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Key Changes for Open Enrollment 2019

Have you looked into the Open Enrollment Period (OEP) for 2019 yet? Not only did registration begin Nov. 1, but the Dec. 15 deadline is looming!

Don’t panic, we have you covered so that you can lock in your policy before then. Here are some important things to note about Open Enrollment 2019 before you make your decision:

No Fines

The good news is you won’t be fined for not having health insurance in 2019. In previous years under the Affordable Care Act, if you went without coverage and didn’t fall under health-coverage exemptions, you might’ve incurred a fee (also known as the “Share Responsibility Payment” or “mandate”)—for as much as $695 per adult and $347.50 for each child under 18. Going forward in 2019, there will be no such tax penalties.

Re-Enrollment

If you do not make the Dec. 15 deadline, re-enrollment in your current health insurance plan may be done for you automatically. However, don’t assume this, because some instances do not allow for auto-enrollment. Also, ensure you’ve provided current income and household information during registration in order to receive any applicable savings. Otherwise, you may get whatever you had for 2018’s insurance package.

Extended Deadlines

While the national time frame is shorter for 2019, some states have set their own periods with extended deadlines. See if your state is among the list here.

Short-Term Plans

Short-term healthcare plans have been extended. It’s one of the biggest changes made to the Affordable Care Act. Unlike the past, short-term plans will last an entire year. Plus, you can re-enroll in this option for a maximum of three years.

Catastrophic Plans

If you’re applying for a Catastrophic plan, you don’t need an exemption to enroll if you’re under 30. For those who are 30 or older and want this type of plan, you must be eligible for a hardship exemption. Access the hardship-exemption form here.

Small Businesses

If you’re running a small business but are struggling to obtain and/or provide group health insurance, you might be relieved to learn the U.S. Department of Labor broadened their criteria via Associated Health Plans. Because of a presidential executive order, small businesses and independent contractors can unite via location or profession to receive coverage as if they were one, large company. This will give smaller entities the same purchasing benefits as bigger companies.

If you want to shop and compare in order to get the best deals, GoHealth provides excellent information on health plans from first-tier carriers in your area.

To get help with Open Enrollment, call GoHealth at (866) 909-0798 and a licensed insurance agent will assist you.

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Open Enrollment 2019: Key Dates to Know [Infographic]

Open Enrollment 2019 is here! Before you shop for health insurance coverage, make note of these key Open Enrollment dates to know so you don’t miss a deadline. Then, when you’re ready to shop for coverage, call GoHealth at 866-931-9240 to get help from our licensed insurance agents.

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The Deadlines for 2019 Open Enrollment by State

It’s that time of year again! The Open Enrollment Period for the 2019 Health Insurance Marketplace is here. The Health Insurance Marketplace is for those who do not have insurance through an employer, Medicaid, Medicare, or the Children’s Health Insurance Program (CHIP).

Open Enrollment is the annual period established under the Affordable Care Act (often referred to as the ACA or Obamacare) in which you can enroll in a new health insurance plan through the Health Insurance Marketplace. Open Enrollment for 2019 runs from Nov. 1, 2018 through Dec. 15, 2018 in most states. Plans sold during the Open Enrollment period will go into effect Jan. 1, 2019.

If you miss the Open Enrollment period for 2019, you will not be able to apply again until the following year, unless you qualify for a Special Enrollment Period (SEP). SEPs are granted to those who have experienced a major life change such as a move, birth of a child, or marriage. If you do not qualify for a SEP, be sure to get enrolled before the Open Enrollment deadline. While Open Enrollment in most states closes Dec. 15, some states have extended deadlines.

The states with extended enrollment deadlines for 2019 are:

California – Enrollment opens Oct. 15, 2018 and runs through Jan. 15, 2019
Colorado – Enrollment opens Nov. 1, 2018 and runs through Jan. 15, 2019
D.C. – Enrollment opens Nov. 1, 2018 and runs through Jan. 31, 2019
Massachusetts – Enrollment opens Nov. 1, 2018 and runs through Jan. 23, 2019
Minnesota – Enrollment opens Nov. 1, 2018 and runs through Jan. 13, 2019
New York – Enrollment opens Nov. 1, 2018 and runs through Jan. 31, 2019
Rhode Island – Enrollment opens Nov. 1, 2018 and runs through Dec. 31, 2018

It’s important to note that in states with extended Open Enrollment periods, coverage may start later than Jan. 1, and even as late as March 1.

You may ask why some states have extended deadlines. When the ACA was first introduced in 2014, the enrollment period lasted a total of six months. Later, for 2015, 2016, and 2017 coverage, the deadline was cut down to three months. Starting this past year the enrollment period was cut down to just one month.

The states listed above with extended deadlines have fought for longer enrollment periods to ensure accessibility and coverage for more people. Several states such as California and Colorado have passed legislation to permanently extend the Open Enrollment periods in their states, while other states have extended the deadlines just for this year (for now).

Now that you know the scoop on Open Enrollment dates in your state, it’s time to find the insurance plan that is right for you. The enrollment and purchasing process can appear daunting, but it doesn’t have to be.

GoHealth allows you to compare thousands of health plans from top carriers in your area, and unlike other exchanges, our expert licensed insurance agents are standing by to guide you through the enrollment process.

To get help with Open Enrollment, call GoHealth at (866) 909-0798 and a licensed insurance agent will assist you.

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Have You Considered Medicare Part B?

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Some things aren’t mandatory, but they’re certainly a good idea. For instance, you don’t have to turn your car off while getting gas, but it might be a little dangerous to leave it running. No one’s going to arrest you if you deviate from a recipe when baking a bundt cake, but then you run the risk of a collapsed treat.

Though some people have the belief that enrolling in Medicare Part B is mandatory when they turn 65, that’s actually not the case. However, delaying enrollment or failing to enroll may result in considerably higher medical bills and even a penalty. The latest numbers show that approximately 52.1 million people in the United States are beneficiaries of Medicare Part B. Let’s look at the advantages of enrolling in Medicare Part B.

Decreased Medical Costs

Defined by Medicare as outpatient coverage, Part B encompasses payment at 80 percent—once the premium is met—for expenses including doctor appointments, laboratory tests, physical therapy, imaging services, medical equipment, mental health services, preventive care, and more.

Although Part A pays for hospital room and board, it doesn’t cover some services that occur within the hospital. By having a Medicare Part B plan, you’re able to save on these out-of-pocket costs. Even if you’re currently in good health, you may need these more advanced healthcare services as you age.

Those with low incomes who are hesitant to do so because of the cost are recommended to enroll in Part B to avoid the penalty for not doing so. They may also qualify for Medicaid, in which case the premium isn’t as high.

Penalty Avoidance

The standard premium this year for enrolling in Medicare Part B is $134 per month, for those who filed a single tax return with $85,000 or less in income or those who filed jointly with $170,000 or less in combined income. If you’re ineligible for the standard premium, the Social Security Administration will notify you. According to the law, those 65 and over who aren’t covered by employer insurance or through a spouse and don’t enroll in Part B or delay doing so for more than a year are assessed a monetary penalty. This penalty is 10 percent of the premium for every year of non-enrollment.

Eligibility for Expanded Coverage

If you’re eligible to enroll in Medicare Part B and fail to do so but want a Medicare Advantage and Medicare Supplement plan, you’re out of luck. Being enrolled in Medicare Part A and Part B is a prerequisite for both registering and applying for these other plans.

As these advantages show, enrolling in Medicare Part B once you turn 65 may be beneficial for you unless you have other health insurance coverage in place.

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The Difference Between Medicare Advantage and Medicare Supplement Plans

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Have you ever gone to the grocery store to buy a product and been confused by how many brands were available for that one item? It makes what should be a simple decision confusing. Likewise, products with similar names can sometimes be hard to differentiate.

If you’re not sure of the differences between Medicare Advantage and Medicare Supplement plans, you’re not alone. The healthcare industry can be confusing with its multitude of complex terms and acronyms.

In fact, it’s fairly common for people to think they need a Medicare Advantage plan and a Medicare Supplement plan. That’s not true, though. You select one or the other. But don’t worry, we’ve broken down each Medicare plan option and explained the differences between the two, so you can make an informed choice. First, a little history.

Former president Harry Truman received the first Medicare card on July 30, 1965, the day it was signed into law by the president at the time, Lyndon Johnson. Medicare coverage took effect in 1966 with a budget of approximately $10 billion and about 19 million enrollees. Medicare Supplement plans were created in the 1980s under a piece of legislation called the Baucus Amendment. They were designed to provide Medicare recipients with coverage for gaps in the Medicare product. Fast forward 50 years later, when there are currently an estimated 57 million Medicare enrollees in the United States, and approximately 16 percent of the population is covered by Medicare.

Medicare Advantage

Medicare Advantage plans are offered by private insurance companies and must cover the same benefits as Medicare Part A and Part B, which are sometimes referred to as “Original Medicare.”

Medicare Part A and Part B are federally-run Medicare coverage programs that cover Medicare basics, like medical and hospital services. It is separated into two different parts: Part A and Part B. You must have both to move forward with additional Medicare coverage options.

The four types of Medicare Advantage plans include Preferred Provider Organizations (PPO), Private Fee-for-Service Plans (PFFS), Medicare Health Maintenance Organizations (HMO) and Medicare Special Needs Plans (SNP).

These types of plans often are comprised of benefits and services not covered by Medicare Part A and Part B, including deductibles and copayments, and may incorporate prescription drug coverage. In that case, they are called Medicare Advantage with Prescription Drug (MAPD) plans. They also may offer benefits and services such as dental, vision, or hearing care.

Some Medicare Advantage plans require enrollees to visit physicians, hospitals, and other healthcare providers that are part of the plan’s network and may necessitate a referral before seeing a specialist. Such plans have an annual out-of-pocket limit. Those eligible for Medicare Advantage plans can enroll in one of the following time periods:

  • During your Initial Enrollment Period when you first become eligible for Medicare.
  • During the Annual Enrollment Period from October 15 to December 7.
  • If you have Part A coverage and you get Part B for the first time during the General Enrollment Period.
  • During a Special Enrollment Period, in certain situations; for example, if you lose your current Medicare plan coverage.

For those who live in rural areas, there is one caveat to note about Medicare Advantage plans. You may have problems finding a plan that works with the healthcare services located in your area.

Medicare Supplement Plans

Sometimes called Medigap plans, Medicare Supplement plans also are offered by private health insurance companies. Medicare Supplement plans can provide you with additional Medicare coverage to fill in gaps from Medicare Part A and Part B. These supplemental plans help cover out-of-pocket expenses, including copays, coinsurance, and deductibles. Regulated by both state governments and the federal government, Medicare Supplement plans pay a portion of the bill not paid by Medicare.

The Open Enrollment Period for Medicare Supplement plans is generally the six months that starts on the first day of the month in which you are at least 65 years old and enrolled in Medicare Part B. The premiums for this type of plan differ based on the plan and company from which it is purchased. Those with chronic conditions often choose a Medicare Supplement Plan, even though it may be twice the cost of its Medicare Advantage counterpart.

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Medicare in 2019: Changes You Should Know

medicare in 2019

Whether it’s your first time enrolling in Medicare or you’re already familiar with the program, all enrollees need to learn about its impending changes coming in 2019. The 53-year-old program—signed into law in 1965 under the Social Security Administration—will undergo a massive transformation affecting its 60 million members.

Although enrollees may feel concerned by the word “changes,” they should find relief in knowing these changes are for their own benefit. Those looking to enroll in Medicare to take advantage of these improvements may do so during Medicare Annual Enrollment, which takes place from Oct. 15, 2018 through Dec. 7, 2018.

From revamped digital resources to increased flexibility and benefits, here’s what you need to know about the improvements coming to Medicare in 2019:

Expanded Benefits for Medicare in 2019

According to Medicare Rights Center, Medicare Advantage plans will be able to expand their coverage to include supplemental health benefits previously not covered by Medicare. These expansions include benefits for social determinants of health, such as nutritional care.

AARP notes that some Medicare Advantage plans will now offer the option to cover home-delivered meals, transportation to doctor appointments, in-home safety features (such as handles or ramps) and provide the option to pay for in-home help (such as health aides for eating and dressing).

Increased Telemedicine

According to AARP, Medicare is broadening telehealth availability. Enrollees undergoing treatments for end-stage renal disease or strokes will now be able to confer with a nurse or doctor via the internet or telephone.

Say Goodbye to a Therapy Cap

Also according to AARP, those who benefit from Original Medicare will no longer have to pay full price for outpatient physical therapy, speech therapy, or occupational therapy. Although this was the case in the past, Congress has officially repealed the therapy cap so that enrollees can have more access to these health services.

Closing the Donut Hole

Are you familiar with the term? “Donut hole” refers to the coverage gap created when enrollees with high prescription costs are required to pay more for their medicine after a certain price threshold is met.

The Affordable Care Act (ACA) was originally supposed to close the donut hole in 2020; however, Congress recently decided to accelerate this process to 2019. Note that this change will only apply to brand-name drugs, at least for the time being. Generic drugs will see the same change, but not until the original deadline of 2020.

New Medicare Cards

Newer and safer Medicare cards are officially being issued. Due to the fraudulent risks associated with the previous cards, Congress authorized a change back in 2015. Rather than using your Social Security number as your ID number, these new cards utilize an 11-character Medicare identifier unique to the service.

Although these new cards intend to reduce the chances of identity theft, enrollees must continue exerting caution. As reported by The New York Times, criminals constantly find new ways to scam people, such as calling to ask for a fee (even though the card is free) or requesting personal information for mailing a new card (even though this process is done automatically). Medicare will never call you uninvited for such requests. If you receive a suspicious call, report it by calling 1-800-MEDICARE (1-800-633-4227).

These changes are just a few of the improvements coming to Medicare in 2019. Stay up-to-date with everything you need to know with GoMedicare.

Still have questions about Medicare coverage and how it affects you? Visit our website for more information. 

 

This information is for educational purposes only. Medicare has neither reviewed nor endorsed this information.

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3 reasons to see a doctor, even if you’re healthy

If you are a healthy person, you may be wondering why you should visit the doctor if you are feeling fine. However, scheduling a routine checkup is important for prevention and could actually save you money on health care costs. Below, we list three important reasons to see a doctor regularly – even if you’re feeling fine.

Peace of mind

Did you know that one-third of all heart attack victims have no warning? Like heart conditions, strokes caused by blockages and high blood pressure can also sneak up on you. Fortunately, these types of conditions can be caught early during a regular checkup. Even if you’re feeling healthy, scheduling time to see and talk to a doctor can give you peace of mind in knowing everything is working as it should in your body.

Prevention is better than cure

Having peace of mind that everything is working properly can be a good feeling. Taking it one step further, should your doctor catch early signs of a disease or an illness, early prevention is better than having to focus on finding a cure. Spotting issues early through routine preventive screenings can reduce your risk for certain types of cancers, diabetes, and more. Similarly, starting treatment in the early stages of a disease or an illness could be more beneficial than waiting until the disease worsens.

Save money on health care costs

In addition to having peace of mind and preventing major illnesses, it’s important to see a doctor regularly to save money on health care costs in the future. Tackling an illness before it worsens can help you save money on medicine and emergency medical treatment, should you need it. In addition, healthy gums, teeth, and eyes contribute to overall health, so don’t forget to get your teeth and eyes checked, too.

 

 

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Did you miss the Open Enrollment Period?

If you missed Open Enrollment and do not qualify for a Special Enrollment Period, you still have coverage options. Short-term coverage can help you fill in gaps in your coverage until the next Open Enrollment Period. Other options, like Medicaid or the Children’s Health Insurance Program, can provide low-cost coverage outside of Open Enrollment.

If you need short-term coverage…

Short-term coverage is available for periods of one to 12 months at a time, depending on your insurer and state. You can enroll in short-term coverage at any time, regardless of the Open Enrollment Period.

Keep in mind that unlike major medical insurance, short-term plans might not cover pre-existing conditions and may have limitations on coverage. In addition, paying for short-term coverage does not protect you from having to pay the tax penalty. This still may be the best option for your current situation.

If you can’t afford a short-term plan…

You might apply for Medicaid or the Children’s Health Insurance Program (CHIP) at any time throughout the year, which both offer free or low-cost coverage.

If you’re not sure what you qualify for outside of Open Enrollment, call GoHealth to speak with one of our licensed agents at (866) 909 – 0798.

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What to do if you still need health insurance for 2018

If you missed the Open Enrollment deadline to purchase health insurance, you may have another chance to find coverage. If you experience a specific Qualifying Life Event, you may be eligible for a Special Enrollment Period in which you can enroll in major medical health insurance.

If you experience one of the Qualifying Life Events listed below, you may be able to enroll in a health insurance plan outside of Open Enrollment. Keep in mind that the Special Enrollment Period for a Qualifying Life Event typically lasts 60 days from the date of the event.

  • Moving to a different ZIP code
  • Getting married
  • Have or adopting a baby
  • Losing previous health coverage
  • Getting divorced
  • A change in income
  • Gaining citizenship
  • Turning 26 and aging off of a parent’s health plan
  • Errors with original enrollment

If you haven’t experienced one of these life events, you still have health insurance enrollment options. Short-term health insurance may be a good option for you and your family.

To find out what type of coverage you qualify for outside of Open Enrollment, call (866) 909 – 0798. Our licensed GoHealth agents can recommend you plans that fit your unique situation and budget.

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How can I use my health insurance coverage in 2018?

If you enrolled in a health insurance plan for 2018, there are many ways in which you can use your coverage to save time, money and maybe even a trip to the doctor’s office. Below, we explain how you can use your health insurance in 2018, plus the first steps to start using your plan.

Routine checkups, preventive care, and emergencies…

One of the best things about having health insurance is that you don’t have to wait until your medical issues worsen before you see a doctor or get treatment. Major medical health insurance allows you to get the care you need when you need it. In addition, under the Affordable Care Act, certain preventive health services are covered under your health insurance plan. The 10 essential health benefits are covered by most major health insurance plans and include emergency services, some prescription drugs, laboratory services, pediatric services, and more. Take advantage of the freebies your health insurance can offer.

Activating your health insurance and choosing your doctor…

To activate your health insurance, you have to pay your first premium. Premiums are monthly payments made to your insurer to maintain your health insurance. To find out how much you’re required to pay monthly and how to pay your bill, it’s best to contact your insurance provider directly.

Once your health insurance has been activated, you can choose your primary care physician. To find a doctor in your network, you can contact your insurance provider or your doctor’s office to ask if they accept your insurance. Choosing a doctor in-network could save you money on out-of-pocket costs for doctor visits and procedures.

Still have questions about your coverage? Visit our website for more information or call to speak with an agent directly at (866) 909-0798. 

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