What do you need to know about open enrollment?

At Triage Cancer, we know that one of the most effective ways to lower your out-of-pocket medical costs is to make sure that you have adequate health insurance that meets your individual needs.

Resources

We have a number of resources available to help you figure out your health insurance options if you don’t have coverage or are losing your coverage; and if you already have coverage, how to make changes to your health insurance coverage:

Open Enrollment Periods

Every year, most people have the ability to make changes to their health insurance coverage, including through Medicare, the Marketplace, or an employer. These changes can be made during an open enrollment period. Depending on the type of coverage you have or are applying for, there are different enrollment periods:

  • Employers: each employer has their own open enrollment period, but it often occurs in the fall. Sometimes an employer offers more than one plan to choose from, and you can switch plans during open enrollment. You can ask the person at work who handles the health insurance for more information.
  • Medicaid: applications are accepted year round
  • Marketplace – 2018: open enrollment for 2018 coverage is closed, but you may still qualify for a special enrollment period to get coverage for 2018.
  • Marketplace – 2019:
    • If you live in one of these states (AK, AL, AR, AZ, DE, FL, GA, HI, IA, IL, IN, KS, KY, LA, ME, MI, MS, MO, MT, NC, ND, NE, NJ, NH, NM, NV, OH, OK, OR, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY) you use the federal Marketplace (HealthCare.gov) and the open enrollment period for 2019 coverage is: Nov. 1 – Dec. 15, 2018
    • C.: November 1, 2018 – January 31, 2019
    • California: October 15, 2018 – January 15, 2019
    • Massachusetts: November 1, 2018 – January 23, 2019
    • Minnesota: November 1, 2018 – January 13, 2019
    • Rhode Island: November 1, 2018 – December 31, 2019
    • Other state-run Marketplaces may still decide to have different open enrollment periods than the federal Marketplace open enrollment period of Nov. 1 – Dec. 15, 2018

 Getting Local Help

If you need help to choose a Marketplace plan or figure out if you qualify for Medicaid, you can visit www.HealthCare.gov or call 1-800-318-2596.

You may also be able to find a local Navigator who has been trained and certified to help you enroll. Visit https://localhelp.healthcare.gov and enter your zip code. Navigators used to be available in all states, but unfortunately, the federal government has cut funding for navigators by 84% in the last two years, so there may not be a Navigator near you. There will be no navigators at all in Iowa, Montana, or New Hampshire.

Short-Term Health Insurance Plans

It is also important to know that for the first time navigators will be required to share information about short term health insurance plans. See our previous blog about these insurance options, so you don’t fall into a trap of buying inadequate health insurance coverage.

Pre-Existing Conditions

And finally, for now, people with pre-existing medical conditions are protected against denials or exclusion periods in both the individual and employer health insurance markets. However, there are some legal cases that might impact those protections moving forward.

In early September, a hearing was held on a lawsuit filed by 20 state attorneys general to strike down the ACA as unconstitutional. The judge seemed to agree that the law should be struck down, but we are waiting on a final ruling. Regardless of the ruling, the case will likely be appealed and ultimately reach the U.S. Supreme Court for a final decision.

In response, Maryland Attorney General Brian Frosh hasfiled a lawsuitto ask the U.S. District Court of Maryland to declare that the ACA is constitutional.

While we cannot know for sure how these lawsuits will be decided, we do know that they will have a very practical impact (positive or negative) on the lives of people diagnosed with cancer and other pre-existing conditions.

Stay tuned. . .

Samantha Skelton
ss@triagecancer.org