MSU Extension MI Money Health

Health insurance helps provide financial protection.  It is for managing the risks of very high medical expenses for potential future health problems.  Plan your choices during health insurance open enrollment for 2019.  If you obtain health insurance from your employer, ask about the enrollment dates and options.  The information below is for people buying health insurance on their own.

Changes for 2019 include the following:

1. Premiums have flattened out for 2019 Health Insurance Marketplace plans after several years of spikes, according to the Michigan Department of Insurance and Financial Services. Consumers should find more affordable, more comprehensive coverage.  In Michigan, nine companies will be competing for policy holders to purchase Qualified Health Plans in the Michigan Health Insurance Marketplace:

• Blue Care Network
• Blue Cross Blue Shield of MI
• McLaren Health Plan Community
• Meridian Health Plan of MI, Inc
• Molina Healthcare of MI
• Oscar Insurance Company
• Physicians Health Plan
• Priority Health
• Total Health Care USA

2. The repeal of the individual mandate requirement to pay for health insurance is still in effect in 2018 but will not be included in 2019. This means when you file federal income taxes for 2019, you will not pay a penalty for not having health insurance.

3. Short-term, limited-duration plans are allowable to cover an initial period of less than 12 months with renewal options, and up to 36 months total. This provides for new, more affordable options.  These plans can provide coverage for people transitioning between jobs, students taking time off from school, and middle-class families without access to subsidized ACA plans.  These plans offer lower premiums than comprehensive health insurance, but also cover less.  They do not have to take people with pre-existing medical conditions.  They may not cover maternity, mental health, prescription drugs and substance abuse treatment.  Read the fine print if you are considering this coverage.

Not new but important to mention are Health Savings Accounts (HSA), which can be set up through your employer or by an individual. These tax-exempt accounts can be used to pay for eligible out-of-pocket health care expenses not covered by traditional health plans.  HSAs must be established with a high deductible plan so that the HSA pays for routine health expenses and the health plan for more significant costs. Individuals can go to many banks and credit unions in Michigan to set up an account.

As noted in my August 2017 article, these 5 things to get ready to enroll for health insurance are also worth repeating:

1. Know the dates of the Open Enrollment period. The Health Insurance Marketplace will have a 45 day enrollment period from November 1 to December 15, 2018.  The Medicare open enrollment period is different from the Marketplace time frame, from Oct. 15 to Dec. 7, 2018.  If you qualify for the Healthy Michigan Plan, Medicaid or MiChild, you can enroll at any time of the year.
2. Ask your employer if it offers health insurance as a benefit. Some employers make use of the Small Business Health Options Program (SHOP) for employees.  If not, you may need to get coverage through the Marketplace, or directly from a health insurance agent or company.
3. Make a list of questions before it is time to choose your health plan. Do you want to stay with your current doctor?  Will the plan provide coverage when you are travelling?  This will help you compare multiple plans.  Have you received a notice from your current health plan about changes to its provider network, co-pays, co-insurance, or prescription drug coverage and what does this mean for you?  Read the notice carefully.
4. Gather your household income information. With the Marketplace, many people qualify for tax credits to save money based on family size and income.  Find your most recent W-2, pay stubs or tax return.
5. Set your budget. You need to figure out how much you can afford to spend on premiums each month.  Think about your health care needs, how often you visit the doctor, the number and cost of prescriptions.  If you expect frequent visits, prescriptions or medical services, you might want a plan that has higher monthly premiums but pays more medical costs when you use them, so you have fewer out-of-pocket costs.  For more information about managing plans with high deductibles, see my February 21, 2017 news article.

This is also a good time to do a financial check-up.  Be sure to check out Michigan State University Extension and MIMoneyHealth.org for great tips on many financial topics plus programs in the Events column.