5 things you need to know about health insurance right now

Newswise — Next year is coming sooner than you think. And right now is a critical time to make decisions about what health insurance you and your family will have in 2024.

It’s a decision that can make a big difference in your physical, mental and financial health.

Here are some key things you need to know right now, compiled with the help of the team at the University of Michigan Patient Financial Counseling office.

“Every fall is a key time to make sure you’re exploring all your options, but this fall is especially important because we’ve seen a lot of people confused about the changes and don’t realize they can get free help from trained experts to navigate in his choice,” said Alena Hill, who leads the team.

Throughout the year, but especially in the fall, her team helps patients and community members understand their options and make wise choices for themselves and their families. You can reach them at 877-326-9155 or 734-232-2621 weekdays from 8am to 4pm or anytime by email at [email protected].

1: If you had Medicaid coverage in 2023 or your child had CHIP coverage, you must act to keep it or find a replacement.

Last spring, all states began “rolling out” the special Medicaid rules that were in place for the first three years of the pandemic.

This means that anyone with Medicaid or CHIP coverage must prove that they or their children are still eligible based on current income. Different people have different deadlines for providing this proof.

Hill’s staff encountered many people who did not receive or open the important notification letters and emails the state sent them about the deadline. Others have had trouble logging into the state website where they can verify and enter their information.

But taking action could mean the difference between having coverage and being uninsured in 2024, which could lead to big financial problems.

Fortunately, she said, Michigan’s “unwinding” is happening more slowly and with more options for maintaining coverage than in other states.

So: If you know your income is still low enough to qualify for Medicaid or for your child to qualify for CHIP, it’s critical to get into the state system or contact your local office of the state health department.

Even if your initial window to renew your coverage has expired, you can still provide information and secure new or continued coverage. If your renewal window is between now and next May, you can prepare now.

If you’ve already received notice that your Medicaid or CHIP coverage has been renewed in the past few months, you’re all set until next year at the same time.

But from now on, you’ll have to prove you’re eligible once a year, unless the state tells you it checked your information directly.

If you’re making too much money now to qualify, keep reading to learn about buying your own coverage.

Learn more about Medicaid waivers and what to do.

2: If you need to buy your own insurance, now is the time to act – and there is financial help available.

Millions of people make too much money to qualify for Medicaid, are not old enough or disabled enough to qualify for Medicare, and do not have insurance through work or the employment of a partner.

If you’re one of them, the healthcare.gov website is the place to find out what insurance plans you can buy directly. On the site, you can compare your options and find out what they will cost you – both monthly premiums and co-payments or deductibles when you receive care.

The good news: Four out of five people buying insurance on this site for 2024 will find a plan for $10 or less a month after all financial assistance is taken into account. Almost everyone has at least three plans to choose from, and this year all plans must include mental health, addictions and rural emergency care.

If you have already lost access to Medicaid coverage or your child has lost access to CHIP coverage because your income has increased, you should go to this site immediately. Not only is it risky for your health and your wallet to go without insurance, but you may be able to get coverage right away through the end of 2023 and choose a plan for 2024 as well.

Open enrollment on healthcare.gov for 2024 plans runs from November 1st to January 16th. If you choose a plan by December 15, your coverage will begin on January 1. If you choose a plan after but before Jan. 16, your coverage will begin on February 1.

What kind of financial aid can you qualify for? The Kaiser Family Foundation offers a handy calculator.

You can contact the NHI call center at 1-800-318-2596 and get help 24 hours a day, 7 days a week, including help in 200 languages. Or find a trained helper near you by clicking “Find Local Help” on healthcare.gov. Or contact the Michigan Medicine team, whose members are trained to help people navigate their options.

  1. If you get health insurance from your job or from someone else’s job, beware!

Many employers are facing higher health insurance costs for 2024, and they may change the options they offer or the monthly costs for employees.

Most Americans with employment-related insurance coverage now have what’s called a “high-deductible health plan,” or HDHP, which means they must pay upfront for the first few thousand dollars of non-preventive care they receive before coverage kicks in. .

If you have one of these plans, are considering one, or your employer is switching to one, you need to take a crucial step now to save money and be prepared for health care costs.

This step? Open a health savings account, or HSA, and start putting money into it.

You don’t have to pay taxes on the money you put into your HSA as long as you spend it on approved health care expenses, including covering deductibles or paying copayments. And as the money builds up month after month, you’ll have the peace of mind that you have a cushion to absorb any financial shocks from health care you suddenly need.

If you don’t spend all the money in your HSA by the end of 2024, you can keep it in the account and hold onto it until you need it. (This is different from flexible spending accounts, or FSAs, that some employers offer; they’re also tax-free, but if you don’t spend all the money you put in for the year, you can lose it.)

  1. If you have Medicare or will be eligible this year or next, weigh your options carefully.

There are two types of Medicare: Original (also called traditional or fee-for-service) and Medicare Advantage.

Original Medicare is administered by the federal government, and Medicare Advantage is administered by insurance companies that contract with the federal government. If you choose Original Medicare, you can also choose a prescription drug plan and a Medigap plan.

Open enrollment for all Medicare plans for 2024 continues through December 7 for coverage that will begin on January 1. During this time, many Medicare Advantage companies are competing for your business, so you may see a lot of direct mail, online ads, and even billboards.

No matter what type of Medicare option you are considering, you should take the time to use the official Medicare Plan Comparison Tool to look at the specific options open to you. This allows you to see which doctors and hospitals are “in network” for any Medicare Advantage plans you may be considering, which is important because unlike Original Medicare, these plans limit which providers you can see.

This tool can also tell you the potential costs of any prescription drugs you take, depending on the plan you choose. UM researchers recently showed that the same drug can cost thousands of dollars more or less depending on the plan. Read more about what UM experts say about using Plan Compare.

If you or your significant other are about to turn 65 and still have health insurance from your job, talk to your company’s benefits office or an individual about your options.

If you live in Michigan and are covered by Medicare or will soon be eligible, or are trying to help a loved one who lives in Michigan navigate their Medicare options, you have another great resource to try.

A nonprofit organization called the Michigan Medicare Assistance Program can help. MMAP can connect you with a certified consultant who can provide free, impartial assistance. Visit https://mmapinc.org/ or call 1-800-803-7174.

Disclosure: Michigan Medicine co-owns a Medicare Advantage plan called Michigan Health Advantage.

  1. No matter what your situation is, don’t delay or try to go without coverage to save money.

All the deadlines mentioned above are serious and if you don’t act before they expire, you can really lose out.

If you’re tempted to skip buying insurance for yourself or enrolling in a plan that your job offers because you want to save money, think again.

Just one illness, accident or new diagnosis in 2024 could wipe out your bank account or increase your debit faster than you can say “I wish…”

Another thing you shouldn’t put off: scheduling preventative care like vaccinations, mammograms, colonoscopies and Pap smears. If you’re in the right age group, they’re free for you, regardless of the type of insurance you have.

Also, getting a photo or scan now can save you from a lot worse later. Read about the vaccines adults should get at different ages.

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