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Understanding your options prior to Obamacare open enrollment

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Open enrollment for Obamacare begins Nov. 1. Open enrollment for Obamacare begins Nov. 1. Anthony Varriano screenshot

Despite Donald Trump declaring Obamacare dead after signing an executive order on Thursday, United States Senators came to a bipartisan agreement on Tuesday to float Obamacare for the next two years. That doesn’t mean Obamacare is in the clear, but it is still the law of the land, and with open enrollment beginning on Nov. 1, it’s time you understood your healthcare options so you can make the right choice for you and your family.

First Thing’s First: Check if You’re Eligible for Medicaid

Medicaid expansion has been implemented in 32 states, and if you’re a citizen of Louisiana, your state expanded Medicaid in July of 2016, so check to see if you qualify. If you make less than $16,040 annually and are single, you do. Here’s the breakdown of the Federal Poverty Level for households of multiple people and here’s where you can find your state’s income requirements. Medicaid in any state will be considerably cheaper than a Bronze plan on the Obamacare marketplace.

Louisianans are already taking advantage of the Medicaid expansion, with enrollment in the program increasing 42 percent since Obamacare debuted in 2013. The state’s 21.7 percent uninsured rate in 2013 has fallen to 12.7 percent.

Weighing the Risk of Going Uninsured

Going uninsured only increases premiums for your family, friends and neighbors, and if you were to require medical care, you would incur considerable medical debt for which you could end up paying the rest of your life. A 2016 study by the National Bureau of Economic Research found those who visit the hospital without insurance double their chance of declaring bankruptc within four years.

Even if your hospital visit doesn’t burden you with medical debt, any “uncompensated care” the hospital provides, it makes up by raising rates on medical care for everyone. So going uninsured raises medical costs for everyone and is not advised.

That said, if you haven’t been to the doctor in years, don’t do dangerous work or have dangerous hobbies and are healthy -- you can determine whether it would be cheaper to pay the penalty for going uninsured than it would be to pay a health insurance premium.

The penalty for going uninsured in 2017 is 2.5 percent of your income or $695 -- whichever is higher. So if you make less than $27,750 annually, you’d pay $695, which would likely be cheaper than any health insurance plan you could purchase on the Obamacare marketplace. In fact, if you make less than $45,000 annually, the penalty for going uninsured ($1,125) is likely less than your premiums would be for the year. Keep in mind that premium payments are only part of your potential healthcare costs, though. It only takes one accident or illness to make you regret going uninsured.

If You’re Healthy and Under 30 (or not), Get a Catastrophic Plan

Catastrophic health insurance plans cover the same essential health benefits marketplace plans cover, including preventative care and three primary care visits. They’re also cheap and protect you from both the penalty for going uninsured and the medical debt that could bankrupt you in the future. You might even qualify for a catastrophic plan if you’re over 30 years old.

If you have experienced any one of the hardships listed here in the past year, you could qualify for a catastrophic health insurance plan. Some examples would be death of a family member, increased expenses due to caring for a sick family member, or damage to property due to natural disaster. You might even qualify if you experienced a hardship applying for health insurance not listed on the website.

You could also be eligible for a catastrophic health plan if your employer doesn’t offer affordable health insurance and Obamacare is prohibitively expensive for you, or if your state didn’t expand Medicaid, for which you would qualify. Be sure to investigate your eligibility for a catastrophic health insurance plan thoroughly, especially if you live in one of the 18 states that didn’t expand Medicaid.

Finding the Best Health Insurance Plan for You and Your Family

If you and your family is healthy and has no history of medical problems, a Bronze health insurance plan is probably all you need. Bronze plans only cover up to 60 percent of medical costs, though. Silver health insurance plans cover up to 70 percent of expenses, Gold plans cover 80 percent and Platinum plans cover up to 90 percent of medical expenses.

Based on you and your family’s medical history and current health, you can determine which plan best fits into your budget while also covering your expected medical costs for the year. If you are injury-prone or have a history of visiting the hospital regularly, a Gold or Platinum plan might actually save you money in a bad year health-wise.

So there’s your checklist for understanding your options prior to Obamacare open enrollment starts on Nov. 1. Exhaust all of your healthcare options before giving up and taking the penalty, because you never know what could happen.

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