Tips to Get Ready for the 2018 Marketplace Open Enrollment

Doctor holding chalkboard that reads "Open Enrollment" on white background

Open Enrollment 2018 starts on November 1st, so it is time for you to reassess your needs and get health insurance for the upcoming year. Marketplace insurance provided by the Affordable Care Act offers a number of great affordable health insurance plans for you to choose from. It’s an easily accessible option to get California health care coverage for you and your family.

However, this might be the first time you’re purchasing a plan through Covered California and the ACA/Obamacare. Going through Obamacare enrollment and navigating through the Healthcare Marketplace can be confusing if you don’t know how it works. Here is a brief explanation of the health marketplace and the enrollment process.

What is the Health Insurance Marketplace?

The Health Insurance Marketplace is where people who do not get health insurance through their job or cannot find a plan through a private insurer can purchase an affordable health insurance plan. It was set up through the Affordable Care Act a.k.a. Obamacare with the intention that everyone have access to low-cost health insurance. The cost of health plans within the Marketplace are based on the amount of coverage you want and your annual income. While Healthcare.gov has more information about the Marketplace for health insurance, California residents can get additional information and enroll in a health plan through Covered California. Remember, Open Enrollment for 2018 starts on November 1st, 2017 and ends on December 15, 2017.

What Do You Need to Enroll?

If you want to enroll in a health plan in the Marketplace, you’ll have to provide some specific bits of information on your application. Here is the basic info you’ll need to have on hand when enrolling for a Covered California/ACA health plan:

  • Home/mailing address of you and every family member applying for coverage.
  • The size of your household and the number of them applying for coverage.
  • Birth dates and other such information about everyone applying.
  • Social Security Numbers of all applicants.
  • Tax information.
  • Employer and income information for every member of your household, such as pay stubs or W-2 forms.
  • Your best estimate of your projected household income for 2018
  • The insurance policy numbers for any current health plans covering members of your household.
  • A completed “Employer Coverage Tool” for every job-based health plan that you or someone in your household is eligible for.
  • Notices and documentation from your current health insurance plan, including your plan ID, if you have/had health insurance coverage in 2017.

Once you have all that information available, you can apply and enroll online, in-person with a licensed agent, over the phone, or with a paper application.

What Are the Four “Metal” Plans?

The health insurance offered by the ACA and Covered California is varied, but is generally broken down into four “metal” categories. Each category is labeled a different based on their general cost of premiums and the amount of coverage they provide. Here is a simplified breakdown of each one:

Bronze Plan

Bronze plans typically have the lowest monthly premium, but you’ll have higher out-of-pocket costs when you receive care. The deductibles you have to pay yourself before your insurance plan starts to pay could be up to thousands of dollars. This is a good choice for people who are generally healthy, want the lowest monthly payments, and just want medical coverage protection for worst-case scenarios.

Silver Plan

Silver plans are insurance policies that are “in the middle.” The monthly premiums are more moderate in cost and you will only have moderate expenses when you receive medical care. If you qualify for “extra savings” on your deductible, copayment, and coinsurance then you’ll save hundreds to thousands of dollars per year if you require consistent medical care. It’s a good plan to pick if you do qualify for extra savings and can pay slightly more than a Bronze plan to get more coverage for routine care.

Gold Plan

Gold plans have high monthly premiums, but your medical costs and deductibles are generally lower than most other plans. This is a good plan for people who need regular health care services and are willing to pay higher monthly premiums to offset those medical costs.

Platinum Plan

Platinum plans have the highest priced monthly premium, but provide the most coverage when you receive medical care. They also have the lowest deductibles than any of the other “metal” categories. If you usually use a lot of health services, platinum plans are worth paying the higher premiums and knowing that nearly all of your medical costs will be covered.

What Health Plan is the Best for You?

Ultimately, only you can decide what health care plan is right for you and your household. Consider the amount you paid for health costs in previous year, such as doctor’s visits, prescriptions, and other medical expenses. Check your finances to see which plans allow you to be able to afford the monthly premium payment and be able to pay the deductible amount. Think about your future, as you may want coverage for planned pregnancies or upcoming surgeries. If you have a specific doctor or hospital you want, make sure the plan you’re considering has them in their network.

If you still need help enrolling for health coverage or need additional guidance on which plan to partake in, there are professionals that can help you fill out your application and find the the plan that fits your needs over the phone or in-person. You shouldn’t purchase a plan until you truly know how much it will cost you and what limits your insurance has regarding your coverage.

Need a hand finding a health insurance plan in California? Cost-U-Less Insurance can help guide you to an affordable plan that can meet your needs. Give us a call or get a free health insurance quote online to get started.