How to navigate your 2018 health insurance options | VailDaily.com

How to navigate your 2018 health insurance options

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Open enrollment ends Dec. 15 for coverage that begins Jan. 1

Written By Lauren Glendenning
Brought to you by Kaiser Permanente

It's hard to keep up with health insurance headlines these days, but open enrollment is the time to break through the noise to determine what kind of health insurance coverage you need in 2018.

If you want health insurance coverage to begin Jan. 1, 2018, you need to submit an enrollment application by Dec. 15. Open enrollment is the yearly period in which you can enroll in a health insurance plan. It's shorter this year than it was last year, officially closing on Jan. 12. Anyone who enrolls in a health plan after Dec. 15 won't see coverage kick in until Feb. 1. If you miss the Dec. 15 or Jan. 12 deadlines, only a qualifying "life change event" (see factbox) would allow you to enroll in a health plan outside of the open enrollment period.

One of the biggest misconceptions about health insurance in 2018 is regarding financial assistance, said Bethe Wright, an independent insurance broker spending time in Kaiser Permanente's Frisco and Edwards medical offices to answer questions about open enrollment. While the Trump administration has ended cost-sharing reduction payments, the payments only affect reimbursements to health insurance companies, not to individuals — however, individuals are feeling the effects via higher health insurance premiums.

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It's important to clarify common misconceptions about health insurance before completing enrollment. Here are five things to consider before the Dec. 15 open enrollment deadline.

1. Do you qualify for tax credits?

There are two types of financial help available through Connect for Health Colorado: premium tax credits and cost-sharing reductions. Eligibility is determined based on household size and income for those unable to get coverage through an employer or another source.

"There still is help out there to pay your premium," Wright said. "So you really need to know what you're buying ahead of time."

Anyone who doesn't qualify for financial assistance does not have to use the Connect for Health Colorado exchange to buy an insurance plan and can instead buy directly from an insurance provider.

2. Estimate your healthcare needs

Are you happy with the level of coverage you had in 2017? Do you anticipate different needs in 2018? Kaiser Permanente recommends assessing your health care needs, especially if you anticipate increased medical care such as a recently diagnosed chronic condition.

3. Shop around

Insurance plans offer varying levels of coverage, with varying levels of co-pays, deductibles and out-of-pocket maximums. Wright said it's important to look at the big picture when considering an insurance plan. Look at the out-of-pocket maximums and compare plans — it might make more sense to pay higher premiums for a silver-tier plan, for example, if you know you're having a medical procedure in 2018.

And once you've chosen a plan, continue to educate yourself on service options and be a good consumer, Wright said.

"Compare costs for things like X-rays, lab work, etc.," she said.

Take advantage of wellness benefits, too, since all Affordable Care Act-compliant insurance plans cover preventative care — such as physicals, mammograms, colonoscopies and more — at 100 percent.

"Know what your plan covers," Wright said.

4. Use a local or regional insurance broker (this service is free)

There is no cost to use an insurance broker to help navigate insurance plans. Wright suggests looking for local brokers who know the market and can help you find the coverage you need.

You can search for brokers based on zip code at connectforhealthco.com (click on "Get Help").

A broker can also help determine whether a high deductible health plan in which you can put pre-tax dollars into a health savings account could help some folks qualify for tax credits. Anyone close to the income thresholds might be able to reduce their taxable income enough to qualify, Wright said.

Life Change Events

A special enrollment period is available only to those who qualify based on a life-change event. Qualifying Life Change Events include some of the following:

  • Birth of a baby
  • Change in marital status
  • Move to a new permanent address in your state
  • Become a U.S. citizen
  • Turning 26 and aging off your parent’s plan

Visit connectforhealthco.com for a full list of qualifying life events

Other tips to consider before picking your plan:

  • Review past insurance coverage — was it adequate?
  • Estimate health care needs in 2018.
  • Examine all costs and look at the big picture