Thursday, October 26, 2017

Des Moines – Open enrollment begins November 1 and ends December 15 for Iowans purchasing or changing their individual health coverage to become effective January 1, 2018.  

“There has been a lot of news recently about Iowa’s individual insurance market.  As the open enrollment season begins, Iowans should thoroughly research all coverage options.  I would encourage consumers to meet with a licensed insurance agent to determine the best plan for themselves and their families,” Iowa Insurance Commissioner Doug Ommen said. “For 2018, Iowans purchasing their own insurance through the individual market will have one option, Medica, available through healthcare.gov.”

Iowans can begin previewing sample premium amounts for individual ACA-compliant health insurance plans for each of Iowa’s seven rating areas.  These premium amounts will become official once posted on during open enrollment beginning November 1, 2017.

Iowans need to complete enrollment between November 1 and December 15, 2017 to have coverage effective by January 1, 2018. During open enrollment, Iowans may call 1-800-318-2596 or visit HealthCare.gov for information regarding enrollment and to calculate applicable tax credits.  HealthCare.gov is the only official government website selling health insurance, and buyers should beware of imitation websites.   

Local insurance agents, navigators, and certified application counselors around the state are available to help Iowans review which insurance plan may best fit their needs.  Iowans can find local help by visiting https://localhelp.HealthCare.gov/.

Most Iowans access healthcare in one of three ways:

  • Employer-Sponsored: A majority of Iowans participate in a group health insurance plan offered by their employer. This includes employees of large and small private companies, federal, state and local government employees and active military.  Consumers in a small business should talk to a licensed insurance agent to discuss all available coverage options.
  • Public Programs: Roughly 1.2 million Iowans receive healthcare benefits through Medicare and Medicaid.  
  • Individually-Purchased: In 2017, approximately 153,000 Iowans purchase health insurance on their own. Nearly 48,000 people in this segment purchased insurance through the online health exchanges.  An additional 105,000 Iowans purchased insurance either through the ACA off-exchange, grandfathered or transitional policies.

Under each category, there are important developments and information consumers should keep in mind as open enrollment begins:

Individually-Purchased Health Insurance

  • The 2018 healthcare.gov open enrollment period is Nov. 1 through Dec. 15, 2017. Coverage begins Jan. 1, 2018. Consumers can begin researching options at any time.
  • Medica is the sole carrier offering individual health insurance plans for 2018. 
  • If you currently have coverage through the exchange and do not choose a plan for 2018 by the end of open enrollment, you will be re-enrolled in a similar plan offered by Medica.

Employer-Sponsored Health Insurance

  • If you’re already covered by an employer-sponsored plan, pay close attention to your enrollment options this year. Premiums and coverage limits may have changed.
  • If you’re changing jobs, you may be subject to a probationary period, up to 90 days, during which you are not eligible for group coverage.
  • If you lost coverage from a previous employer, you typically have 60 days to enroll in private individual insurance through healthcare.gov under a Special Enrollment Period. If you have recently lost a job and access to employer-based insurance, you and your dependents may be eligible for continuation coverage under COBRA
  • Consumers in a small business should talk to a licensed insurance agent to discuss all available coverage options.

Public Healthcare Programs

  • 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 also may be eligible for Medicare if they are disabled, suffer from kidney failure or ALS (Lou Gehrig's disease). If you have questions about enrolling in Medicare, you can contact Iowa’s Senior Health Insurance Information Program at http://therightcalliowa.gov  or call 1-800-351-4664.
  • Medicare open enrollment for Medicare Advantage and Medicare Prescription Drug coverage (Part D) takes place from Oct. 15 through Dec. 7, 2017. If you miss the deadline and didn’t experience a qualifying event, you can apply later, though you 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 is jointly funded by federal and state governments. Eligibility is means-based with state-based income requirements.   To see if you and your family are eligible for Medicaid, please visit the Iowa Department of Human Services at dhsservices.iowa.gov or call 1-855-889-7985.

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