Q: What are the main things to know about enrolling in health insurance for next year through the government exchange?
A: Premiums are rising, on average, by 6 percent next year for Affordable Care Act-compliant plans sold both on and off the government exchange, according to research published last week by the Kaiser Family Foundation.
Ten more things to know:
1. Open enrollment runs for 45 days only, today to Dec. 15, for coverage starting Jan. 1. After that, you will still need to qualify for one of the exceptions that allow for "special" enrollment outside the open period.
2. There are 35 health plans through Health Alliance and Blue Cross Blue Shield of Illinois available on the government exchange for Champaign County. Enter your ZIP code at healthcare.gov to see plans in your area.
3. You can buy coverage on or off the government exchange, but to be eligible for a subsidy to write down the premium costs, you still need to enroll in one of the plans on the exchange.
4. Subsidies aren't available to help lower the premium costs for two other types of coverage available next year — catastrophic and short-term health plans.
5. If you're considering a short-term plan, be aware they generally offer thinner coverage because they don't have to provide the 10 essential health benefits required for plans sold through the government exchange.
Also, short-term plans can cover you for as long as 364 days (with renewals available) rather than just for three months, which was the limit for most of this year. And under a short-term plan, an insurer can reject you if you have a pre-existing condition.
6. Catastrophic plans are available only for people under 30 or those who meet certain hardship conditions, but, unlike short-term plans, catastrophic plans include the 10 essential health benefits.
For 2019, catastrophic plans provide benefits for at least three primary care doctor visits for the year and some preventive health services before a $7,900 deductible is met. You'll pay for other health services 100 percent until you rack up $7,900 in out-of-pocket costs.
7. Even if you were happy with the health plan you've had this year, investigate the options and shop carefully, advised Health Alliance VP SINEAD RICE MADIGAN.
Look at more than premium and out-of-pocket costs, she urged. Make sure the health care providers you see will be in network and the benefits meet your needs.
It's best not to delay, Madigan advised.
"It's not a really long window to shop," she said.
8. Madigan also advised those who don't financially qualify for a subsidy and thus find premiums too pricey to check with insurers about their off-market plans.
9. Nearly all the bronze level plans (those with the lowest premiums and highest out-of-pocket costs) offered in the area require deductibles in the $3,000-$6,000 range to be met before insurers begin paying for any of your covered expenses.
10. Need help enrolling? Champaign County Health Care Consumers will, again, be offering assistance with enrollment. Call ahead for an appointment, the organization requests.