**updated 11/7/2018 we will continue to update this blog as information comes in**
It’s the busiest time of year, between Thanksgiving and Christmas, going out of town or hosting out of town guests, cooking, cleaning, and choosing new health insurance. While we probably won’t come help clean your house or make that turkey, we’d love to help you choose the right insurance that best fits your needs. Open enrollment began November 1st and ends December 15th.
Some good news is that healthcare costs nationwide is leveling out.
Marketplace insurance is healthier, evident in the low premium increases (premium decreases, in some situations!) and expanded coverage for some insurers.
In contrast to the startling jumps in premium pricing the past few years, Modern Healthcare reports that 16 states will see premium declines, two will see no change, and the rest see marginal, single digit increases. On average, CMS reports that rates are dropping 1.5 percent on average across the country. For Indiana, the average rate increase is only 5.1%, which is considerably less than it was last year.
- Availability of short-term plans that can last a year.Short term plans aren’t for everyone- if you see your doctor often, have chronic illness or pain, or any other serious medical problem, a major medical coverage is probably better for you financially. These short term, limited duration plans (STLDs) come with more restrictions, such as limits on preexisting conditions, and offer less coverage (i.e., no coverage on well-visits or maternity care), but their lower price point can be attractive to those that are relatively healthy and looking for more affordability.
- Association health plans: While recent legislation has opened the doors for association health plans, where small businesses and individuals can come together to buy group plans, we don’t expect this to have much of an impact this year since people are still trying to figure it out.
- Individual mandate is disappearing. The Individual Mandate put into effect by the Obama administration fines Americans who choose to not purchase health coverage. However, beginning in 2019, this mandate no longer exists. Some think that this decision to do away with the mandate could increase premium prices even further as the market adjusts for the decline in number of young people choosing to purchase health insurance. However, it might have less effect than people think because healthy young people weren’t buying plans the way families and older folks do and the markets are priced for that. Even with the individual mandate in place, healthy young people could decide to pay $200 a month for health insurance they didn’t think they needed or a $200 fee once a year.
- QSEHRAs are becoming more popular. For small companies and startups that can’t afford traditional group plans, QSEHRAs (aka Qualified Small Employer Health Reimbursement Arrangements) offer a new way to reimburse for premiums and medical expenses tax-free. Plus, in addition to being reimbursed for plans and alleviating the financial burden of individuals buying their own health insurance, employees can choose their own plan that works best for them instead of fitting into a one-size-fits-all group plan! If you or your employer wants to learn more about this, we have a first-of-its-kind QSEHRA guide that explains everything you need to know!
What’s the Same?
- Financial Aid. Many individuals and families can only afford decent health insurance because of the tax credits and other financial assistance offered through the federal exchange.This financial aid will continue to be available through the exchange for health insurance in 2019.
- The Affordable Care Act’s consumer protections are remaining the same. These protections include coverage for pre-existing conditions (including pregnancy), free preventive care, and no lifetime or yearly dollar amount limits.
- Doctor networks continue to stay small: An ongoing trend since the start of Obamacare, many plans will cover an increasingly smaller percentage of doctors in a given area. That leaves the consumer with fewer choices and a greater chance of having to go out of network to get the care they need. This is a strategy used by carriers to keep costs down, but it leaves consumers financially vulnerable for shouldering those scary and sky-high out-of-network costs. Even if your doctor is on your plan this year, it’s worth double checking for this coming year, since things might have changed. Our doctor search tool on our website is a simple way to do that!
- Shortened enrollment period: Just like last year, open enrollment is only 6 weeks—Nov 1 to Dec 15.
Individual health insurance in Indiana for 2019
Remember: "on exchange" means that plans are available on the ACA marketplace or exchange, and are eligible for tax credits. Off-exchange means that plans are only available through a broker or carrier directly, and not on the ACA marketplace. It's important to compare both when shopping for the best okay for you and your family, and Take Command Health's platform is an easy place to do that!
- CareSource- 2 percent increase. CareSource’s plan filing states that they will offer coverage in 79 counties in 2019. This is 4 more counties than they offered in 2018. The requested premium average was set at $540. Plans will be available both on exchange and off exchange.
- Gold: high monthly premiums with lower out of pocket costs. A valued plan if you have high medical needs.
- Silver: moderate monthly premiums with lightly higher out of pocket costs. Silver plans are marketed as offering the highest benefit for those who qualify for financial assistance.
- Bronze: lowest monthly premiums with highest out of pocket costs. HSA eligible and beneficial if needing minimal medical care.
- Ambetter/Celtic- 5 percent decrease. Ambetter will offer coverage in all 92 counties in Indiana in 2019- this is a HUGE increase as they currently only offer coverage in 43 counties! The requested premium average was set at $479. Plans will be available both on exchange and off exchange.
- Essential Care (Bronze)-low premiums, higher out of pocket costs
- Balanced Care (Silver)-best if eligible for government assistance. Balanced premiums an out of pocket costs
- Secure Care (Gold)-higher premiums, lower monthly costs
- Anthem Insurance - 4 percent increase. Anthem is only offered off of the exchange and is only offered in 5 counties. The requested premium average was set at $371.
Affordable Alternatives You Can Check Out
Major medical plans may not be the best choice for everyone. If that’s the case for you, or even if you’re simply looking for more affordable options, check out some of these alternatives to traditional insurance.
Pivot short term plans: Pivot provides short term medical insurance solutions until a qualified major medical health plan is chosen. Pivot plans are renewable 90-day plans which, in most states, can be automatically renewed 4 times without additional medical screening to provide up to 12 months of continuous coverage. This is a great option for those who plan on obtaining health insurance in the near future - through a new job, change in marriage status, or some other form of a life change.
Faith-based: Medi-Share is a Faith-based program that has a state-wide PPO network available in 2019 managed by PHCS (Private Healthcare Systems, now owned by Multiplan). It may be smaller than some of the PPO networks in the past, but it does provide flexibility to see your doctors and will cover out-of-network expenses as long as it meets Medi-Share’s faith-based guidelines. Medi-Share won’t be for everyone but is a good option if it happens to fit your personal convictions and lifestyle. Make sure to check out our Medi-Share review and compare it to other major medical plans on our website before you enroll.
Next steps: What's my best option?
While more choices are a welcome change, hunting down and comparing all of these options can feel overwhelming. However, at TakeCommandHealth.com we help you compare all of your options side-by-side including off-exchange plans, marketplace plans, and faith-based options. You can use our award-winning tools to search for your doctors, check your prescriptions, and even simulate conditions and health needs to make sure you get the most of for your money.
A few other updates we'd like to tell you about:
We've expanded the capabilities of our doctor search tool to search doctor networks from all of the carriers above (no matter if the plan is off-exchange, on the marketplace, or faith-based).
We've negotiated some pretty awesome deals for our members. Call a doctor 24/7 for $0, enjoy medical bill negotiation support, a personal health advocate, dental, vision, and pharmacy discounts, etc. These really help save money with some of the higher deductible plans.
We're pretty confident we have the biggest, most complete line-up of plans in Indiana this year. With growing demand, we've also put together a bigger support team ready to help you tackle any issue. You can get started by chatting with one of our licensed professionals on our website or emailing us at firstname.lastname@example.org.
Throughout open enrollment, you can visit our website and we'll walk you through your options. Our goal is to help you get the most out of your money and find the plan that really works for you and your family.
Remember you have until Dec 15th to select a plan that starts Jan 1st, 2019.