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The Journal Gazette

Friday, November 01, 2019 1:00 am

Time is tight to weigh 2020 health care options

Steve Smitherman

Steve Smitherman is president of CareSource Indiana.

Open enrollment is upon consumers again, and there are likely questions on what to do in terms of health care coverage for 2020.

Options can be overwhelming, but consumers can choose a plan that fits them best through education on open enrollment, understanding what's new in terms of health plans and learning of any changes.

CareSource, a nonprofit, multistate health plan, wants to help consumers find and afford the best health insurance for them and their families. CareSource is now available in all 92 Indiana counties. CareSource encourages consumers to look into the benefits each plan offers.

This year, CareSource will offer a free gym membership to members who choose an enhanced plan. While this is just one benefit, consumers should look into all the benefits they could receive. For customers who are on the fence about buying health insurance through the Marketplace, here are some tips when considering enrollment this year.

Enrollment is open for a short window of time, so act now.

Open enrollment runs from Nov. 1 to Dec. 15. This short window means consumers need to act quickly, but also understand what their coverage needs are for the coming year.

While looking into premiums, customers should be sure to check which doctors will be in each network in 2020.

Although some doctors may not have been in a specific network in previous years, doctors may be in new networks starting Jan. 1. Consumers need to research coverage options before the open enrollment window so they will be ready to enroll when the Marketplace opens.

See how options have changed since the Marketplace has stabilized.

In the past, there has been confusion and turbulence surrounding the Marketplace. The Marketplace is now in its sixth year and has stabilized. This stabilization brings modest rate increases to Indiana.

There are also tax credits and subsidies available for those who qualify based on their income. Consumers should take time to research their options to help find the best fit for them and their family.

Learn about tax credit qualification for lower premiums.

About 75% of Marketplace consumers have an income that qualifies them for tax credits and subsidies that can reduce premiums. Depending on their income, some consumers may even qualify for premiums as low as zero. It's important for consumers to complete the application process to see whether they qualify. When reviewing and comparing plans on CareSource, there is a calculator that can determine a consumer's tax credit by entering income and household size.

Are short-term options a good fit?

Short-term health plans are appealing to healthy individuals looking for “catastrophic only”-type coverage. These plans are especially tempting as they keep expenses down. Short-term health plans often exclude people with preexisting conditions, while Marketplace plans cover people with preexisting conditions and don't carry lifetime coverage caps for most benefits. Short-term plans typically come with a long list of exclusions, often carry high deductibles and don't cover prescription drugs outside of a hospital. Consumers should be aware of what is included in their specific plan and prepare for future possibilities to ensure they will be covered.

Research Marketplace plans to find 2020 cost.

The Marketplace offers levels including Bronze, Silver, Gold and Platinum, which represent plans with various deductible and premium coverage options. Customers should look into each option to decide where their deductible and premium needs fall. The Bronze-level plan is a great fit for someone looking for a lower premium cost. This plan offers the lowest premium among Marketplace plans. Consumers may want to consider setting up a health savings account, which helps cover deductible costs they may be faced with throughout the year.