You eat an apple a day. You make it to spin class on a (semi) regular basis. You even skip the whip on your daily PSL. You’ve got this whole healthy, adult thing down on lock.
But no matter how healthy you feel, you’re not really adulting until you’ve got health insurance. Obamacare open enrollment is officially underway, so if you’re not insured through work or are too old to be on your parents’ plan, now is the time to buckle down and start shopping for the right coverage.
Whether you want to go for the gold or bring home the basic bronze, I’m officially prescribing a healthy dose of Open Enrollment 101. Here’s everything you need to know.
When is it?
Don’t blink; this year, open enrollment is shorter than ever.
It kicks off Nov. 1, and runs through Dec. 15. If you don’t enroll within that time frame, you’ll have to live with some major FOMO. Miss that deadline, and you won’t be able to sign up for health insurance coverage in 2018, unless you qualify for special enrollment. No pressure.
I know, I know. I think you’re special. But the government considers only those people who have experienced a life event as eligible for special enrollment, including:
- Loss of health insurance
- A change in household size (so if you had a baby, got married or had a death in the family)
- Change in residence
Bottom line? Pencil this deadline into your pretty little planner, and carve out a few minutes between Friendsgiving and Thanksgiving to enroll in some coverage. The turkey can wait.
Who needs to enroll?
OK, now that I’ve got you all freaked out over hustling to enroll, the reality is that not everyone will have to during open enrollment season. If you already have qualifying health insurance coverage, you’re good to go.
You’re all set and don’t need to sweat if you’re insured through:
- Your job
- A qualifying individual plan outside the marketplace
- Plans sold through the Small Business Health Insurance Program or the Children’s Health Insurance Program
Other qualifying health insurance plans include many student plans and your parents’ plan, if you haven’t turned 26 yet (#winning).
Not sure where you fall? Here’s a more extensive list of qualifying health coverage.
So, what’s considered not legit under the gov’s standards? Coverage for only vision or dental care, worker’s comp, coverage only for a specific disease or condition, and plans that only offer discounts on medical services.
Think you’re Wonder Woman and never get sick? That’s great, but if you’re able to pay for health insurance and still choose not to, you’ll face a stiff penalty for not being insured. You’ll have to fork over the fee for any month you, your spouse or tax dependents do not have qualifying for health insurance. And the money is due when you file your taxes. Talk about an incentive, amirite?
In 2017, that fee was either 2.5 percent of your household income, or $695 per adult—whichever of the two was higher. No word yet on what that fee will be for 2018, but it’s safe to say it’ll be a sucker punch to your savings.
How much can you expect to save?
Obamacare plans come with a couple of ways to save on health care, based on your income. This cool calculator from HealthCare.gov takes into account how many people are in your household, where you live and how much you’re on-track to make in 2018.
After you apply through the marketplace for your state, you might qualify for a premium tax credit, which will ultimately lower the amount you pay monthly for health insurance. You might also find out that you’re eligible for extra savings called cost-sharing reductions, which can help with pricey copayments and deductibles.
But there has been some turmoil over the cost-sharing reductions. In October, President Donald Trump announced his decision to halt $7 billion in subsidies to insurance companies, to pay for the discounts.
What does that mean for you? The law requires insurance companies to provide the out-of-pocket help, so insurers are scrambling. Many of them have raised their rates to compensate for what the President did. Expect to see higher costs for premiums. (Remember when I stressed the importance of that emergency fund?)
This map from the Kaiser Family Foundation really paints the picture of how premiums are changing in 2018, breaking it down by county. Spoiler alert: Unsubsidized premiums for the lowest-cost bronze, silver and gold plans nationwide are estimated to seriously spike, according to the analysis.
But wait! There’s a twist.
In a serious game-changer, Kaiser’s analysis found that many people receiving premium tax credits will actually pay less for health plans than they did in 2017. In fact, Kaiser’s analysis reveals that in 1,540 counties, a 40-year-old eligible for a tax credit could potentially receive free insurance on the lowest-cost, basic bronze plan.
That could seriously shake things up.
I’m sure all this talk about gold, silver and bronze makes you want to go straight to the jewelry store for a sparkly new necklace (same). But real talk, it also should motivate you to do your research. Shop around, weigh your options and stash that holiday bonus in your savings account. You need to look at more than just your monthly payment for a particular plan, and also factor in any potential health care costs you might face in the new year.
How do you apply?
Actually applying for health insurance isn’t that hard! You can apply online, by phone, with in-person help, with a broker or agent, or through good ol’ fashioned snail mail. After applying during open enrollment, your coverage will start Jan. 1.
After that, the fun isn’t exactly over quite yet; keep up with those monthly payments! If you build up a solid emergency savings account, cut back on spending, stay within budget and keep on-pace with your payments, you’ll be in sizzling shape. Happy enrolling!
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