Open enrollment for healthcare.gov ends Friday; automatic re-enrollment may not be best option

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By Melissa Patrick
Kentucky Health News

You have just a few days to enroll in a 2018 health-insurance plan on healthcare.gov. Open enrollment under the Patient Protection and Affordable Care Act ends Friday, Dec. 15.

“The clock is ticking,” Whitney Allen, the outreach and enrollment coordinator for the Kentucky Primary Care Association, said in an e-mail. ” We encourage anyone that has questions about enrolling in a 2018 health insurance plan to contact their local application assister before Dec. 15!”

And even if you don’t need marketplace coverage, Allen says you should remind others, because that seems to be the way most people are hearing about government-subsidized insurance this year.

“It seems word of mouth has been the best advertising, this open enrollment,” Allen said.

The state health agency has said it is using direct mail, text messages, phone calls and e-mails to communicate with current policyholders and potential new enrollees about open enrollment because it no longer gets federal funds for outreach.

Allen said most people in southeastern Kentucky who have called for application assistance say they heard about the service from family members and friends who have used it.

Who needs coverage?

Anyone who doesn’t have health coverage through a job, Medicare, Medicaid, the Children’s Health Insurance Program, or other coverage that meets federal standards, needs to sign up for marketplace coverage or risk paying a penalty.

The penalty for not having health insurance in 2018 is $695 per adult and $347.50 per child, with a maximum of $2,085 per family, or 2.5 percent of the household’s income, whichever is larger.

If you miss the deadline and don’t qualify for a special enrollment period, you will have to wait another year to sign up, says the healthcare.gov website.

Health advocates have encouraged consumers to actively pick a plan to make sure they are getting the best coverage for the best cost, even if they will be automatically re-enrolled, as around 80,000 Kentuckians could be if they don’t pick their own plan.

Stan Dorn, a senior fellow at Families USA, an advocacy group, told Kaiser Health News that auto-enrollment doesn’t take premiums or benchmark plan changes into account, which means that even if you are assigned to the same plan, your cost could be different next year.

Kaiser Health News has also reported that it’s important to actively choose a plan because “if you don’t like the plan you’re auto-enrolled in this year you may be stuck with it in 2018, unlike previous years when people could generally switch.”

In general, the federal exchange plans are more attractive to individuals and families who earn less than 400 percent of the federal poverty level because they will qualify for subsidized coverage. And those who make too much to qualify for a subsidy are encouraged to connect with a certified health insurance agent or a broker to determine whether an exchange or off-exchange plan is best for them.

Humana CareSource, which is offering exchange plans in 61 Kentucky counties, encouraged consumers to also check to see if their doctors are on their plan’s network.

“Even if a plan did not include your doctor last year, check again for 2018. Some plans, like CareSource, have recently signed agreements with new provider groups. This means more doctors may be in network beginning on January 1, 2018,” CareSource said in a news release.

Anthem Blue Cross Blue Shield is selling plans in the other 59 counties. Here’s a healthcare.gov checklist of the information that you need to have available when you sign up for coverage:

Where can I get help?

Application assisters are available in every Kentucky county to help people sign up for coverage, and their services are free. There are also sign-up events throughout the state. To find an event in your county or an assister, go to healthbenefitexchange.gov.

Help is also available through the state call center at 855-459-6328 and the healthcare.gov customer center at 800-318-2596, which is available 24 hours a day, seven days a week.

Click here for a live stream open enrollment information session that aired Friday, Dec. 8 on the Kentuckians for The Commonwealth Facebook page. The video features application assisters from the Primary Care Association.

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