Pine Bluffs Post - Serving all of Eastern Laramie County since 1908

Wyoming Department of Insurance explains Open Enrollment Choices

 

October 8, 2020



CHEYENNE ------ It seems like we just recently made our decisions about health insurance and now it’s time to do it again. Now is the time for all Wyoming consumers to evaluate their health insurance choices for plan year 2021. The Wyoming Insurance Department advises ALL consumers to be aware of the Open Enrollment periods for both Medicare and the ACA Marketplace. If you get your health insurance through an employer, check with your human resources representative about open enrollment dates for that particular employer insurance group.

Medicare Open Enrollment runs from October 15 to December 7, 2020. During this time, people with Medicare can change their Medicare health plans and prescription drug coverage for 2021 in order to better meet their needs. It may be that you choose to not make any changes, but it is important to annually review your coverage.

Wyoming Medicare beneficiaries should review their health care needs for the upcoming year and determine if changes to their current coverage are necessary. Plan costs, coverages, and drug prescriptions can change each year. Make sure your plan still meets your needs and budget. During Medicare Open Enrollment, anyone with Medicare can make changes to their prescription drug (Plan D) plans for the next year, or change from original Medicare to a Medicare Advantage plan, if available.

Wyoming State Health Insurance Information Program (WSHIIP) is a federally mandated program to help people on Medicare to understand their rights and to answer their questions about plan options. Trained counselors across the state promote understanding of Medicare, Medicaid, Medigap and long-term care insurance. There are numerous consulting firms around the state who offer these

services for a fee, however the WSHIIP program is free of charge. To reach a WSHIIP counselor, call

1-800-856-4398.

Open Enrollment for the ACA Health Insurance Marketplace. The 2021 Open Enrollment Period runs from Sunday, November 1 to Tuesday, December 15, 2020. 2021 Open Enrollment is only a few weeks. If you don’t act by December 15, you can’t get 2021 coverage unless you qualify for a Special Enrollment Period (SEP). Plans sold during Open Enrollment start January 1, 2021.

Shop and compare choices and update your enrollment information. Whether you are renewing a plan or you are a new enrollee, the Open Enrollment periods are an opportunity to evaluate your insurance coverage. Individuals who were financially impacted by COVID19 and experienced a loss of income may now qualify for a subsidy on the Marketplace. Depending upon your income, you may qualify for an Advanced Premium Tax Credit (APTC) and might qualify for coverage that has very low premium costs.

It is very important for Wyomingites who receive their insurance through Marketplace to re-enroll during Open Enrollment to avoid any break in coverage. The Affordable Care Act (ACA) remains the law and subsidized insurance coverage is still available for those who qualify. The federal government operates the Health Insurance Marketplace or Exchange in Wyoming at: http://www.HealthCare.gov. Be certain that you are looking at the official government site and not a look-a-like imposter site. Remember: Always look for official government seals, logos, and websites. The official Marketplace website is at: http://www.HealthCare.gov. Contact the Department of Insurance if you have any questions.

Talk with your insurance agent or go to the HealthCare.gov website to become familiar with offered services. Compare Marketplace insurance plans and rates. Advanced Premium Tax Credit (APTC) and Cost Sharing Reductions (CSR) are only available for plans purchased on the Marketplace. Licensed insurance agents may advise you what plan is best for you. If you decide to purchase insurance off the Marketplace or Exchange, be a wise consumer and understand what you are purchasing. Be especially cautious of Off-Exchange plans that seem too good to be true. Ask about exclusions, medical provider networks, and hidden costs in Off-Exchange plans. Plans sold on the ACA Marketplace (also called the Exchange) are always Qualified Health Plans (QHPs) and cover all ten of the Essential Health Benefits required by the ACA. ACA qualified plans are not rate based on pre-existing conditions. Short-term limited duration plans (STLD), fixed indemnity,

and specified disease plans may exclude coverage for pre-existing conditions and may charge you a rate based upon your age and any prior medical conditions.

If you receive health insurance through an employer, consider the following before selecting a coverage plan:

• Look closely for changes: Don’t automatically renew the option you had before; employer plans may have changed since the last Open Enrollment.

• Take advantage of wellness incentives: Your employer may offer a wellness program that includes money-saving incentives for healthy behaviors such as exercising regularly or not smoking.

• Check out tax-free savings: You may be eligible to open a Flexible Spending Account (FSA) or a health savings account (HSA).

If you are self-employed or if your employer doesn’t offer coverage, you may face challenges in finding and keeping health insurance, but you still have choices.

• Spouse plan: Consider being added to your spouse’s plan.

• Individual insurance: Consider purchasing private insurance to customize to your lifestyle, health, and budget.

If you are unemployed, you likely had to determine how to continue your health insurance. Now is a good time to review your decision. Also check whether you or your family might be eligible for Medicaid or the Children’s Health Insurance Program CHIP).

In addition to insurance agents, the federal government also has trained Navigators and certified assisters in Wyoming to help you at no cost. To find help, visit: http://www.HealthCare.gov or get a referral to a Wyoming Navigator for in-person assistance, by contacting Wyoming 2-1-1 (in Wyoming dial 2-1-1 or 888-425-7138) or visit Wyoming211.org.

 

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