The number of Utah residents who have enrolled in insurance plans so far in the federal health exchange is exceeding that of last year, but insurance experts say some may still be confused about their options.
“Too many consumers still believe that coverage is too expensive or out of reach. And yet, approximately 80% of those who buy at the exchange qualify for financial assistance to make health coverage affordable, “according to Take Care Utah, a nonprofit organization that helps people sign up. in health insurance through the Low Price Health Care Law.
As of November 23, the most recent date by which the Centers for Medicare and Medicaid Services have published updated enrollment numbers, 62,090 Utahns had purchased insurance at the federal health exchange. In comparison, Utah saw 56,105 people sign up last year at the same time, according to service data.
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Open enrollment began on November 1, and the last day to sign up for an exchange plan is December 15.
Premiums across the country on average fell 4% by 2020, according to the Centers for Medicare and Medicaid, as 20 more issuers now participate, which brings more competition.
In Utah, Molina Healthcare re-entered the health exchange market last year for 2019 in 10 of the 11 most populous counties in Utah. The organization recently announced by 2020 that it expanded to include Box Elder, Morgan, Rich and Wasatch counties.
“Our market expansion will mean more options for Utah residents who buy insurance in the individual market,” Brandon Hendrickson, president of Molina Healthcare of Utah, said in a statement.
In Utah, the average reference plan premium decreased from $ 509 in 2019 to $ 456 in 2020, according to federal data.
In general, in the US In the US, 2,372,957 had registered as of November 23, compared with 2,424,913 last year, a decrease of approximately 2.1%.
Many of those living with lower incomes are unaware that they are eligible, even when a recent analysis by Avalere Health found that 96% of low-income residents in eligible counties can find a basic plan at no cost to them, Associated Press reported. .
While the administration of former President Barack Obama emphasized marketing during open enrollment, President Donald Trump, who has openly opposed the so-called Obamacare, lowered the program’s advertising budget, according to the AP. Federal officials have said they are “focused on providing a quality registration experience and keeping the healthcare.gov website running smoothly,” AP reported.
Take Care Utah, which provides “assistants” throughout the state that help people sign up, has seen that the number of people in Utah seeking help to sign up is consistent with last year, spokeswoman Maria Guadarrama said.
But he noted that the numbers halfway through open enrollment are not an indication of how many will finally be enrolled. The group tends to see high figures when the period begins on November 1, followed by “a little slowdown between weeks.”
The organization expects to see an increase in people seeking help to enroll during the two weeks before the December 15 deadline.
Guadarrama said he believes that during open enrollment in recent years under the Trump administration, there has been some confusion about whether the Affordable Care Act still exists. And since Utah voters passed a full Medicaid expansion bill, which was later replaced by state legislators with a more limited expansion plan, some don’t realize they could be eligible for Medicaid.
Take Care Utah sees the open enrollment period as an opportunity not only to educate people about enrolling in federal market insurance, but also to help them see if they can be eligible for Medicaid.
“We not only focus on open enrollment for the market, but we also help people and families, and examine them for Medicaid and CHIP. Because as household size and household income changes, people tend to ignore that they could potentially qualify for Medicaid or CHIP, “which have enrollment periods throughout the year, he said.
Now, because the full expansion of Medicaid is not expected to occur in Utah until January, it is unknown how many families that enroll in the market could now go to Medicaid, according to Guadarrama.
“But for now, we know that families that still qualify for adult expansion remain in Medicaid, and families and people who qualify for the market will enroll in those (plans),” he said.
Companies that offer federal health exchange plans in different Utah counties include SelectHealth, Molina Healthcare, University of Utah Health Plans and Cigna Healthcare.
Heidi Castenada, director of sales for individual and small employers at SelectHealth, which offers 29 of the 54 plans available in Salt Lake County, said the company is also seeing average enrollment numbers.
SelectHealth premiums have “stabilized and declined slightly” in recent years, but premiums increase as people get older, according to Castenada. Although the final price has dropped slightly, the average person may see a slight increase as they get older, he said.
Regardless of the provider, Castenada recommends those already in the market to review their current plans and ensure that the overall annual cost and coverage is appropriate for their needs. They should also reevaluate their provider networks every year, as there is a “variety of different sizes and networks that you can access,” he said. Some people pay more than they need in a larger network, when they can access the providers they regularly use in a smaller network, Castenada said.
It also suggests looking into the future what types of medical care might be needed by 2020, including upcoming surgeries or other events. In addition to considering premiums, people should see what their out-of-pocket costs will be throughout the year, he said.
“Combine those things to get a general value of the plan you are enrolling in. I think that is something that people overlook: they may be simplifying too much and just looking at the premiums, but there is a better way to do it by observing the value general of the plan, ”said Castenada.
People should also know the additional benefits that different plans can provide, such as virtual visits to the doctor.
Like Take Care Utah, SelectHealth also expects an increase in people who enroll as the deadline approaches.
“That is human nature to wait until the last minute to make decisions, and yes, we hope that people at this time just think about things, do their shopping. But a large majority of people will wait until the last minute to make a change, ”Castenada said.
To review the plans, visit healthcare.gov/lower-costs.