If you don’t have health insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying coverage, the Health Insurance Marketplace can provide you with coverage. If you are already currently enrolled in a 2017 Marketplace health insurance plan, or you are looking for brand new health coverage on the Marketplace for 2018, plans and prices for 2018 are now available.
Health Insurance Open Enrollment runs from November 1 until December 15 for coverage beginning January 1, 2018. If you don’t enroll in a 2018 health insurance plan by December 15, 2017, you can’t enroll in a health insurance plan for 2018 unless you qualify for a Special Enrollment Period.
Things to Consider during Open Enrollment
According to the North Dakota Insurance Department, depending on your qualification and method of enrollment there are important developments and information consumers should keep in mind as the Open Enrollment Period begins:
Individually-purchased Health Insurance
- The 2018 Open Enrollment Period will run November 1 through December 15, 2017. Coverage begins January 1, 2018. Consumers can begin researching their options at any time.
- There are two ways to purchase individual insurance, either through the federally run healthcare exchange (healthcare.gov) or via a licensed insurance agent.
- Consumers who qualify for a subsidy should shop on HealthCare.gov in order to receive the subsidy. Those who do not qualify for a subsidy should consider contacting a licensed insurance agent to review all available options.
- A qualification calculator is available at www.healthcare.gov/lower-costs/qualifying-for-lower-costs/
- Those who currently have coverage through the Exchange and do not choose a plan for 2018 will be re-enrolled in the same or a similar plan. Consumers should take notice that this re-enrollment could result in higher out-of-pocket costs.
- North Dakota’s Exchange plan options are more limited this year; Sanford Health Plan is only available in Traill, Cass, Oliver, Burleigh and Morton counties, and there are not any plans available from Medica through the Exchange. To purchase a Sanford Health plan outside of those listed counties or a Medica plan for 2018, you will need to contact a licensed insurance agent.
Employer-sponsored Health Insurance
- If already covered by an employer-sponsored plan, consumers should pay close attention to enrollment options this year. Premiums and coverage limits may have changed.
- If an individual has recently changed jobs or plans to change employment, they may be subject to a probationary period, up to 90 days, during which they are ineligible for group coverage.
- If coverage from a previous employer is lost, an individual typically has 60 days to enroll in private individual insurance through a Special Enrollment Period.
- Consumers are encouraged to contact their employer with questions about their Health Savings Account or Flexible Spending Account, or if they have questions about enrolling in either.
Public Health Care Programs
- Medicare and Medicaid are government programs that help pay for health care. However, benefits, costs and eligibility requirements differ:
- Medicare is a federally funded program available to most U.S. citizens and permanent legal residents age 65 or older who have lived continuously in the country for at least five years. People younger than 65 may also be eligible for Medicare if they are disabled, suffer from kidney failure or ALS (Lou Gehrig’s disease).
- By contrast, Medicaid is jointly funded by federal and state governments. Eligibility is means-based and the program has strict income requirements that vary from state to state.
- Open enrollment for Medicare Advantage and Medicare Prescription Drug coverage (Part D) takes place from October 15 through December 7, 2017. If an individual misses the deadline and didn’t experience a qualifying event, they can still apply during general enrollment (January 1 through March 31 of each year), though they will have to pay a premium penalty.
- High-income earners (above $133,500) may see increases in 2018 Medicare Part B premiums. Enrollees should contact Medicare for an estimate and plan accordingly.
- Medicaid enrollees should pay particular attention to possible changes to eligibility and coverage options.
To help you choose the right coverage for yourself and your family, the North Dakota Insurance Department recommends that you start early, stay well-informed and shop around. If you have questions, contact your TCI Insurance advisor. We’re here to help!