It’s time! Although there was speculation as to whether the Affordable Care Act (ACA) would make it through to 2019, it looks like it’s hanging on for at least one more year.
This means it is time once again for another rundown of “what’s new, what’s the same, and what has changed” in the world of health insurance.
There’s a couple of changes I’m really excited about this time around, so let’s take a look.
Is the Affordable Care Act Still Called Obamacare?
One of President Trump’s campaign promises was to repeal and replace the national healthcare program, so you may have seen a few op-ed pieces here and there where the author refers to the Affordable Care Act as Trumpcare, but this new name hasn’t really stuck.
Since Obamacare was a nickname given to the program and it initially started while President Obama was in office, it continues for the most part to carry the same name as it did when it first began.
To keep things simple and on track, I will also continue to refer to it as Obamacare throughout this article.
When is Open Enrollment for 2019?
The Open Enrollment period for 2019 began on Thursday, November 1, 2018. The Open Enrollment period then continues on until December 15, 2018.
This is the same amount of time that was offered last year in 2017 for the 2018 Open Enrollment period and is still a shorter amount of time than what was offered in previous years.
If you fail to sign up for a program during that time period, you cannot get coverage for 2019 under Obamacare unless you qualify for a Special Enrollment period, but there are now alternative health insurance options that are available year round.
The plan you choose during the Open Enrollment period will then start on January 1, 2019.
What is Staying the same for 2019?
Open Enrollment: As I mentioned above, the Open Enrollment period is the same as it was last year although some states will most likely offer extensions, which give people a little more time to choose a plan.
As an example, the state of Florida will probably offer an extension to its residents since the area of Panama City Beach is still in recovery after Hurricane Michael made landfall there during the second week of October.
It would also not be a surprise to see an extension offered in Georgia because there was wide spread damage from the same hurricane in parts of southern Georgia as well, but as of October 18, 2018, this has not yet been determined.
Pre-Existing Conditions: No, changes here either. If you have a pre-existing condition it is still covered.
This means that even if you have a serious health condition, you cannot be turned down for health insurance.
What is Changing for 2019?
More Choices on the Health Insurance Marketplace
As you may recall, if you purchased your insurance through the Marketplace last year, residents in the state of Georgia had only two choices for their health insurance coverage if they wanted to purchase it through Obamacare. These two choices were AmBetter and Kaiser Permanente.
This year, Blue Cross and Blue Shield of Georgia, which was noticeably absent last year, is back. It will be under a new name on the Marketplace, however, as the company has recently announced that they are changing their name to Anthem Blue Cross Blue Shield, which puts them in affiliation with the branding of their parent company Anthem Inc..
Anthem Blue Cross Blue Shield won’t be available to everyone in Georgia, but will be available to residents in the following Georgia counties:
- Bartow County
- Cherokee County
- Cobb County
- Dekalb County
- Dougherty County
- Fayette County
- Floyd County
- Gilmer County
- Paulding County
- Richmond County
It will not be available, however, in Bibb County, Butts County, Chatham County, Clayton County, Cowetta County, and Houston County.
Obamacare Tax Penalty is Gone
Although the legislation did pass last year in December 2017 to repeal the ACA tax penalty, it does not become effective until January, 1, 2019.
What this refers to is that under the current law, if you are not exempt from having to purchase health insurance coverage and you failed to enroll in a plan that provided you with at least the minimum amount of essential coverage you are required by law to have, you could find yourself owing a tax penalty at tax time for the time period when you were not insured.
Removing this tax penalty is a great thing because this allows you to have more health insurance coverage options, including health insurance that is outside of the available Obamacare plans that will be offered for 2019.
Depending on your healthcare needs and your budget, you not only can choose a plan through the ACA Marketplace, you can now elect to choose an alternative insurance plan, such as a Catastrophic PPO plan without having to worry about the tax penalty.
You could, of course, also go without a health insurance plan and you wouldn’t have to worry about a tax penalty, but I certainly wouldn’t recommend it. Especially, when a Catastrophic PPO plan offers such great coverage for major medical events and isn’t all that expensive to have. In fact, it’s about half the price of what you would pay through Obamacare.
Think About a Catastrophic PPO Plan
If you haven’t heard of a Catastrophic PPO plan, which is sometimes known as a hospital indemnity plan, they are a type of plan that has a zero deductible for major medical expenses, such as hospitalization, surgery, inpatient, and even outpatient services.
Just like Obamacare is right for some people, Catastrophic PPO plans work great for others, especially those who are budget-conscious like me.
One of the examples I like to use to show you how this works is from when I was in the hospital for pneumonia. When my hospital bill arrived, it was for over $34,000, but my out-of-pocket cost was ZERO. That’s why I love this plan!
On the other hand, if I would have chosen a policy through Obamacare, my out of pocket cost would have been over $7,350 in 2018 or now $7,900, since this is the new deductible for Obamacare for 2019.
An Affordable Coverage Option
The best part about these types of plans is that they are so affordable and provide great coverage. They are so affordable in fact, that the monthly premium is often half the price you would normally pay for coverage if you bought a health insurance plan through the Marketplace.
Unfortunately, Catastrophic PPO plans are not for everyone because you have to qualify (i.e. go through underwriting). This doesn’t mean a blood test or physical, just that you have to be fairly healthy. By this, I mean no cancer or heart disease. Contact me and I can let you know If you would be able to qualify for this type of plan.
Don’t Wait Until the Last Minute! Here’s How to Prepare for Open Enrollment.
Open Enrollment started on November 1, which means it’s go-time. Here’s how you can be proactive;
Visit Your Doctor for a Wellness Exam: If it’s been a while since you visited your doctor, now is the time for you to schedule a visit for a wellness exam. During a wellness exam, your doctor will check your blood pressure, listen to your heart and lungs, and see if any of the chronic conditions that you have are starting to get worse.
Once you have this information, you can use it to help determine the type of health insurance coverage that you will need for the following year.
For instance, if you are in your early 30s, healthy and seldom visit the doctor, you may find that a Catastrophic PPO plan will provide you with all the coverage you need.
As an added benefit, when you purchase a Catastrophic PPO plan while you are still young and healthy, the amount of your monthly premium will never change. It locks in at the price that you purchased it for and you get to keep that price until you reach 65 when you will switch over to Medicare.
Even if you buy it in your 40s or 50s, your monthly premium will never change as long as you keep the policy.
Get a Mammogram: October is National Breast Cancer Awareness Month. I use this as my reminder to make myself get checked. If you’re over the age of 40 and purchased your health insurance through Obamacare, you can still get a mammogram for $0 every 1 to 2 years.
If you do not have insurance or if you have alternative coverage, many health clinics are offering special deals during the month of October where you can get a mammogram for as little as $15.
Think About the Type of Health Insurance You Will Need for 2019: What do you like and dislike about your current health insurance coverage? Maybe you didn’t like that you couldn’t see your regular doctor and want to find a plan that allows you to visit the doctor of your choice. Maybe you’ve realized that there are benefits that you never use, but you’re paying for them anyway.
Noting what you like and don’t like about your current coverage will allow you to make an informed decision when it comes time to choose your new plan for 2019.
Talk to a Health Insurance Professional: Since there is no longer a tax penalty, you could have more health insurance choices than you are aware of and some of them could save you and your family big money.
Even if you ultimately decide that purchasing your health insurance through the Marketplace is the best option, I can help you with that too and I will do this free of charge with no cost to you.
At least then you can rest assured that you are making an informed decision instead of trying to decipher your way through the “insurance alphabet” with all their HMOs, PPOs, and EPOs.
What’s the Next Step?
Whether you need a short-term plan to get you through until your insurance coverage starts on January 1 in the next year, or you want to know more about alternative coverage or even the types of health insurance plans that will be available – I’m here to help.
Find out how to get started by clicking here.