that captures raw signup numbers for HealthCare.gov. Using data from the 39 states that use the federal health insurance exchange created under the Affordable Care Act, the CMS reports that this year’s signup season is off to a sluggish start compared with previous years.
At the end of week one, just 371,676 people had enrolled in a health plan for 2019 using the federal exchange. Last year during a similar time frame, over 600,000 people had signed up. This year’s first week of open enrollment spanned just three days while the 2017 signup season spanned four. Enrollment data is reported from Sunday to Saturday each week. Since the 2019 open enrollment period started on a Thursday, data is only available for the first three days of the month.
That disclosed, the numbers are down, even when factoring in one fewer day than last year’s enrollment kickoff. In 2017, the first four days of open enrollment saw an average of over 150,000 consumers pick a health plan for the year. This year’s average isn’t as promising at just under 124,000 people per day.
These are raw averages, though. Consumers may flock to HealthCare.gov on a weekend day, for example, when they have time off from work, instead of a weekday, making averages a relatively useless way to identify enrollment activity. Nevertheless, fewer people enrolling overall signals some problems with the 2019 open enrollment period at the outset.
On a more positive note, the number of new customers – represented as a percentage of the total number of enrollees – increased during the first week of enrollment this year. Of the people who signed up during the first three days, 24 percent were new to the exchange. Last year, 22.8 percent of exchange customers were new during the first four days.
A slight boost in new enrollees is actually a promising sign given the Trump administration’s aggressive actions to undermine outreach efforts for the Affordable Care Act. Having slashed funding for advertising and navigator assistance last year, the CMS raised the stakes even higher for 2018. In September, the agency announced that funding for navigator programs across the U.S. would be cut down to $10 million, a reduction of about 84 percent since 2016. Three states – Iowa, Montana and New Hampshire – received no funding at all for navigator programs.
Navigators help people understand (“navigate”) Obamacare and enroll in health plans on the exchanges. They are not licensed agents, but they serve an important role in raising awareness about the health law for consumers.
The CMS argued in its justification for the funding cut that navigators don’t need to spend as much face time with consumers since public awareness of the ACA has increased with time. The agency also reported that navigators don’t play as big a role as brokers in helping people find health insurance.
The Trump administration continues to tout access, affordable alternatives and choice as benchmarks of a successful health insurance marketplace. As the second week of open enrollment wraps up (the first full week measured from Sunday to Saturday), it will be interesting to see how navigator cuts, the midterm elections and other factors influence signups for 2019.
Our 2018 – 2019 Guide To Safely Enrolling In Obamacare
It isn’t often that we get to kick off our Annual Obamacare Open-Enrollment announcements with some good news, but that’s precisely what is occurring today. So first and foremost, without question the best news we have to share, is that Obamacare plans are declining in price in some states for the first time ever. Even in states where rates are not declining, the states that have an average increase, it is relatively modest. On a national level, there’s about a 5% increase in average premiums. While we do agree that 5% is in fact additional cost, it pales in comparison to some of the increases of the past, which on a national level exceeded 25% in some years.
Below we break out all of the different rate increases and decreases on a state by state basis. You will notice two different sets of percentages per state. One rate is reflective of CSR (cost-sharing reduction) payments being made to the government by the Trump Administration, and one rate without. It is unlikely that the CSR payments will be made, just like they were not paid last year.
Before you focus entirely on the rate chart, we wanted to take a moment and issue a serious consumer warning regarding some negatives about this coming open-enrollment. We strongly advise you to read this entire update, as it could help you avoid some serious headaches when it comes time for you to shop your options and see what plans are available.
Obamacare Rate Changes By State For 2019
|STATE||Approved Rate Change For 2019 With CSR Payments||Approved Rate Change For 2019 Without CSR Payments|
|Alabama (AL) 2019 Obamacare Rates||-16.41%||-2.01%|
|Alaska (AK) 2019 Obamacare Rates||-9.60%||-3.90%|
|Arizona (AZ) 2019 Obamacare Rates||-18.97%||-5.27%|
|Arkansas (AR) 2019 Obamacare Rates||-7.96%||4.54%|
|California (CA) 2019 Obamacare Rates||5.20%||8.70%|
|Colorado (CO) 2019 Obamacare Rates||-5.10%||5.94%|
|Connecticut (CT) 2019 Obamacare Rates||7.43%||12.30%|
|Delaware (DE) 2019 Obamacare Rates||-7.00%||3.00%|
|District of Columbia (DC) 2019 Obamacare Rates||6.42%||15.52%|
|Florida (FL) 2019 Obamacare Rates||-2.50%||8.80%|
|Georgia (GA) 2019 Obamacare Rates||-5.82%||6.14%|
|Hawaii (HI) 2019 Obamacare Rates||3.82%||13.82%|
|Idaho (ID) 2019 Obamacare Rates||-2.78%||8.00%|
|Illinois (IL) 2019 Obamacare Rates||-12.18%||0.72%|
|Indiana (IN) 2019 Obamacare Rates||-7.90%||5.10%|
|Iowa (IA) 2019 Obamacare Rates||-5.00%||3.00%|
|Kansas (KS) 2019 Obamacare Rates||-3.49%||6.11%|
|Kentucky (KY) 2019 Obamacare Rates||-0.35%||12.15%|
|Louisiana (LA) 2019 Obamacare Rates||-15.70%||-6.40%|
|Maine (ME) 2019 Obamacare Rates||-8.99%||1.01%|
|Maryland (MD) 2019 Obamacare Rates||-6.56%||0.55%|
|Massachusetts (MA) 2019 Obamacare Rates||4.12%||4.12%|
|Michigan (MI) 2019 Obamacare Rates||-3.44%||1.69%|
|Minnesota (MN) 2019 Obamacare Rates||-15.40%||-8.00%|
|Mississippi (MS) 2019 Obamacare Rates||-9.85%||0.15%|
|Missouri (MO) 2019 Obamacare Rates||-10.32%||1.88%|
|Montana (MT) 2019 Obamacare Rates||-3.90%||6.00%|
|Nebraska (NE) 2019 Obamacare Rates||-12.60%||1.00%|
|Nevada (NV) 2019 Obamacare Rates||-7.70%||2.30%|
|New Hampshire (NH) 2019 Obamacare Rates||-26.33%||-13.47%|
|New Jersey (NJ) 2019 Obamacare Rates||-9.20%||-9.20%|
|New Mexico (NM) 2019 Obamacare Rates||4.02%||10.02%|
|New York (NY) 2019 Obamacare Rates||8.60%||8.60%|
|North Carolina (NC) 2019 Obamacare Rates||-8.10%||-4.10%|
|North Dakota (ND) 2019 Obamacare Rates||-15.38%||7.42%|
|Ohio (OH) 2019 Obamacare Rates||-4.90%||6.30%|
|Oklahoma (OK) 2019 Obamacare Rates||-14.31%||-1.91%|
|Oregon (OR) 2019 Obamacare Rates||1.20%||7.30%|
|Pennsylvania (PA) 2019 Obamacare Rates||-5.52%||0.70%|
|Rhode Island (RI) 2019 Obamacare Rates||8.86%||9.66%|
|South Carolina (SC) 2019 Obamacare Rates||-2.28%||9.22%|
|South Dakota (SD) 2019 Obamacare Rates||-10.86%||3.54%|
|Tennessee (TN) 2019 Obamacare Rates||-22.79%||-10.79%|
|Texas (TX) 2019 Obamacare Rates||-10.61%||1.52%%|
|Utah (UT) 2019 Obamacare Rates||-14.00%||0.49%|
|Vermont (VT) 2019 Obamacare Rates||1.65%||6.06%|
|Virginia (VA) 2019 Obamacare Rates||-2.70%||11.34%|
|Washington (WA) 2019 Obamacare Rates||5.08%||19.08%|
|West Virginia (WV) 2019 Obamacare Rates||1.55%||14.85%|
|Wisconsin (WI) 2019 Obamacare Rates||-16.50%||-3.50%|
|Wyoming (WY) 2019 Obamacare Rates||-12.65%||-0.25%|
There have been two key things that have occurred that will have a material impact on this open-enrollment for the 2018 and 2019 OEP.
Short term health insurance has been deregulated, which in our opinion, is better than how it was set previously. Under the new regulations, consumers can now sign up for a short term health plan for up to twelve months, instead of being limited to three months. We think that long term, that is better compared to limiting these plans to three months. Now here’s the downside of this deregulation it encourages the shady operators and companies in the health insurance industry to use misleading practices, or outright false information in their marketing materials. They will often try to steer you towards some kind of alternative plan, from a company you have never heard of. Some sites will make it seem as if they are associated with a government entity, and also require you to disclose any pre-existing conditions that you might have, simply before giving you a health insurance rate quote. Don’t be fooled. HealthNetwork has never required consumers to disclose if they have a pre-existing condition. We do not require that information in order to provide you with accurate rates. The only time you should be required to disclose if you have a pre-existing condition, is on your actual short term insurance application.
The other issue, is that most of these companies will often collect your information, and then immediately resell it to a third party, who then does the same thing. Then your phone starts ringing, and ringing, and ringing, for what can sometimes be, days on end. We do not do that. Our goal is to provide consumers with factual information and access to reputable, licensed, health insurance professionals. These are highly vetted companies that have too much to lose by using slimy business practices.
So What Does This Mean For Enrolling In An Obamacare Plan?
What this means, is that it is now even more critical that you be extremely discerning with respect to who you interact with online, or over the phone. At HealthNetwork, parent company of this website, we have made a very clear distinction as to whom it is that we feel is best serving consumers with regard to short term health insurance. Those companies are National General, and United Healthcare. They are both multi-billion corporations, and frankly speaking, when it comes to health insurance that isn’t as tightly regulated as ACA plans are, which short term health insurance is not, we feel that it is best to go with a well established company. United Healthcare Short Term Health Insurance, and National General Short Term Health Insurance, are, in our opinion, the best options for an alternative to Obamacare.
Why Should You Trust What We Have To Say?
For one, we are very transparent as a company and as an organization. We don’t hide who we are, nor do we make it difficult to get in contact with us. We are also very clear about our business practices, and that we DO NOT resell consumer data and create that toxic experience where you phone rings non-stop. We choose to place the consumer experience above everything else, and the end result, is that we have become a company that more than 15 million consumers rely on annually for help regarding their health insurance. A lot of this is from word of mouth referrals. For nearly six years, essentially as long as Obamacare has been around, we have been providing consumers with a safe and secure way to research their options under Obamacare. Now, with the expansion of short term health insurance, we felt it was imperative that we provide factual information on short term health insurance, and highlight in detail, all of it’s positives, and negatives.
Having this consumer focused approach is why this website, and our parent company, HealthNetwork, have been featured on some of the following national news sites as a helpful resource regarding information regarding Obamacare and health insurance in general.
– Huffington Post
– National Review
– The Boston Globe
Something Else That Is Extremely Important About This Open Enrollment For 2018 and 2019
Rates have declined in many states, and others they have not, but one additional thing that has occurred that is actually a positive, is that there are now more insurance carriers participating within the marketplace that last year. While some carriers are still not participating with the on-exchange (Obamacare) segment of the business, some, for example, Oscar Health Insurance, are actually jumping into new markets. Any time there are more companies participating within a market, that means (typically) more competitive pricing and benefits for consumers.
Either way, there are now more legitimate reasons why consumers should be seeking out pricing information and plan comparisons. Again, we advise that you do so carefully. For some individuals and families, they may qualify for an Obamacare plan at little to no cost, thanks to subsidies provided by the Affordable Care Act, aka, Obamacare. How much cheaper your insurance is, depends entirely on how much money your household makes, and the total number of individuals within the household. The state and more importantly county, that you are located in, also makes a difference as well. The point of telling you this is for the following reason. It IS CRITICAL that your household eligibility information be 100% ACCURATE and updated for the 2018 – 2019 season. If we have outdated information regarding your income and household, then we can not provide you with accurate information on what the final cost will be when subsidies are factored in. When open-enrollment kicks off, we will send you an email with a link to where you will be able to go to see what your options are, based on the submitted household data. As long as your profile has been updated for 2018, then you will be able to compare accurate health insurance rates, for all available health insurance carriers.
You can use the form below to update your household census information for the 2018 – 2019 open-enrollment season.
Again, at HealthNetwork, we are, and always will be a consumer focused entity who strives to go above and beyond in our effort to make obtaining health insurance, not be so darn difficult. It doesn’t have to be, and we’re doing everything we can to be as helpful as possible. Helping you before we help ourselves has always been our #1 priority.
Why? Because People Matter.
Previous Updates Prior to 9/4/2018 Listed Below
The 2019 Open Enrollment Period is Right Around the Corner and With the Expansion in the Short Term Health Insurance Rules, You’ll Have More Options Than Ever!
HHS announced on Wednesday, August 1st that it was reversing the 2016 rule that limited all short term health insurance plans to three-month terms.
The new rule:
- Allows for people to have a short term health insurance plan for 364 day-terms
- Allows for people to renew their short term health insurance plan for 2 years, or a total coverage period of 3 years (36 months)
- Consumers can start to buy these 364-day short term plans on October 1, 2018.
Short term health insurance is a health plan that acts a lot like major medical plans (Obamacare plans), but it typically does not cover pre-existing conditions or pregnancy. These plans are oftentimes half of the cost of an Obamacare plan and they can start next day. There’s also no enrollment period and you can cancel at any time.
Despite the fact that these plans did not qualify as compliant coverage under Obamacare, which means that people with short term health insurance plans would be penalized under the individual mandate, these plans were still a great fit for some people. But, after a ruling by the Obamacare administration in 2016 limited their term to only three-months, many people found the plans to be unhelpful. The biggest issue with the three-month term limit was the fact that the deductible requirements would start back over again at the end of every term. Some carriers found ways around that if a person was signing up for a consecutive term, but it was still less coverage than you would get under Obamacare.
Short term health plans made a bit of a come-back and their attractiveness increased in 2017 and 2018 when their low prices outweighed any of the negatives when compared to the high prices of Obamacare plans, particularly for people who were not eligible for sufficient subsidies.
The 2019 Open Enrollment Period starts on November 1st. People will be able to start buying these new, longer duration short term health insurance plans on October 1st, which means that when consumers are weighing their options for health insurance in 2019, they will not only have Obamacare plans to consider, but also short term plans.
For the 2019 calendar year, it doesn’t matter whether a consumer picks an Obamacare plan or a short term plan because there’s no individual mandate penalty for being uninsured or having insurance that doesn’t meet the requirements of the Obamacare law starting on January 1st, 2019.
Open Enrollment For Obamacare Has Ended – What To Do If You Didn’t Sign Up In Time
Friday, December 15th was the last day of the 2018 Open Enrollment Period. If you didn’t get health insurance coverage but still want it, you’ll need to check out an Obamacare alternative called Short Term Health Insurance.
Otherwise, if you wish to enroll in an Obamacare plan after December 15th, you are required to have what is called a qualifying life event (QLE). This is a life event that allows you to sign up for health insurance (Obamacare) outside of open-enrollment. In previous years, often individuals would end up finding a health insurance broker to help them find a way around this regulation. Within the last 12 months, however, CMS has cracked down on these practices, because often individuals would simply wait until they needed some kind of medical care or a procedure, and then sign up, and then stop paying for their coverage when they no longer needed it. These type of practices make health insurance costs incredibly high for everyone else who is doing the right thing and keeping their coverage year round, which is why CMS is taking such a hard line on this issue.
If you missed open-enrollment through no fault of your own, you may have the ability to get an exemption that allows you to still sign up. If you don’t, however, qualify for an exemption, a short-term health insurance plan, or better yet, a bundled plan that combines short term with some other benefits, really is going to be your best option. That said, the industry is littered with some very crappy plans being marketed in ways that we do not agree with. Below we will explain what we feel is the best approach when it comes to exploring alternatives to Obamacare.
Pros And Cons Of Short Term Health Insurance – How To Get The Best Coverage Possible In 2018
Pros of Short Term Health Plans – And Obamacare Alternatives
- Lower Premium Costs: Short term health insurance plans, and or supplemental insurance plans and bundles, can often offer excellent coverage at half the cost of an Obamacare plan. This is particularly true for anyone who doesn’t receive a substantial subsidy.
- Access To Doctors And Hospitals: Now this is one area where you have to be careful about reading the fine print, thankfully, we’re doing a lot of that for you, by helping you bypass the plans that are not worth considering. Of the short-term-health-insurance plans, or Obamacare alternative plans, that from great insurance carriers, the level of coverage and access to doctors and hospitals that they provide, is excellent. Just note, that it is really important that you (in our opinion) only go with a plan from a large well-established provider. There a lot of smaller short-term plans hitting the market, and a few have come and gone already. That’s why we feel it is best to go with a short term health plan, or bundle, from a large national insurance carrier, whom you can have confidence is going to remain in business indefinitely.
- Out of Pocket Costs: A lot of these plans, particularly, health insurance bundles, which are often short term health plans combined with additional coverage policies that help pay for out of pocket expenses, will result in much lower overall costs compared to ACA plans, which are often complained about as having out-of-pocket expenses that make the coverage too expensive to use.
Cons of Short Term Health Plans – And Obamacare Alternatives
- No Coverage For Pre-Existing Conditions: Plans that are alternatives to Obamacare, almost never provide coverage for any serious pre-existing condition. So if you have serious health problems, or even ones that are not life-threatening now, but could be later, like diabetes, one of these alternatives is most likely not going to be a fit for you. That said, it doesn’t hurt to have a conversation with a licensed health insurance professional, because some conditions will be covered and some will not. We feel the best thing to do, is to connect with a company who can help you enroll in both types of plans, an ACA plan, as well as an alternative. We can help you connect with a company who can provide precisely this level of service.
- ACA Alternative Plans Do Not Cover Pregnancy: So if you are expecting, or planning on expecting, you should consider exploring a plan through the ACA, or a group health insurance plan that does cover pregnancy.
- Crappy Plans With Limited Benefits: There’s a lot of junk coverage hitting the market from companies that to be totally candid, we just don’t understand how their executives sleep at night. Plans that are marketed under familiar names, but with benefits that really aren’t going to help anyone in reality, certainly in a medical emergency. We can’t name-names, but what we can do is give you an example of one such plan that is marketed as an alternative to Obamacare, where it is hard to determine where the value is. If a plan that costs $200 a month, but offers a maximum of $200 a day if you are hospitalized, up to a maximum of 20 or 30 days. That’s a plan with questionable value. Why? Well if you are hospitalized at all, your daily out of pocket costs will be in the thousands, not the hundreds. Unless that plan comes along with a time machine to take you back to 1905, $200 a day doesn’t get you much coverage in a hospital. So it is very much buyer beware, and again, we will repeat this often, if we had to make this decision for ourselves, we would be going with a large national brand, with a wide range of coverage and benefits.
In previous years, short term health insurance was not a good option for people who were concerned about the individual mandate because short term plans do not comply with the Affordable Care Act, which means that you would be penalized if you had one instead of an Obamacare plan. However, Congress repealed the individual mandate requirement in their tax bill, which was signed into law by President Trump on December 22nd, so this means you can get any type of health insurance plan that you want without fear of being taxed for not complying with the Affordable Care Act.
Short term medical insurance is an interesting health insurance option for a lot of families because it is more affordable than a regular, major medical plan. Short term medical insurance has the same, up front benefits that a regular, major medical plan (Obamacare plan) has, meaning that you can go to the doctor and present your insurance card to the medical provider and your plan will cover the portion of the medical expense that it is responsible for and you will pay the rest in the form of a deductible or copay or coinsurance, similar to major medical plans.
If you need prescription drug coverage, that is available in some short term health insurance plans as well.
It’s important to make sure that you’re insured at the end of the day. Facing a medical emergency without any kind of health coverage could be devastating to your bank account and your ability to get access to the healthcare you need to get better quickly.
Everything You Need To Know About Obamacare’s Open-Enrollment (And How To Avoid Having A Horrible Experience Trying To Get Healthcare)
As if healthcare were not already complicated enough, we at HealthNetwork (the company responsible for publishing the guide to Obamacare enrollment and other information on this website) just can not imagine a way in which this enrollment year could be any more complicated than it already is. First of all, let’s start off by disclosing that we’re most likely in the exact same situation that you are, so we feel your pain.
HealthNetwork was founded because the team of dedicated individuals working within it saw a real need for a company to exist in healthcare that could help consumers in ways that the government exchanges and existing insurance brokers could not. HealthNetwork is unique in that we are neither an insurance broker nor a lead generation company. Instead, our mission has been to help consumers avoid some of the common pitfalls that can await them when it comes time to enroll in a health insurance plan.
What are some of those pitfalls? Well, we want to keep this brief, but here’s a list of some of the areas where consumers can run into an issue.
How Does HealthNetwork Make Healthcare Less Of A Headache?
Not every insurance broker, or insurance carrier for that matter, has the consumer’s best interest at heart. At HealthNetwork, we only work with highly reputable companies. We work with companies who frankly have too much to lose if they were to operate in an unethical manner. We require that these companies comply with the standards that we set, which are put in place to protect the consumer experience and if our partner companies do not comply with these standards, we terminate the relationship and stop working with them.
Lead generation companies, which operate websites that often lead you to believe that you are going to receive pricing information or quotes after you provide them with your personal information, just end up reselling that data to whoever is willing to purchase it. That’s when your phone starts ringing off the hook multiple times a day for weeks on end. It’s a terrible experience that we actually know for certain places peoples lives at risk when it’s done in the healthcare space. We feel so strongly about it that we spent $100,000 producing a viral video explaining why we’re different and why “lead generation” sucks for the consumer. Here’s a link to the most honest commercial ever about Lead Gen.
Government can be great, but they often miss the mark when trying to execute on highly complicated initiatives like healthcare reform. It doesn’t matter who is running the government, all sides of the aisle routinely shoot themselves in the foot when it comes to healthcare reform. Part of the problem with the state exchanges, as well as the federal exchange, is that they are not really realistic about just how complicated health insurance or healthcare is. It is ridiculously complicated, and consumers are often going to need more than just a website with data in order to make the right decision.
Healthcare.gov and state exchanges do not employ licensed insurance agents to answer the phones and answer questions. So the end result is that the phone support provided by exchanges is turned over to individuals who certainly are trying to be helpful, but legally, cannot advise consumers on what plan might be best for them based on their specific circumstances.
Additionally, depending on the circumstances, in some states you can actually pay less for an off exchange health insurance plan (no subsidies) if you go through a broker or direct to the insurance carrier, and not one of the exchanges because brokers and carriers may have access to more plans than are offered on Healthcare.gov.
Also, we will update you very soon with more information on an interesting circumstance that many more people will face this open enrollment period where, due to some bizarre circumstances driven by politics, there will be more policies available to people for absolutely zero cost per month.
We are always practical and pragmatic, and we ignore the politics surrounding healthcare reform. While we might report on it and comment on it, we are not taking a side in the healthcare debate. As such, we do not believe that we should automatically reject a health insurance plan that does not comply with the standards set by the Affordable Care Act (Obamacare).
We recognize and understand that not everyone can afford an on-exchange Obamacare plan or an off-exchange plan (major medical plan). There are a number of “Obamacare alternatives” or alternatives to major medical health insurance, out there this year and some of them are really great and some of them are complete garbage. Our goal is to help you educate yourself on how to understand the difference and not get duped into buying something that is not a quality insurance product.
Because of everything mentioned above, we felt that there needed to be a company like HealthNetwork to take a practical approach to helping consumers make the best of how difficult healthcare is. So what does that mean exactly?
If you are researching Obamacare health insurance or one of the Obamacare alternative plans, it is probably because you work for a company who doesn’t provide health insurance coverage or you are self-employed or you are currently not working. So the following reasons are all of the different ways in which HealthNetwork and this website, Obamacare.net, can help you this open enrollment period, and frankly year-round.
- Research And Enroll In An On-Exchange or Off-Exchange Major Medical Insurance Plan Through An Online Broker
- Research And Enroll In A More Affordable Alternative Plan To Obamacare or Major Medical Insurance
- Purchase A Health Insurance Plan Direct From An Insurance Carrier
- Speak With A Licensed Health Insurance Agent That Can Have A Detailed Conversation About Your Specific Needs
- Gain Access To Certain Benefits Like Discounted Telemedicine Services, Urgent Care Services, and Prescription Discounts
Some important disclosures, we are in fact a for-profit business. We do get compensated by some, but not all of the entities that we direct consumers to. That said, since our company was founded in 2013, we have sacrificed tens of millions of dollars in revenue by doing right by the consumer and trying our best to treat the consumer exactly how we would want to be treated. That’s not an exaggeration, it’s just a fact. If we didn’t care about people, we would would not put things in place like the HealthNetwork Gives Back Program.
Our focus is to always be a sort of Swiss Army Knife for healthcare, helping you deal with whatever problem or challenge you might be facing from moment to moment. We choose not to be a licensed broker because we feel it removes a potential conflict of interest. Additionally, not being licensed gives us more freedom to be completely candid with consumers and to tell people exactly how it is.
As we get closer to November 1st, when Open-Enrollment officially kicks off, we will have a detailed update on what we’re advising consumers to do with respect to their healthcare options this year.