California’s annual health insurance enrollment season for individuals and families kicks off this week against a backdrop of drama: the hotly contested presidential election; an uncontrollable pandemic across much of the United States; and, on November 10, a Supreme Court hearing on a case that could end the Affordable Care Act and lock millions of people without coverage.
Massive unemployment caused by the pandemic has already deprived employers of health insurance millions nationwide and induces severe financial anxiety as families struggle to pay rent and purchase food.
One question hanging over enrollment in 2021 health plans is whether the large-scale loss of medical coverage will generate an increase in enrollments, or if more pressing financial concerns for many people will push insurance lower in the future. their priority list.
“People have so much to deal with: they’ve lost their jobs, they’ve lost a lot of income, and in California they’re also facing fires. I don’t think health insurance has been a priority for people, ”says Cheryl Fish-Parcham, director of access initiatives at Families USA, an organization that advocates for consumer health care.
But Peter Lee, executive director of Covered California, the state’s ACA marketplace, is confident it will match the 40% increase in new listings he had for 2020 coverage.
“It’s clear that COVID is on the minds of Californians,” he says. “You can’t have COVID in your head without having coverage in your head as well. “
A Supreme Court ruling on the future of ACA probably won’t come until next year, and it’s unlikely to affect your 2021 coverage. “So people need to feel confident when they are looking for a health plan, ”says Sara Collins, vice president of health care coverage and access at the Commonwealth Fund.
If you’re 65 or older, you’re likely eligible for Medicare, the federal program for seniors, which is entirely separate from ACA scholarships and the larger individual market. Registration open to private health insurance Advantage plans and Part D drug plans are also ongoing and end on December 7th. Insurance agents can usually help you with Medicare, and you can get advice by calling 1-800-434-0222.
If you’re under 65, live in the Golden State, and want to purchase insurance for you and your family, start with Covered California. You can get federal and state help to cover some or all of your premiums, if you meet certain income criteria.
The listing period for California Covered, and for the individual off-the-exchange market, began on November 1 and ends on January 31. In states with federally administered scholarships, the enrollment period the window closes on December 15th.
If you’ve lost your coverage and need it by December of this year, you can still get it through Covered California if you sign up by November 30. For regular annual coverage that begins January 1, you must register by December 15. If you miss this deadline, you can still get coverage from February 1 if you register before the January 31 deadline.
A lot of people leave money on the table because they don’t know about financial aid or think they are earning too much to qualify. But you don’t have to be poor to get help.
Federal grants, which are tax credits typically provided in the form of reduced monthly premiums, are available for people with annual income of around $ 51,000 and a family of four with income of nearly $ 105,000. .
California has complemented federal aid with state-funded aid that extends further to the middle class: up to about $ 76,500 for an individual and $ 157,000 for a family of four.
If you log into the Covered California website, www.coveredca.com, you can check the amount of financial assistance you are entitled to and compare health plans. Or, an insurance agent or certified recruiter can do the job for you, at no cost. You can find one on the site. You can also call Covered California directly at 800-300-1506.
If your income is below 138% of the federal poverty line, you will likely have qualify for Medi-Cal, the government insurance program for people with limited resources. The Covered California website – or a recruiter – will let you know if you do and walk you through signing up. You can also contact your department Medical Office. If you are not eligible for Medi-Cal, your children may be eligible because the income threshold is higher for them.
If you’re looking for exchange sponsored coverage, click the “Buy & Compare” tab on the Covered California website, which takes you to a screen that asks for your age, income, zip code, and your size. family and displays the available health plans, their premiums and the amount of your assistance.
The website also offers quality notes participating health plans. And you can check which plans have your doctors in their networks – although, as the website warns, that information isn’t always up to date.
The price comparison on the website is straightforward, because at each of the four levels of coverage – bronze, silver, gold and platinum – benefits are uniform from one insurer to another. So, once you have decided which level of metal is best for you, you just need to think about the price and whether your suppliers are in the network.
If you already have a covered health plan in California, shop around rather than automatically renewing the one you’re in. “The best deal last year isn’t necessarily the best this year,” says Anthony Wright, executive director of Health Access California.
California Covered announced a 0.5% statewide average premium increase last month, but actual rate changes vary state to state and carrier to carrier.
Anthem Blue Cross, for example, will increase rates by 6% on average statewide and California’s Oscar health plan by 7.6%, while California’s Blue Shield will reduce rates by 2.4. % on average and the LA Care health plan by 4.6%.
If you upgrade to the cheapest plan at your current metal tier, you could reduce your premium by up to 7.4%, according to Covered California.
Keep in mind that the lower premium, a bronze plan, is not necessarily the wisest or cheapest choice.
Tom Freker, an insurance agent from Huntington Beach, advises people not to buy bronze because his higher deductibles and coinsurance the rates could cost more than a higher premium plan if you get sick or have a serious accident.
Freker recommends that you register with Covered California rather than the OTC market, even if you are not initially eligible for assistance. Indeed, if your income declines and you report it to the stock exchange, then you could qualify and get a premium reduction for the rest of the year or a tax credit the following April, he says.
If your income increases during the year, you should also report this so that your monthly premium subsidy is reduced, saving you from a potentially high tax bill in April.
Your initial assistance amount, if you qualify, will be based on your expected income for 2021. In this time of pandemic-induced leave, reduced hours and lost jobs, it could be difficult to predict.
Maria Weston, a massage therapist in Long Beach, said her income has fluctuated week to week since the start of the pandemic and has fallen by about 50% overall.
Her priority for 2021 was to find a cheaper option, so she switched to a cheaper money plan last month (current registrants were allowed to make their health plan choices from October 1).
Weston’s new health insurance plan will save him nearly $ 1,700 a year on premiums. “I could put this in my retirement account – or eat it,” she said. “One of the two.”