Oh my. Since premium increases were announced last week, MNsure has certainly commandeered headlines. Lawmakers are frustrated, while health insurance companies insist that heightened rates for the individual market were unavoidable. Though the current marketplace we must navigate will likely see tweaks in future years, our focus now is 2017. If you are part of the 250,000 Minnesotans who look for insurance on the individual market or the nearly 250,000 without insurance, the start of open enrollment on November 1 is fast-approaching. Understanding the current options and knowing your plan “must-haves” will allow you to feel secure in your 2017 plan choice.
What to consider when enrolling in your 2017 health plan:
Premium costs. Yes, premiums increased, on average, between 50 and 67 percent. However, based on your family size and income, you may qualify for discounts in the form of a premium tax credit or a cost sharing reduction (CSR) subsidy. With the help of an agent, you’ll find a tax credit may significantly reduce your monthly premium, while a CSR could lower the amount you have to pay out-of-pocket for deductibles, coinsurance, and copays. (They can also lessen the maximum out-of-pocket costs your plan determines you are accountable for during a policy period.)
Foreseeable medical costs in 2017. Whether you do or do not qualify for discounts, your health insurance agent will review plan options that are sensible for your family in the next year. In a “good” year medically-speaking, you may visit a provider for preventative care only and your out-of-pocket expenses will be low. Some examples from a “bad” year might include a family member who requires major surgery, or the need for costly prescriptions to treat an illness. Your agent will work with you to understand your predicted health needs and expenses. It is, of course, a bit of a guessing game, but when he knows how you may utilize your insurance, he can highlight your best plan choices beyond simply comparing premiums.
Networks. For 2017, health plan provider networks have narrowed. A provider network is a collection of individual providers, clinics, hospitals, etc. Different insurance companies contract with a number of these provider groups to create its provider network(s). Depending upon where you live in Minnesota and which insurance carrier you choose — like Blue Cross Blue Shield, UCare, HealthPartners or Medica — your in-network provider options will vary. If you are particular about with whom or where you seek medical services, it is especially important this year that you are sure your plan is aligned with your preferred network.
Availability of plans. Health insurance will be available to everyone who enrolls — but it is important to note that some carriers will cap their plans at a certain number of enrollees. Open enrollment, or the insurance merry-go-round, will keep spinning until January 31st — but the earlier you know what plan you want, the more likely you are to leave the marketplace with your top pick. An agent is available to meet with your prior to the start of open enrollment (November 1, 2016) to help you choose a plan in advance.