Healthcare Open Enrollment is RIGHT Around the Corner!
There are LOTS of Changes YOU Need to Know About!
Before we get into the specific changes, there are some dates you need to put on your calendar for the open enrollment period:
- November 1, 2016: Open Enrollment Begins
- December 15, 2016: Meet this enrollment deadline to ensure coverage begins on January 1, 2017
- December 31, 2016: Coverage ends on this date. If you have NO changes to your plan, your plan will be auto-renewed
- January 31, 2017: This is the VERY LAST day you can apply for 2017 healthcare coverage
If you miss these deadlines, you cannot enroll again until November 1, 2017 unless you have special “life event” changes take place. Life event changes include: having a baby or losing your job.
Did you know?
If you do not enroll in Obamacare or have an approved form of health insurance during 2017, you will be fined 2.5% of your income or $695 per adult – whichever is higher. Please note that the amounted listed is only an estimation as the higher 2017 dollar amount has not been released as of yet.
Those living at poverty levels can enroll at any time in the Medicaid or CHIP (Children’s Health Insurance Program). These programs do not have a specific enrollment period or timeframe to adhere to. Please note, there are some restrictions to adhere to such as income restrictions.
Let’s first say good-bye to:
Say Hello to:
- Cigna – they exited the Florida Exchange in 2015 but are coming back in 2017
- Molina – They are expanding from South Florida to the Tampa Bay area
- Harken Health (a subsidiary of United Healthcare) is planning to enter the exchange in the Miami and and Fort Lauderdale area
Humana plans to scale back it’s participation in the Marketplace but will remain in the Florida Exchange system.
Other changes coming down the pike in 2017 include rate changes that have not been approved by the state yet.
Other Obamacare changes people can expect to see in 2017 are:
When you select a healthcare plan, there are usually two things you ask:
1) How much is it going to cost me
2) Is my doctor or the hospital I prefer in my plan
A common complaint last year was inaccurate doctor and hospital information. The new rules mandate that:
- Insurance providers are required to give consumers a 30-day notice when a doctor is being removed from a network
- If a doctor/provider is being removed from a network and a patient is in active care/treatment with the physician being removed, the insurance company must allow for up to 90 days treatment under the physician’s care
Reduction in “Surprise” medical bills from out-of-network providers
Many patients have complained about receiving unexpected invoices and bills from out-of-network doctors, even when the patient thought the doctor was in network. The new rule calls for:
- Ancillary care amounts to be applied towards a patient’s yearly out of pocket maximum expenses
Note, this rule only applies to those instances where the insurer has not given patients the correct notification that they will be receiving care from individuals outside of the network. The general rule is that a patient must be notified that they will receive care from an out of network provider within 48 hours.
Better Explanation of Out-Of-Pocket Expenses/Costs
During 2017, insurers are to offer plans with a standard set of coverage costs (deductibles and copays). With this information easily attainable, the patients will better understand the out-of-pocket fees associated with the plan they select.
Do you have specific questions about open enrollment and how the 2017 marketplace changes could affect you? Contact me, Your Obamacare Guy! I can be reached at: (813) 391-3448 or email address: dave@YourObamacareGuy.com