Open enrollment season for the Affordable Care Act health insurance marketplace began Nov. 1 and runs through Jan. 15.
Katie Roders Turner, the executive diector of the Family Healthcare Foundation, said four of five Floridians eligible for plans on the health insurance marketplace can find plans for as low as $10 per month.
However, that doesn’t mean everyone signing up for coverage is paying that price.
Turner stresses the importance of comparing plans every year.
“Don't just automatically let yourself reenroll. Really get in there, update your application information, make sure that information is correct,” she said. “Maybe your income has changed, maybe your family size has changed. That's always going to impact perhaps how much your plan is going to cost.”
Turner said the best and only way to compare plans is on the official federal government website for the Affordable Care Act, Healthcare.gov.
“On that website, there's a really wonderful window shopping tool (where) you can plug in just a few pieces of information, and you get to see all of the plans right away, without creating an account, without filling out the entire application,” she said. “So you really get a preview of all the plans prior to going throughout the whole process.”
When selecting a plan, Turner said, knowing the costs of your prescription drugs,and whether there is a separate pharmacy deductible, can assist you in making an informed decision.
“If you do have a lot of prescriptions that are important to you throughout the year, make sure that you understand that if you're looking at the cost of the deductible for your insurance plan, knowing if there's also a separate pharmacy deductible for that same insurance plan,” she said. “And that's something that you really need to look at in your summary of benefits.”
Turner adds that choosing a plan with the lowest premium may not be the most economical choice for individuals or their families as they could have to pay more out of pocket down the line.
She said a higher premium can take the fear out of some medical costs in the future.
“You're able to access copayments for services like in urgent care, primary care or specialty care, even if you have to pay more in a premium.” she said. “Because if you do need to go to urgent care, if you do need to start seeing a specialist, at least you know what those costs are going to be.”
Therefore, Turner suggests comparing a $0 premium plan with plans at a higher price like $60 or $120.
But most importantly, Turner said, “If somebody is really trying to save money in the new year, at least having insurance is so important. Do not forgo it, because medical debt is a real thing. So if anything, please, please, please, the value of insurance is so important.”
Assistance and competitiveness
As more carriers enter the insurance market, Turner said, it’s making the marketplace a competitive space, which can get overwhelming for some shoppers.
“It can be a little bit difficult to navigate for people with that,” she said. “There's that importance of our role at the Family Healthcare Foundation as navigators, ensuring that we're there side by side with people, helping them understand what these plans are, what the benefits are, maybe what some of the drawbacks are.”
With many insurers and plans to choose from, Turner said those looking for financial assistance can access it through the Consolidated Omnibus Budget Reconciliation Act (COBRA), which is part of the American Rescue Plan Act.
Medicaid’s redetermination process
Florida disenrolled 1.3 million people from Medicaid during the unwinding period, according to the Florida Policy Institute.
Turner said that the redetermination process is pushing more people to the ACA marketplace.
“We're seeing people who are used to having health insurance, wanting to maintain health insurance, and are now looking for other options,” she said.
Florida is one of 10 states that have not expanded Medicaid.
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