Open Enrollment for Individuals
By Chris McPike, Location Manager/Agent
Open enrollment for individuals and families begins November 1 and continues through December 15. Nebraskans will have many new options in 2022 for their health insurance. There are two new companies that will be offering health plans – Ambetter and Oscar – along with changes in networks and plan options.
The American Rescue Plan Act was passed in March 2021 and remains in effect throughout 2022. The new law increased the amount of Premium Tax Credit that each person is eligible to receive and eliminated the maximum income that someone can earn and remain eligible for a Premium Tax Credit. The bottom line is that many more people are eligible for lower health insurance premiums. Even if you have not qualified in the past, you should find out if you qualify now. Example: Two adults, age 40, plus two children with a household income of $150,000 will qualify for a Premium Tax Credit (PTC) of $1,174 per month. At $200,000 income, the PTC is $820. These figures are based on 2021 rates.
The Health Insurance Marketplace (healthcare.gov) offers health insurance coverage to those under the age of 65 that do not have access to employer-provided health insurance or government- sponsored health benefits such as Medicaid or Medicare. Self-employed individuals, early retirees, and those whose employers do not offer health insurance will typically be eligible for Marketplace coverage.
Many health insurance plans are advertised with low premiums. Most of the time, these are plans with limited benefits, and your eligibility for coverage may be based upon your health history. A policy through the Marketplace meets all of the requirements of the Affordable Care Act and will always cover pre-existing medical conditions, preventive care, mental health, and maternity.
A Marketplace-certified agent will make the choice of plans far less complicated, especially for 2022. Health insurance benefits are much different than even three years ago. The most critical factor is understanding the network of doctors and hospitals that can be used. Most plans are an EPO – Exclusive Provider Organization. This is not the same as a PPO or HMO. With an EPO you have access to selected doctors and hospitals within a limited geographic area. If you see a provider that is not in the network and it is not an emergency, your health insurance plan will not cover it. It will be your financial responsibility. This never applies to emergency care. You can always seek treatment from the closest facility and it will be considered in the network. The lowest priced plan may not be your best choice.
The ComPro Team has been working with healthcare.gov since it began and can be trusted to guide you through the whole process.
Learn more at comproins.com or call (402) 488-5100.