If you have health insurance through the individual market – or no insurance – you should check out your options on HealthCare.gov before Dec. 15 because you may find a plan that better fits your needs and budget. The Ohio Department of Insurance says that average premiums in Ohio have gone down 7.7% for 2020, compared to 2019. Be sure to go to the right website – HealthCare.gov (there are many confusing options with similar names.) You can apply online, find free local help, and access the website’s consumer protection tools, which allow you to compare plans side by side on price and coverage. The website allows you to check which plans include your doctors and if your prescriptions are covered. You can window-shop on HealthCare.gov by putting “See Plans and Prices” in the search box.
There are three ways ACA plans can cut your costs. The first is through lower premiums. The Department of Health and Human Services reports that 8 in 10 Obamacare enrollees this year qualified for tax credits. These credits covered 86% of their monthly premium costs, leading to an average monthly premium bill of $87 after the subsidies. The second way to save is through cost-sharing reductions for eligible consumers (people earning between 100 and 250% of the poverty level). These benefits – which operate on a sliding scale – can dramatically reduce a family’s deductible and out-of-pocket costs. To get cost-sharing reductions you must choose a silver plan. If you know you will need to use health care, silver plans could save you money: the lower premiums of bronze plans saddle you with maximum deductibles and cost-sharing costs. The third path to savings is that working age adults making up to 138% of the poverty level can get free coverage through Ohio’s expanded Medicaid, which is part of the Affordable Care Act. Ohio’s expanded Medicaid covers prescriptions, dental, and vision care. If you are self-employed, you may qualify for Medicaid because your adjusted gross income – used to determine eligibility for self-employed people – reflects your business expenses.
When you complete an application through HealthCare.gov, you will immediately get eligibility results which tell you the monthly amount you can use to reduce your premium, and whether you qualify for “extra savings,” the cost-sharing reductions. When you look at plans you will see all the savings you qualify for reflected in the premium prices, deductibles, and out-of-pocket maximums.
Despite the chaos of the past three years, the individual market is getting more robust in Ohio, with 10 companies offering plans on the Exchange and many counties having more options than in 2019. In 2020, every county except one has at least two companies offering plans. Most have three or more insurers each offering an array of plans. It is very easy to check out your options and you can still get free help from assisters in local health departments, federally qualified health centers, and some community non-profits. Click on “Find Local Help” on the HealthCare.gov website. These assisters are federally certified and must give you unbiased help. Agents and brokers can also help you find plans. The assisters in health centers and non-profits, however, generally have more experience with Medicaid applications and can help you find out if you might qualify. You can apply directly for Ohio Medicaid at any time during the year via the state’s own website at benefits.ohio.gov Note that people aged 18-64 applying for “expanded” Medicaid do not have to answer the asset questions on the application. Only answer the questions with red asterixes.
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Ariel Miller, a member of Ascension and Holy Trinity, Wyoming, has been a volunteer certified application counselor with Health Care Access Now since 2014.