Getting a jump on Obamacare enrollment
- Analyze out-of-pocket costs from 2014. Were you on target for your projected costs?
- Know how many family members will need coverage. Did anyone gain coverage through an employer? Was there a birth, adoption or death in your family?
- Before switching to another plan, consider your attachment to your providers. It may be worth paying a few dollars more each month to keep a doctor who knows you and with whom you feel comfortable.
- Did you or a family member receive a diagnosis in 2014 that could prove expensive? If so, you may need to expand your coverage. Do you plan to become pregnant this coming year?
- Were you pleased with your coverage for 2014? What did you like? What didn't you like? Consider what you might like to change. Did you pay more than you wanted for your deductible? How about out-of-pocket costs?
A plan to automatically re-enroll thousands of Georgians in health plans they bought through the federal insurance marketplace for 2014 may allow some to happily avoid the government’s website when open enrollment starts next month.
But those who stay the course instead of taking the time to sift through new coverage options for 2015 could end up paying more for their current plans. That’s because new health plans and prices to choose from will almost certainly change the size of federal tax credits consumers can qualify for to help shrink their monthly premiums.
Add to that the fact that some individuals may have had significant life changes this past year — a marriage or divorce, birth or death, job loss or pay raise — that could make a big difference in which marketplace plans offer the best deal.
“If you just auto-renew, you could end up paying a lot more, so you should definitely shop around,” said Cynthia Cox, a policy analyst with the nonprofit Kaiser Family Foundation.
More than 7 million Americans — including nearly 316,000 Georgians — signed up for insurance plans through HealthCare.gov in its first year of operation. A pillar of the Affordable Care Act, the website allows consumers to sift through dozen of health plans offered by private insurance companies, see if they qualify for federal tax credits or learn if they’re eligible for a government health program like Medicaid or Medicare.
Four new insurers are offering marketplace options in Georgia for 2015, bringing the total number of insurance companies to nine. That means more competitive prices and benefits to pick from, experts say.
Premiums will not be the only change that could affect consumers’ pocketbooks. The amount individuals receive in tax credits will also likely change slightly since the new options being offered by insurers this go around will change the base plan that’s used to calculate the credits. Tax credit amounts will also vary by region, said Russ Childers, an insurance broker in Americus who enrolled close to 100 consumers last year. In Georgia, more than 85 percent of those who enrolled in Obamacare last year received subsidies.
So while a person’s premium may not change, if her tax credit decreases then she could end up paying more for the exact same plan, Childers said.
‘I was pretty amazed’
Kerry Grissom of Lawrenceville said the plan he selected last year may have saved him from bankruptcy — and even death.
The 41-year-old had an abscessed gall bladder in July. Emergency surgery and eight days in the hospital came to $80,000.
“All I had to pay was $750,” he said, referring to the deductible. “I was pretty amazed by that. People can talk about Obamacare or the Affordable Care Act or whatever they want to call it, but it saved my life.”
Now, he’s preparing to go back into the marketplace Nov. 15 to check rates and coverage. While he feels confident doing that, Grissom said he will likely use a health insurance navigator again like last year. He knows he will need a second surgery this coming year, and his wife has developed carpel tunnel syndrome. Those diagnoses will play a role in his choice.
Just as with the Grissoms, other consumers’ health and health insurance needs change each year, too. Family members come on or off the plan due to a birth, a death or the obtaining of insurance elsewhere. Household incomes change as well.
“I would say that because there are more insurers, consumers should take a closer look,” said Beth Stephens with nonprofit consumer group Georgia Watch. “Look at health care needs and household income to see what their needs are.”
Shop around
Like Grissom, consumers who have existing plans will receive notices in the coming weeks that their insurance will automatically renew unless action is taken. And while the move is aimed at simplifying the renewal process and helping people stay insured, even federal officials have urged people to shop around for the best plans and rates possible.
Health insurance navigators and around-the-clock help from HealthCare.gov will be available to help guide people through the process, said Renard Murray, who heads the Centers for Medicare & Medicaid Services’ regional office, in an interview with The Atlanta Journal-Constitution. Murray added that the federal website is expected to operate much more smoothly this year.
A host of technical problems plagued the site’s launch last fall with the website crashing nearly daily and shoppers unable to complete applications. However, the Obama administration recently launched a revamped version it touted as smoother, faster and easier to use — though likely not totally glitch-free.
“The actual time a person has to spend on the system has reduced dramatically,” he said.
About the Author
