Health insurance in the United States has been a huge issue this year.
Different parties are using health insurance as a political issue in order to reinforce their partisan message, and unfortunately, a lot of people’s lives are getting caught up in the confusion.
It’s important to educate yourself on health insurance, so you can enroll yourself and your family, and get coverage for anything life throws at you. Here’s an overview of American health insurance today, and dates for Open Enrollment 2018.
There are a few different types of insurance that are administered by various federal departments. One of these, Medicare, is only available to people who are over the age of 65, or those who are younger than 65 who have certain types of disabilities or diseases.
Medicaid and CHIP (Children’s Health Insurance Program) are both joint state and federal programs that are administered at the state level, and extend free or low-cost health care coverage to lower-income individuals and children, respectively. Medicaid and CHIP may be called something different depending on which state you live in.
In March of 2010, the new Affordable Care Act (ACA) expanded Medicaid to cover anyone who lived below 138% of the poverty line, and made health insurance accessible to millions of Americans. You may be more familiar with the ACA through its colloquial name — Obamacare.
Who is Eligible?
If you’re a child, living with a disability, or living below 138% of the federal poverty line, you’re eligible for federal health insurance through Medicaid or CHIP. However, if you don’t fit into any of those categories, you are still eligible for health insurance through the Affordable Care Act Marketplace, regardless of any pre-existing conditions.
Cost of Coverage
If you’re a regular American enrolling in health insurance through the ACA Marketplace, you can buy any insurance as long as it meets the minimum essential coverage. This includes coverage that you buy through the HealthCare.gov website, insurance that you get through your job, or any other private insurance.
Costs vary widely depending on your state, and whether you’re enrolling privately or through your job, but the general costs for an adult range from anywhere between $100 to over $500 monthly. Health insurance isn’t cheap, but the ACA ensured that even if you have a pre-existing condition, you are guaranteed access to insurance.
What It Covers
The health care available to all Americans under the ACA covers 10 categories of essential services like inpatient and outpatient hospital care, prescription drugs, doctor’s visits, mental health services, and pregnancy. You can opt for a more expansive plan that includes dental, vision, and assorted other non-essential services, but you’ll be paying a much higher monthly premium. Although all ACA-compliant plans must cover the 10 categories of essential services, plans vary depending on which state you’re living in.
ACA plans also cover pre-existing conditions, which used to make health insurance completely cost-prohibitive for people who had conditions like diabetes, asthma, or epilepsy. Your insurance provider is not allowed to discriminate against you based on any pre-existing condition. Additionally, certain types of preventative treatments like screenings and immunizations are free for all adults enrolled in an ACA health insurance plan.
If you’re enrolled in a health insurance plan through the ACA Marketplace, then you don’t technically need supplemental insurance, because your health insurance is meant to cover all essential and most preventative services. However, some families find that supplementing their ACA insurance is helpful.
If you’d like, you can buy an additional insurance plan that helps with copayments and deductibles, or a vision and dental insurance plan. These additional insurance plans are not required, but can help you with initial out-of-pocket expenses, or services not covered by your primary health insurance plan.
When you enroll in health insurance through the ACA Marketplace, you need to do so during a period of time known as Open Enrollment. This year, Open Enrollment is shorter than in previous years, so it’s important to have your documents prepped and ready to go as soon as it starts. Open Enrollment for 2018 health insurance starts on November 1st and goes until December 15th, 2017.
If you do not have 2017 health insurance, you can still apply now if you’ve had a major life event occur that changes your health insurance needs, like having a baby, or getting married.
Open Enrollment for all health insurance plans is on now, so make sure that you’re prepared to enroll, or make any changes to your health insurance before December 15th.