Please share this public service announcement.

If you don’t have health coverage at work, the next two weeks are your only chance to get federal help to lower your premiums and health care costs for 2019.  In this post, I describe the kinds of financial assistance available, how to window-shop plans in your county, and how to find free, unbiased assistance to understand your options. I’m writing as a volunteer because federal funding for public outreach to Ohioans about the Affordable Care Act has been cut by over 80%.

Here’s how the ACA works:
The lower your income, the more federal help you can get, but this is only available if you apply and enroll in a Marketplace (“Obamacare”) plan by Dec. 15.

Here are people who should check their options right away:

  • Any adult 18-64 who isn’t offered insurance through their job.
  • Young adults who are aging-off their parents’ insurance, or who are over 18 and not claimed as dependents by parents or anyone else.
  • Small business owners:  your eligibility is based on your net income. Affordable Care Act subsidies could save you a lot of money.

The HealthCare.gov Marketplace plans offer two kinds of savings:

  • Lower premiums: Ohioans making from 138-400% of the federal poverty level qualify for subsidies to reduce their premiums. Hamilton County residents with Marketplace plans are paying an average of $142 per person a month for insurance this year.
  • Lower deductibles and copays:  if your income is below 250% of the federal poverty level, you can also qualify for lower deductibles and copays, but only if you choose a silver plan. People on the lower end of this income scale can save thousands of dollars a year if they need to use care. HealthCare.gov will calculate and show your savings when you complete an application and look at plans.

Apply as soon as possible to avoid the deadline crush.  To get the help you qualify for, you must complete an application through HealthCare.gov and enroll by Dec. 15.

You can window-shop on HealthCare.gov to see what savings you qualify for.
Go to HealthCare.gov and put “Preview Plans and Prices” in the search box. On the next screen, choose “Preview health plans and prices based on your income.” Follow the prompts to put in your family size, ages, and expected household income for 2019.  This will enable you to compare plans based on what you would pay after the subsidies are applied. With 10 insurance companies in the Ohio Marketplace instead of eight last year, Ohio families have more choices this year. Forty-six plans are offered in Hamilton County.

Free, unbiased help
Clinics and non-profits throughout Southwest Ohio have federally-certified assisters who can help you compare the costs and coverage of each plan, as well as which plans cover your doctors and prescriptions. This help is free. Go to HealthCare.gov, click on “Find Local Help,” and put in your zip code.

Many Ohioans between 18-64 are eligible for free coverage under Medicaid, which includes prescriptions, dental and eye care.
You can apply any time of year for Ohio Medicaid. To find out if you are eligible, go to benefits.ohio.gov and take the screening test.  The income limits are:  $16,753 for a household of 1, $22,715 for a household of 2, $28,676 for a household of 3, $34,638 for a family of 4, and so on.

You can easily complete the application at benefits.ohio.gov (answering only the questions with red asterixes) or get help from the Cincinnati Health Department, most of the health centers listed above, HCAN, or UHCAN Ohio.  Those numbers are listed above.

Buyer beware
Consumer advocates are reporting a huge uptick in health insurance scams. Do not provide your private information to any cold caller: you risk identity theft. The Ohio Department of Insurance issued a consumer alert Oct. 31 about the newly-available “short term” plans, which are not required to provide minimum essential coverage such as coverage for pre-existing conditions, prescriptions, or mental health.  These plans may be cheaper, but they may not provide the protection you need if you get sick.

Ariel Miller has five years experience as a Certified Application Counselor authorized by the federal government to help consumers apply and choose individual plans through the ACA Marketplace. Now retired, she volunteers at HCAN, a Cincinnati non-profit, and holds a master’s degree in health planning from Johns Hopkins.