Open Enrollment for 2020 Health Coverage is coming to a close this Sunday, December 15th. If you haven’t yet reviewed you Health Insurance coverage for 2020, you still have a couple of days! It’s always advisable to review your coverage each year during the enrollment period as some of the details within your plans may have changed, including rate changes, occur from year to year.
If you don’t have Health Insurance currently, here is some information about what is offered and who can apply.
1. Who Should Apply?
The Affordable Care Act (ACA) Health Insurance Marketplace is where most people who do not have health care coverage through their employers or through a government program, such as Medicare or Medicaid, can purchase Health Insurance.
2. Where to Apply?
The best place to start is contacting a broker, as they can assist you with showing you all the available options, breaking down how they work and the benefits included in each plan, as well as helping advise which plans will be the most effective for you. Shopping Health Insurance can be complex with all of the various options available, as well as tax credits and other intricacies that might not be easily understood online. You can also apply directly at healthcare.gov. You can also call the marketplace call center at 800-318-2596 and apply over the phone. It accepts calls 7 days a week, 24 hours a day. You can even apply in person using a feature that assists you in finding a navigator, to help you apply for coverage. For this you can go to localhelp.healthcare.gov, plug in your zip code and a list of nearby navigators will pop up.
3. When to Apply?
Marketplace Open Enrollment in Arizona is from November 1st through December 15th.
4. What Do the Plans Cost?
The cost will vary depending on your income. About 88% of the more than 10 millions people who already have insurance through the marketplace receive a federal subsidy to help them pay the monthly premiums. In general, you may be eligible for a subsidy if, for example, you are single and your 2019 income falls between $12,490 and $49,960; or if you are a family of three and you have a household income between $21,330 and $85,320. You can choose to use the subsidy to lower your premium, or you can pay the full premium and deduct the subsidy from your federal income taxes.
In addition, more than half of marketplace enrollees qualify for assistance that defrays the cost of deductibles and copays. To be eligible, individual income in 2019 must be between $12,490 and $31,225, for example. To determine whether you will qualify, use the subsidy calculator at healthcare.gov/lower-costs.
5. Are Premiums Going to be Lower Next Year?
Maybe. Monthly premiums for the most popular silver plan on the ACA health insurance marketplace will drop, on average 4% for 2020, according to CMS. Premium changes will vary widely across the country. If you qualify for a subsidy, you likely won’t be affected by premium increases. Under the ACA, the subsidy increases in proportion to the rate increases. If you earn too much to qualify for federal financial assistance, you may find your premium has increased. The amount of premium change will vary widely as well by state and plan.
6. How do I prove my eligibility for the Subsidy?
You’ll need to provide some detailed information on the application, including:
- Birth dates and home addresses for all individuals who will be applying for coverage under the plan.
- Social Security numbers, name of employer and income information for every member of your household, even if they aren’t applying for coverage.
- Estimated household income for 2020.
- Policy number and plan ID of your current insurance plan.
- Any letter or document your current plan has provided regarding renewal.
7. How Do I Find a Plan?
We advise using a broker service of course, as they can help you understand all the complexities of each plan, but you can also go to healthcare.gov/see-plans. You’ll be asked for personal details such as where you live, your age, gender and some health-related questions such as “Do you smoke?”. You will then be directed to a screen that will list all the plans available within your county.
8. What Are the Different Types of Plans?
The marketplace plans fall into four categories:
- Bronze – Lowest monthly premium; highest out-of-pocket costs; very high deductible.
- Silver- The most popular plans. Moderate premiums; moderate out-of-pocket costs; deductibles are lower than bronze plans.
- Gold- High monthly premiums; lower out-of-pocket costs; low deductibles.
- Platinum – Highest monthly premiums, lowest out-of-pocket costs, very low deductibles.
9. What if I’m Already Enrolled in a Marketplace Plan?
If you don’t do anything by December 15th (or when your enrollment period ends, for AZ, it’s the 15th), you will automatically be renewed in your current plan. If your plan is no longer available, the marketplace will enroll you in the most similar plan.
10. Does it Pay to Shop Around for a Plan?
Yes! Insurance plans come in and out of the market all the time. In addition, if you are currently enrolled, your doctor may leave the plan’s network in 2020 or join another network you are interested in. Premiums also vary from year to year.
11. What Happens if I Don’t Buy Insurance?
The ACA still requires that nearly all Americans have health insurance. There are some exceptions: You can apply for a warship exemption if, for example, you have filed for bankruptcy, cannot find affordable coverage or had a death in the family.
Congress has repealed the tax penalty that individuals without insurance had to pay. However, though the penalty has been removed, health care experts emphasize that even if you are healthy, it’s important to have health insurance, because you never know when an accident, severe illness or injury will occur.
Fill out the form below if you would like to receive a direct quote and assistance from one of our expert Arizona brokers! Our family business has been helping residents of Arizona manage their risk and obtain quality health care plans since 1977!