For Floridians who get their health insurance through the Affordable Care Act Marketplace, it’s that time of year again.
Also known as Obamacare, open enrollment on healthcare.gov kicked off on Nov. 1, and runs through Dec. 15.
Those looking for health insurance because they are not covered by their employer can buy directly from healthcare.gov or through certified insurance brokers at no cost.
ACA “navigators” are also available for free to help people compare plans and costs.
Next week, those interested in speaking with a navigator can go to the Kissimmee Goodwill Tuesday, Nov. 26, from 9 a.m. to 5 p.m. Find more events at www.coveringcfl.net/schedule.
Nationwide, about 10 million people are covered through the health law’s insurance markets, which offer taxpayer-subsidized private plans for people who aren’t covered on the job.
An average of 6.4 percent of the population was covered by individual market plans, including on and off-exchange policies, in 2017. But in Florida, it was double the national average, at 12.7 percent.
About 1.8 million Floridians purchased health insurance through the ACA Marketplace for 2019, more than any other state. Florida is one of just nine states where enrollment during the open enrollment period for 2019 plans was higher than it had been for 2018 plans.
Florida’s 2019 enrollment was an increase of about 4 percent over the prior year.
But Florida also has rejected federal funding to expand Medicaid, leaving a gap in coverage for the state’s working poor – those who don’t qualify for Medicaid and don’t earn enough to qualify for federal government subsidies on the ACA Marketplace.
Starting in 2018, premium subsidies in the Florida exchange became larger than they were in 2017, making coverage for many enrollees more affordable than it was in the past. That’s because cost-sharing reductions were added to silver plan premiums in Florida.
Many Floridians signing up on the federal exchange will find lower rates and more choices for 2020. The average national premium for the benchmark plan will drop 4 percent and 20 more insurers are offering policies, bringing the total to 175.
Here is a rundown of the Marketplace basics from healthcare.gov.
Knowing just a few things before you compare plans can make it simpler.
• The 4 “metal” categories: There are 4 categories of health insurance plans: Bronze, Silver, Gold and Platinum. These categories show how you and your plan share costs. Plan categories have nothing to do with quality of care.
• Your total costs for health care: You pay a monthly bill to your insurance company (a “premium”), even if you don’t use medical services that month. You pay out-of-pocket costs, including a deductible, when you get care. It’s important to think about both kinds of costs when shopping for a plan.
• Plan and network types: HMO, PPO, POS, and EPO: Some plan types allow you to use almost any doctor or health care facility. Others limit your choices or charge you more if you use providers outside their network.
Remember that plans also may differ in quality. For the 2020 plan year, HealthCare.gov is expanding the health insurance plan quality ratings (or “star ratings”) program to all states.