Here’s what you need to know about enrolling in a health insurance plan for 2019, including information on how GoodRx can help you save on your prescription drug costs.
Open enrollment deadlines
In most states, open enrollment begins November 1 and ends December 15, with all plans becoming effective January 1, 2019. Whether or not you live in a state with its own enrollment platform, start at www.healthcare.gov to search for a marketplace plan that’s right for you.
There are a total of 12 state-run insurance marketplaces that have some flexibility in terms of enrollment schedules. Seven of them have extended enrollment periods:
- California: Open enrollment for 2019 is October 15 to January 15. California residents who enroll after December 15 will be covered starting February 1 instead of January 1.
- Colorado: Open enrollment for 2019 is November 1 to January 15. Colorado residents who enroll after December 1 will be covered starting no later than February 1.
- District of Columbia: Open enrollment for 2019 is November 1 to January 31. DC residents who enroll between December 16 and January 15 will be covered starting February 1. Those who enroll after January 15 will be covered starting March 1.
- Massachusetts: Open enrollment for 2019 is November 1 to January 23.
- Minnesota: Open enrollment for 2019 is November 1 to January 13.
- New York: Open enrollment for 2019 is November 1 to January 31.
- Rhode Island: Open enrollment for 2019 is November 1 to December 31.
The remaining five state-run marketplaces (Idaho, Vermont, Connecticut, Washington and Maryland) are slated to follow the November 1 to December 15 schedule, but last-minute extensions could still be added before the end of open enrollment.
Check this page for updates on enrollment deadlines for state-run marketplaces: www.healthcare.gov/marketplace-in-your-state.
Special enrollment deadlines
Plan changes and new enrollments outside of the open enrollment period are only possible for people who experience a qualifying event. Enrolling in health insurance outside of open enrollment is called special enrollment, and the deadline for enrollment is 60 days following the qualifying event. If you miss that deadline, you’ll have to wait until the following year’s open enrollment period to apply.
Qualifying events include (but are not limited to) these life events:
- Losing health insurance
- Having a baby, adopting a child or fostering a child
- Getting married or establishing a domestic partnership
- Returning from active duty
- Gaining citizenship or lawful presence
For more information about special enrollment and qualifying life events, visit this guide here: www.healthcare.gov/coverage-outside-open-enrollment/changing-plans.
What’s changing in 2019?
A lot has changed in health insurance policy recently, including the loss of federal subsidies for insurers, an increased availability of short-term, non-ACA-compliant plans, and the repeal of the individual insurance mandate. Reading about what these changes mean can be dizzying, but in short, they all impact insurance availability and pricing. Here’s a summary of how these changes will affect your options for next year’s ACA plans:
- Participation of health insurance companies in ACA marketplaces will increase. In 2019, we’ll have a total of 155 state-level health insurance issuers, 23 more than what we had in 2018. This might sound promising, but how accessible plans will be within states remains to be seen. In 2018, rural counties saw disproportionately fewer insurance options than urban counties.
- Options for qualified plans will increase. The average number of qualified health plans (QHPs) on ACA marketplaces will go up from 25 in 2018 to 26 in 2019. QHPs are plans that meet minimal benefit and cost-sharing standards, along with other requirements as defined by the ACA. In addition, more people will have more than one option for an insurance issuer.
- Premiums for silver plans will go down, but still remain high. From 2018 to 2019, the average premium for a 27-year-old on a silver plan will decrease by 2%. But that’s not saying much considering premiums in 2019 will be 85% higher than that in 2014. Most people who enroll in a plan through the ACA marketplaces choose a silver plan.
- Average monthly subsidies will decrease by 3%. Cost assistance in the form of subsidies are available to those who qualify and purchase an insurance plan through the ACA marketplaces. If you received subsidies in 2018, you may see your monthly subsidy drop a bit next year. However, average subsidies in 2019 will still be 110% higher than the average subsidy in 2014.
- Access to low-cost plans will continue to decrease. Only 6% of current enrollees in 2018 have access to a plan with a premium of $200 or less compared to almost 40% in 2015. That percentage will drop again in 2019 to 5%.
- The individual mandate will disappear. Health insurance protects people against unexpected and overwhelming medical costs. However, starting in 2019, you will no longer get a tax penalty for not having “minimum essential coverage” as defined by the ACA. The individual mandate, which currently requires most Americans to carry a minimal level of health coverage or else incur a fine, was repealed and will only stay in effect up until the end of this year.
Watch out for auto-enrollment
If you enrolled in your current plan through an ACA marketplace, open enrollment is your time to choose a different plan. If not, you will most likely be enrolled again for 2019 in the plan you already have. This might sound nice, but plans change every year—including their premiums, benefits and coverage—so be sure to log in and re-enroll before your open enrollment deadline.
Some insurers may leave the ACA marketplace after December 31. If you currently have ACA coverage, but your insurer is planning to leave the marketplace at the end of the year, you will be automatically enrolled with a different insurer unless you pick a new plan by the end of open enrollment. Depending on which state you live in, you may be eligible for a special enrollment period, which will give you 60 days after your old plan ends to enroll in a new plan.
How can GoodRx help?
GoodRx discounts can help you get the best deal on your prescription medications, even after you enroll in health insurance. In many cases, just because a drug is covered doesn’t mean it’s affordable. And having insurance doesn’t guarantee that your drug will be covered at all.
So, don’t forget to shop around. Check GoodRx coupon prices for your medications against their prices with your insurance, and choose whichever option is cheaper. If you don’t already know what your copay will be for a prescription, call your insurer or use their web portal to get an estimate of your cost.
When using GoodRx instead of your insurance to pay for a prescription, your payment won’t count towards your deductible. However, you can always contact your insurance company to see if you can submit a receipt and apply that towards your deductible. Some plans will allow you to submit receipts for potential reimbursements or deductible credits.
Need more than a coupon? GoodRx can also help you find savings tips, suggestions for alternative, less-expensive drugs, and information on assistance programs and manufacturer savings.
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