It's almost that time of year again. Time for open ACA (Obamacare) open enrollment which begins on Nov. 1 and ends on Dec. 15 for the 2018 plan year. The open enrollment period this year has actually been reduced by about 45 days.
So how does the Obamacare situation look for us Regionites going into open enrollment? It is once again wrought with uncertainty and disappointment. In short, it's a mess.
Two of the four insurance companies offering plans in Indiana, Anthem and MDWise announced earlier this year they intended to pull out of the program in Indiana and of the remaining two companies in the state only one, CareSource, will offer plans in Lake and Porter County. While I haven’t seen the actual premium rates for next year, in a little bit of good news, indications are rate increases on CareSource plans will be nominal over this year’s rates.
The stress level this issue is causing many of my clients is disheartening. It remains shocking to me that we as Americans have allowed the Federal government to do this to us, and at this point both political parties share some blame.
So let me go through some survival tips that might just help you endure.
First, get help. While carriers, plans and premiums rates are confusing, in my experience working with clients, the most difficult questions to navigate in NWI involve provider networks. While the Region has no shortage of quality healthcare institutions, with some of the world-class healthcare options available in the Chicago area, many NWI residents feel the ability to access these resources is mission critical.
With this in mind, I feel like an experienced health insurance agent, or perhaps health Navigator, can be extremely helpful in assisting with exploring how these health plans can be used. Often times actual real-world health care decisions are made during stressful emergency situations, having a frame of reference beforehand so that the financial implications of such decisions are understood is extremely important. An agent or navigator can answer questions in this area enabling better decisions if an unfortunate healthcare situation arises.
Second, understand the ACA subsidy system. Federal premium subsidies for ACA plans are based on income level. Not on assets, and not on net worth. For many early retirees between the ages of 58 and 65 the ability to get a Federal premium subsidy is absolutely imperative.
With some understanding and a bit of financial engineering, a good retirement planner can be very helpful in making sure income is structured within the context of the rules to receive a subsidy. The income to determine subsidies is based on a complicated Modified Adjusted Gross Income or MAGI. This MAGI calculation includes IRA withdrawals, but not Roth IRA withdrawals, it includes interest and capital gains, but not withdrawals from savings or investments. Armed with some knowledge and creativity these rules can be harnessed to put you in a good situation to receive a subsidy.
Finally, for most, the ACA system coverage is expensive and unsatisfying. The coverage is expensive and unsatisfying. Explore all options available with employers, always look at COBRA coverage from prior employers, learn about non-ACA individual plans, and be open-minded to alternative programs like the Christian sharing network my family uses. The ACA may be fixed over time, but it won’t be fixed anytime soon.