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As Open Enrollment Begins, BHSJ Community Health Agency Encourages Consumers to Save Money – and Exercise Caution

Wednesday October 30, 2019

Open enrollment on the Affordable Care Act (ACA) marketplaces approaches on November 1.

This is a great time for consumers to examine the deals found on the marketplace, to save money and better meet their health care needs. In fact, consumers who went on HealthCare.gov, compared their plan options, and selected the plan that best fit their health and financial needs ended up paying 38 percent less per month on average in 2019 than the consumers whose plans were automatically renewed. It’s also important for consumers to exercise caution with plans offered outside the marketplace, due to the removal of key consumer protections. Consumers have until December 15 to enroll.

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“Once again this year, the vast majority of people can find good deals on the marketplace and can receive financial assistance to help lower their monthly health care costs,” said Rebecca Burns, Health Officer at the tri-county health department. “Because plans and prices change year over year, it’s vital that consumers take the time to compare their plan options.”

In Michigan, 65% of current marketplace consumers will have plans available for 2020 that cost less than $50 per month after tax credits. Nearly 8 of ten marketplace enrollees in Michigan received premium tax credits to help them pay for their 2019 coverage. In addition, over 40% of Michigan marketplace enrollees also qualified for cost-sharing reductions this year, which lowered their out-of-pocket costs for health care services.

The number of insurers participating in the marketplace in Michigan is up this year, as is the number of health insurance plans people can choose from, increasing from an average of 39 plans in 2019 to 50 plans on average available for 2020. And even for the minority of marketplace consumers who don’t qualify for tax credits, it’s worth shopping around. Average premiums are down again this year, with the average premium for the lowest-cost plan reduced by 1%.

Consumers enrolling in a plan on HealthCare.gov, known as a Qualified Health Plan or QHP, are guaranteed to receive comprehensive coverage, with no pre-existing condition exclusions or markups. In addition to covering essential health benefits (including prescription drugs, mental health treatment, maternity care, among other health care services), consumers enrolled in a QHP also receive free preventive care services, such as annual checkups and immunizations.

Consumers should avoid insurance plans offered outside of HealthCare.gov that seem too good to be true. Unfortunately, a bevy of “junk insurance” products will be available due to loosening of regulations, and they pose huge financial risks to consumers. These products aren’t required to comply with ACA regulations, which means they can deny coverage to consumers with pre-existing conditions, charge consumers more based on their gender, reject claims altogether for health care services related to a pre-existing condition, and impose annual coverage limits. “Healthcare.gov is the only website where Michigan consumers are guaranteed to get comprehensive coverage,” said Burns. “Consumers buying skimpy plans will be exposed to serious risks.”

Consumers should log on to Healthcare.gov before December 15th to get the comprehensive health coverage they need.