With summer on its way out, many people have been giving more thought to the upcoming open enrollment and process of applying for health insurance coverage . Are the rules the same as they were last year? Have new rules been added over the summer? Do I enroll online, in person, over the phone? And if I'm uninsured now, when can I officially sign up?
So many questions. Let's review some of the most important things to keep in mind as we approach the 2015 open enrollment period.
Applying for a New Health Insurance Policy
A lot can change in seven months. Maybe you were insured through your company when the Obamacare debate was at its most heated, but have since left that job and need to purchase a plan. Perhaps you got married over the summer, moved, got a raise, are expecting a child or considering the switch to a family health insurance plan. Whatever the reason, the key thing to remember is that the process of shopping for health insurance has changed significantly.
Of the many changes in place, four are worth a closer look. Some of this will be a brush-up, while much will be new to those learning how the Affordable Care Act works for the first time.
Coverage is Now Guaranteed
In short, you can't be turned down for medical insurance under the new system. Underwriting is a thing of the past as today's plans are now considered guaranteed issue. Not only will you not be turned down for coverage, you won't have to pay more than others based on your health or medical history. The only exception to this (and there are limits in place) is that carriers can impose increased premiums based on a person's age, geographic location and tobacco use status.
Healthcare Subsidies to Offset Higher Premiums
It is no secret that the major carriers have raised premiums across the board to cover the cost of increased claims. To make coverage more affordable, healthcare tax credits are available to eligible applicants through the Illinois health insurance exchange. If your income falls within the defined poverty levels, you can apply for a healthcare subsidy to lessen the financial burden of mandatory health insurance or premium increases. It's worth noting that if you are currently employed by a company that offers a group plan, you can not apply for a subsidy.
Essential Health Benefits
Under the new healthcare reform laws, all health insurance plans are now required to provide a list of Essential Health Benefits. These include things like emergency room visits, outpatient surgery, pre-natal care, mental health and substance abuse treatment, Rx medications, physical therapy, lab tests, preventative services, counseling, vaccines, pediatric care and more. The majority of these have always been offered with standard copay plans; the only difference is that now they're mandatory and built in to all healthcare plans.
Narrow Open Enrollment Period
One of the most significant changes, is that you can no longer sign up for health insurance whenever the mood strikes. There is a very limited three-month window for open enrollment, which begins on November 15, 2014 and ends on Feb 15, 2015. The question on everyone's mind, is whether or not they will be required to renew the plan they purchased last year. And sadly, there is no fixed, definitive answer. This is where we anticipate the majority of the confusion to come from, and one of the best reasons to work with a licensed agent.
In some cases, your plan will automatically renew. Many, though, will need to take certain steps to renew it or make changes to existing plans, and this can make things complicated. If your employment, income, marital status or address has changed, you will most likely need to re-enroll, or renew your existing plan.
Avoiding Stress, Mistakes & Possibly Overpaying
Something to keep in mind here: If you go at this alone, be it online or via mail, correcting even simple mistakes will require a call to a government customer service helpline and/or the already overwhelmed carrier. The best way to make sure that you're signed up properly, in the right plan, and at a rate you can afford, is to work with a health insurance broker. An agent essentially does all of the work for you, there are no fees involved, you pay the same rates you would by signing up on your own, plus, you have the assurance that it's been handled properly.
If you're feeling the pressure of the 2015 open enrollment, don't let it stress you out. Premier is located in the Lisle Naperville area, and staffs a team of licensed agents who are ready to help you free of charge. Call 800-369-0287 or e-mail us today to get started or learn more.