It’s time to choose health insurance again: This Q&A may help.

Monitor Staff
Sunday, October 29, 2017

Amid all the debate swirling about the present and future status of the Affordable Care Act, the federal health insurance program’s open enrollment window will happen on schedule, starting Wednesday, Nov. 1, and running to Dec. 15. 

If you want insurance through the ACA in 2018, that will be your time to sign up. But you may have some questions. Here are some answers – including where to find more answers.

Q: We’ve been doing this for four years. Has anything changed?

Oh yeah. Notably, only three companies are participating through the New Hampshire Marketplace next year: Anthem, Ambetter from NH Healthy Families, and Harvard Pilgrim Health Care. The total number of plans being offered has fallen sharply, from 44 to 15, which includes only three options for the cheapest level, known as bronze, and only one “catastrophic coverage” plan, all from Anthem.

Further, your costs will be higher, perhaps much higher – premiums are expected rise by one-third or more, depending on the plan, for people who don’t get assistance – so you may want to switch in order to to take on, for example, higher deductibles, or to add some additional no extra cost office visits. 

But New Hampshire’s situation is actually pretty good compared to many other states. About half the country has just one or two health insurance companies to choose from.

Q: Do I have to buy through thefederal marketplace?

Nope, but you do have to buy health insurance or face a fine. The fine was up to $695 per adult, or $2,085 per family, this year and will probably rise next year, although details haven’t been released.

You can get private insurance from an agent or an insurance company, if you prefer their offerings or cost or if your income is above the threshold for financial assistance. If your employer offers insurance you are probably not eligible to get the financial help offered for ACA insurance, although ask your human resources department just in case.

But remember: If you don’t buy insurance through the federal marketplace you aren’t eligible for most subsidies and tax breaks that, depending on your financial situation, can make a big difference.

The state estimates that 54,000 residents plan to purchase health insurance in the federal individual market for 2018 coverage.

Q: I like the insurance I bought through the federal Marketplace, so can I just let it ride and ignore this whole annoying process?

No, no, no! Sorry, but there’s no getting around the annoying process: Your current health insurance may not even be offered next year. You’d be foolish not to shop around.

At the very least, go to HealthCare.gov to update your application and compare plan options.  If you haven’t done it before, go there and create an account.

Even if your current plan is still available, the cost has changed and you may prefer a different choice. Further, you will be prompted to enter your “tax household” size and some financial information, to learn if you qualify for help paying premiums or out-of-pocket costs, or for the no-cost or low-cost coverage under the New Hampshire Health Protection Program, expanded Medicaid.

All subsidies remain available for 2018 plans, so long as you sign up during open enrollment.

Q: I have a small business. What do I have to do? 

Insurance is offered through the federal marketplace for New Hampshire companies with up to 50 full-time equivalent employees. Anthem is the only company offering plans for small businesses under the program known as SHOP. They have six different plans available.

Small business owners should contact an agent or broker qualified to set up a SHOP account in the marketplace. A list of certified helpers is located at the New Hampshire Insurance Department website. 

Q: This stuff makes my head hurt. Can’t somebody help me?

You bet. The state has a number of navigators, who are paid and trained by the federal government to  help consumers, as well as small businesses and their employees, to find information and fill out those forms. They cannot recommend a specific plan but can help you wade through the morass of information and applications. There are also dozens of certified application counselors.

The website FindaHealthCenter.org can point you to a nearby community health center where you can get free help.

The New Hampshire Insurance Department, which was one of the state’s more obscure departments until Obamacare thrust it into the public eye, and can help you find assistance in some cases help you use the marketplace. Go online to nh.gov/insurance/consumers/mp_plans.htm.

If you have questions or issues with using the marketplace and getting coverage, you can also call the federal government at (800) 318-2596.

Once you have coverage, the Insurance Department can help with questions or concerns, at 1-800-852-3416 or (603) 271-2261, or by email at consumerservices@ins.nh.gov.

Q: Wait, I just remembered: Because I’m not 26 years old yet, I am carried on my parents’ insurance! Forget I asked anything.

Youth is wasted on the young.

(David Brooks can be reached at 369-3313 or dbrooks@cmonitor.com or on Twitter @GraniteGeek.)