Big Open Enrollment Changes – What You Need to Know

Oh No! it’s that time again. You have to select a new individual health plan for 2018.  Last year you had three months to decide – that was hard particularly for those who procrastinate. But this year, the rules have changed.  

Instead of the three months, you get a whopping 45 days (Nov. 1-Dec 15, to be exact), which face it, is not a lot of time. So, no time like the present to start researching about what you want to do for 2018.

When you do start your search, you could expect some sticker shock. Central Texas insurers (out of the few that are left, for individuals) have submitted requests for 2018 rate hikes, according to Healthcare.gov. Most existing insurers, have requested an increase of 23% or more.

Phew. That’s a lot to take in.

The good news is that Central Texans still have several options and one of those is based right in their neighborhood — regional health plan Vista360health. Adding to their uniquely Austin health plans is a new one called The Fusion Bronze Plan that addresses what many healthy Austinites (those with few medical needs) want –  a lower cost, higher deductible option with perks like $0 copay for your PCP office visit and an allowance towards x-rays and labs.

Before you pour that extra large cup of coffee to begin the laborious research process consider these important shopping tips:

Your current plan may change

Your 2017 coverage automatically renews– but remember that changes can be made to your plan each year. Find out if copays or deductibles are changing. Also, new options could become available that might better suit your needs.  

Miss the small window and you could be uninsured

You can sign up for a qualified health plan after Dec. 15 only if you have a Special Enrollment Period (SEP). Examples of a SEP include, marriage; divorce; baby birth or adoption; or losing insurance due to job loss. You will only have 60 days from one of these events to enroll in a new qualified health plan. Be aware, penalties (taken from income tax refunds) will remain – and likely increase.

Greater choice off the exchange.

The health insurance exchange (i.e. healthcare.gov) isn’t the only game in town. People who qualify for subsidies should shop on the exchange to acquire tax credit subsidies. But, for everyone else, the free market awaits! What’s the benefit? Choice! From provider network to deductibles to drug benefits, qualified “off exchange” health plans (like Visat360health), meaning those that comply with the federal healthcare rules, often have a wide variety of options that may better suit your needs and that you wouldn’t find on the exchange. A good place to search for off exchange options is KindHealth.co another locally-based company that makes shopping a little bit easier.

Check network first.

Do you love your doctor? Of course you do! You’ve been sharing a lot of information with your doc over the years. Instead of searching for your providers on each health plan, make your search easier by calling your doctor’s practice and finding out which individual health plans they accept. For instance, Austin Diagnostic Clinic only accepts one individual health plan — Vista360health. So, if you have an ADC doc and want to keep them, your shopping just got easier.

Need help negotiating the healthcare maze? Get it from Austin-based Vista360health. Contact us — we’re local, we understand what you need. For more information visit, Vista360health.com.