ACA open enrollment period shortened this year

© 2018-Mendota Reporter

In Illinois, average premium increases are lower in 2018 than 2017 for all metal levels

SPRINGFIELD - This year, the open enrollment period for purchasing health insurance on the Marketplace has been cut in half. In the previous four years of the Affordable Care Act, open enrollment ran for 12 weeks. Enrollment this year will take place over a six-week period from Nov. 1 to Dec. 15.

During this time, consumers who are enrolling or re-enrolling in coverage will be able to look at all options that may be available on or off the Marketplace. After Dec. 15, enrollment will only be available to those who qualify for a Special Enrollment Period. The health insurance plans chosen during open enrollment will be for coverage that begins on Jan. 1, 2018.

The Illinois Department of Insurance says consumers in all counties of the state will have options. “DOI is committed to ensuring that consumers are prevented from incurring higher health insurance costs due to uncertainty in Washington,” said DOI director Jennifer Hammer, referring to recent attempts in Congress to end the Affordable Care Act. “Insurers have been advised to apply the CSR (Cost Share Reduction) uncertainty cost solely to silver plans.”

The DOI emphasizes that this change makes it important for people to diligently shop for a plan this year. Consumers are reminded that cost alone may not be the only factor to consider when selecting a plan. For example, consumers may want to also consider a plan’s provider network.

Illinois residents are encouraged to visit the Get Covered Illinois website ( for further information and assistance. Beginning on Nov. 1, consumers can compare plans, check their eligibility and enter their ZIP code to find local, free application help in English or Spanish. Consumers can also call (866) 311-1119 to get assistance in choosing a plan.

In Mendota, application assistance will be offered at Community Health Partnership of Illinois, 1009 Main St.; phone (815) 539-6124.

Who should enroll?

* The Health Insurance Marketplace is for people who do not have health coverage through their job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying health coverage.

* People with job-based insurance can buy a plan through the Marketplace but will pay full price unless their employer’s insurance does not meet certain standards. (Most job-based plans do meet the standards.)

* Individuals on Medicare cannot switch to Marketplace insurance, supplement their coverage with a Marketplace plan, or buy a Marketplace dental plan.

How much will it cost?

* What people pay for insurance on the Marketplace depends on their income – and they will probably save. Savings depends on one’s expected household income for the year. Over 8 in 10 people who apply are eligible to save, and most can find plans for $50 to $100 per month (after accounting for savings). The website provides consumers with a quick idea if they will save money.

Based on one’s income estimate, a person may qualify for:

* A health insurance plan with savings based on income. You may qualify for a premium tax credit that lowers your monthly insurance bill, and for extra savings on out-of-pocket costs such as deductibles and copayments. The plans are offered by private insurance companies with a range of prices and features.

*Medicaid and the Children’s Health Insurance Program (CHIP). Medicaid and CHIP provide free or low-cost coverage to millions of people and families with limited income, disabilities, and some other situations. Children may qualify for CHIP even if a parent does not qualify for Medicaid.

Important: If you had Marketplace health insurance in 2017, you can renew, change or update your plan for 2018 during the open enrollment period starting on Nov. 1. Consumers should be sure update their income and household information on their 2018 application, so they receive the right amount of savings. They can then compare all available plans and enroll in any one they choose. Plans sold during open enrollment will start Jan. 1, 2018.

Your 2018 insurance status

All insured individuals should expect to receive two letters regarding their insurance prior to Nov. 1. One letter will be from your current insurance company and one from the Marketplace. Together they explain your 2018 coverage status, which plan (if any) you will be enrolled in or matched with if you do not act by Dec. 15, any changes in your coverage and financial help, and directions if you need to send the Marketplace any documents.

If you do not receive an insurance company letter by Nov. 1, contact your insurance company; no Marketplace letter, call (866) 311-1119.

Update & compare plans for 2018

No matter which plan people wish to enroll in, strongly recommends that consumers update their Marketplace application with their most recent income and household information and compare their current plan to what is available for 2018. This can be done beginning on Nov. 1.

* New, affordable plans may be available this year. Plans and prices change every year. Additionally, a person’s situation may have changed. You may find 2018 plans with coverage and features that better meet your needs — especially if you have had or expect income or household changes.

* Update your application so your 2018 financial help is correct. Financial help is based on your expected income for 2018 (not last year’s income). If you do not update your income and household information, your premium tax credit and other savings could be inaccurate for 2018. Please note: If you have the wrong financial help, you could wind up paying more for your monthly premium than you have to, or you may use more advance payments of the premium tax credit than you qualify for and you would then have to pay back some or all of the difference when filing your federal taxes.

* You may be automatically enrolled for 2018 — but people are strongly encouraged to update their application and check out new insurance plans first. People who do not renew or enroll in a plan by Dec. 15 may be automatically enrolled in the same or a similar plan.

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