Gordon Hopkins | Rural Health News Service
Open enrollment for the Affordable Care Act (aka: Obamacare) ends on Friday, Dec. 15, of this year. Previously, open enrollment lasted until the end of January, so the enrollment period for this year has been cut half.
But if you miss the December deadline, you may still qualify to enroll.
For example, you are eligible if you have lost your healthcare coverage. If you lost your job and your employer-sponsored healthcare plan, or you are recently divorced or legally separated or your spouse has died and you are no longer covered under your spouse’s insurance plan, you will usually have 60 days from the date of that loss to sign up.
Other life-changing events may also qualify you to enroll after the original deadline: getting married, moving, having a child, adopting a child or placing a child in foster care.
According to a Kaiser Family Foundation poll, only 5 percent of uninsured persons know when the enrollment period ends, so it seems quite likely that many of those who need to sign up with ACA for the first time will miss the official deadline.
If that happens to you, don’t assume you are out of luck. While the special enrollment period is usually 60 days, you should contact HealthCare.gov or the Marketplace Call Center at 1-800-318-2596 to make certain, as well as to ensure that you qualify.
The Dec. 15 deadline is also important for those already on one of the ACA policies. If people do nothing, they will be automatically re-enrolled in their current plan if it is still offered. However, many of those plans have been changed, and premiums may be higher.
Once the Dec. deadline has passed, enrollees will not be able to make changes, so they need to be sure they are on the policy that best meets their needs. There are some new, alternative plans, and some may actually be less expensive.
The Trump administration authorized insurers to sell bronze plans in 2018 that pick up less of the overall healthcare cost because of lower premiums but higher out-of-pocket costs.
Also, despite the name, do not assume that all gold plans are more expensive than the silver plans.
Some insurance carriers have pulled out of the ACA exchanges altogether. Many enrollees have received notice that their 2017 policies will no longer be available in 2018. Someone whose plan has been discontinued will be automatically enrolled in a similar plan but premiums may have increased, and covered services may not be the same. So it is important for enrollees to verify the new policy is the one they want.
As a result of insurance carriers leaving the exchanges, many counties are now left with only one insurance option. In Nebraska and Iowa, the Minnesota based health insurer, Medica Health, is now the only insurance provider available on the ACA exchange. In Missouri, 25 counties were at risk of having no carrier at all, until Centene announced earlier this year that it would fill the gap left by Blue Cross and Blue Shield of Kansas City.
This lack of insurance providers willing to participate in Obamacare has a disproportionate impact on rural areas. Currently, there are 454 counties across the country where there will be only one ACA insurer available in 2018, according to the Kaiser Family Foundation. Of those counties, 86 percent have fewer than 50,000 residents according to current census data. ■
— Gordon Hopkins is a native of Nebraska and a graduate of Creighton University. He is a member of the Association of Certified Fraud Examiners and has worked as a professional insurance investigator. He now writes an award-winning column for The Fairbury Journal-News.