The deadline to sign up for individual health insurance coverage under the Affordable Care Act is fast approaching, and officialsare encouraging consumers to make sure they make their selections while they can.
The enrollment period to receive coverage in 2019 runs through Dec. 15.
Geoff Bartsh, vice president of individual and family business for Minnesota-based insurer Medica, said open enrollment activity so far this year has been slower than in years past.
As of Friday, Medica had enrolled 86,000 people in Nebraska and 42,000 in Iowa for coverage beginning Jan. 1.
The Washington Post earlier reported that total sign-ups nationally were down compared with the same time last year. More than a half-million Americans had used the federal HealthCare.gov website to select a plan by Nov. 24, the most recent date available. That number may not include all enrollments.
“We do expect activity over the last two weeks of open enrollment to pick up dramatically,” Bartsh said in an email.
The surge will include new people enrolling and people selecting a different plan. That’s been the case with every open enrollment period.
Bartsh said even people who are happy with their current plan should go through the process and see what their options are for 2019.
“A lot of people will find very affordable products that can provide even greater benefits than what they may have this year,” he said.
Here are some points to consider as you decide what coverage you need.
What are my options in Nebraska?
Medica is the lone insurer offering individual Affordable Care Act plans in Nebraska.
The provider announced in October a new health plan for 2019 called Elevate by Medica. A variety of options are available under the new offering, including plans with copays, plans compatible with health savings accounts and catastrophic plans for those who qualify. The new Medica plan launched in partnership with Methodist Health System and Nebraska Medicine.
The plan will be available to individuals and families in Douglas and Sarpy Counties in Nebraska and in Pottawattamie and Mills Counties in Iowa.
Medica also offers a statewide plan in Nebraska called Medica Insure and another affiliated with CHI Health in southeast to central Nebraska and western Iowa.
In Iowa, Blue Cross Blue Shield affiliate Wellmark also was set to offer plans on the exchange for 2019.
How much will it cost?
The 125,000 Nebraska and Iowa residents who rely on the exchanges for coverage can expect to see single-digit increases or slightly lower premiums.
Still, more than 80 percent of people buying coverage through the federal health exchanges are expected to receive subsidies to help them cover the costs.
Those wondering whether they qualify for a subsidy — and if so, how much — can work with their insurance agent or broker, said Martin Swanson, the Nebraska Department of Insurance’s health policy administrator.
They also can visit websites such as one offered by the Kaiser Family Foundation at kff.org/interactive/subsidy-calculator. Those signing up for plans can get their final subsidy numbers when they sign up through HealthCare.gov.
Do I have to sign up?
The federal government eliminated for next year the Affordable Care Act’s requirement that most people have coverage.
That means you won’t face a fine for remaining uninsured. And if you don’t sign up, you can avoid monthly coverage bills that often top several hundred dollars.
But remaining uninsured exposes you to bigger bills.
A broken bone can cost several thousand dollars to fix. More complex problems like cancer can ruin patients financially.
Swanson said those who don’t qualify for a subsidy or are looking for something different for themselves or their families also have new options in the market this year. Those who meet certain membership criteria, particularly in the agricultural field, may want to look into new association health plans.
Such plans have limited benefits and lower costs but may screen out people with serious health problems.
Can someone help me navigate the sign-up process?
You can buy coverage through state-run insurance marketplaces or the federal government’s HealthCare.gov website, but it might make sense to have an expert review your plan. An expert can make recommendations based on your doctors, how often you go the doctor and your biggest concern.
Brokers also can point out changes that the average shopper may not notice.
If you opt for an agent, ask about fees or whether commissions vary according to the plan they sell.
Health insurance navigators can help people sign up for coverage on the ACA’s marketplace or enroll in government-funded Medicaid coverage. Their services are free.
The number of navigators has dwindled due to funding cuts.
Other help can include certified application counselors, who also are free. To find assistance, visit localhelp.healthcare.gov.
What if I miss the deadline?
If you miss the Dec. 15 deadline, you can still find short-term coverage. But those plans may not cover prescriptions or medical conditions you already have.
Swanson advised those who miss the deadline to talk to their local insurance agent about which options are available to them and would best fit their needs.
This report includes material from the Associated Press.