5 things to know about health insurance right now

Whether you buy your own, get it from a job, or qualify for Medicare or Medicaid, this is an important time to pay attention

1:15 PM

Author | Kara Gavin

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Credit: Justine Ross

Next year is coming sooner than you think. And right now is a critical time for making choices about what kind of health insurance you and your family will have in 2024.

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

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

“Every fall is a key time to make sure you explore all your options, but this fall it’s especially important because we have seen many people confused about changes and not realizing they can get free help from trained experts in navigating their choices,” said Alena Hill, who directs the team.

Year-round, but especially in fall, her team helps patients and community members understand their options and choose wisely for themselves and their family. They can be reached at 877-326-9155 or 734-232-2621 on weekdays from 8 a.m. to 4 p.m., or anytime on email at [email protected].

No matter where you live, you may be able to get help from other independent sources. For instance, the state of Michigan offers information and links at michigan.gov/healthinsurance, and the nonprofit Washtenaw Health Project offers help to individuals in southeast Michigan.

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 started “unwinding” the special Medicaid rules that were in place for the first three years of the pandemic.

This means everyone with Medicaid, Healthy Michigan Plan or CHIP coverage has to prove they or their children still qualify based on current income. Different people have different deadlines for providing this proof.

Hill’s staff has encountered many individuals who have not gotten, or opened, the important notification letters and emails that the state has sent them about their deadline. Others have had trouble logging into the state website where they can check and enter their information.

But taking action can make the difference between having coverage and going uninsured in 2024, which can bring serious financial challenges.

Fortunately, she said, Michigan’s unwinding is happening more slowly, and with more opportunities to keep coverage than other states.

So: if you know that your income is still low enough to qualify for Medicaid, or to qualify your child for CHIP, it’s crucial to log in to the state system or contact your local office of the state health department.

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

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

But from here on, you will need to prove your eligibility once a year unless the state tells you they have verified your info directly.

If you now make too much money to be eligible, keep reading to learn about buying your own coverage.

Learn more about the Medicaid unwinding and what to do.

2. If you need to buy your own insurance, now’s the time to act -- and there’s financial help available.

Millions of people make too much money to qualify for Medicaid, aren’t old enough or disabled enough to qualify for Medicare, and don’t have insurance through a job or a partner’s job.

If you’re one of them, the healthcare.gov website is the place to go 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 in monthly premiums and copays or deductibles when you get care. This year, the healthcare.gov marketplace celebrates its 10th anniversary. About 1.6 million people chose insurance on the marketplace in the first week of open enrollment for 2024.

The good news: four out of five people who buy insurance on this site for 2024 will find a plan for $10 or less per month, after all financial assistance is considered. Nearly everyone has at least three plans to choose from, and this year all plans must include mental health, addiction and rural emergency room care.

If you already lost access to Medicaid coverage, or your child lost access to CHIP coverage, because your income went up, you should go on this site immediately. Not only is it risky to your heath and wallet to go without insurance, but you may be able to get coverage right away for the rest of 2023 and pick a plan for 2024 too.

Open Enrollment on the healthcare.gov site for 2024 plans runs from Nov. 1 to Jan. 16. If you pick a plan by Dec. 15, your coverage will start Jan. 1. If you pick a plan after that, but before Jan. 16, your coverage will start Feb. 1. 

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

You can contact the national health insurance call center at 1-800-318-2596, and get assistance 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 Michigan Medicine’s team, whose members have trained to help people navigate their options.

3. If you get health insurance from your job or someone else’s, heads up!

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

A majority of Americans with employment-related insurance coverage now have what’s called a “high deductible health plan” or HDHP, which means they need to pay up front for the first few thousand dollars’ worth of non-preventive care they receive, before their insurance kicks in. 

If you have one of these plans, or you’re thinking about choosing one, or your employer is switching to one, you need to take a crucial step now to save you money and be ready for health costs.

That step? Open a health savings account, or HSA, and start putting away money in it.

You don’t have to pay taxes on the money you put into your HSA, if you spend it on approved health costs including meeting your deductible or paying copays. And, as the money builds up month by month, you will 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 on to it until you need it.  (This is different from the flexible spending accounts, or FSAs, that some employers offer; these are also tax-free but if you don’t spend all the money you put in for the year, you can lose it.)

4. If you have Medicare, or you’re going to become eligible this year or next, weigh your options carefully.

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

Original Medicare is run by the federal government, and Medicare Advantage is run 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 2024 Medicare plans runs until December 7, for coverage that will start January 1. During that time, a lot of Medicare Advantage companies are competing for your business, so you may see a lot of direct mail, advertisements online and even billboards.  

No matter what type of Medicare option you’re considering, you should take time to use the official Medicare Plan Compare tool to look at the specific options open to you. This lets you see which doctors and hospitals are in network for any Medicare Advantage plans you might be considering, which is important because unlike in 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 what plan you choose. U-M researchers recently showed that the same drug can cost thousands of dollars depending on the plan. Read more about what U-M experts have to say about using Plan Compare.

If you or your significant other will turn 65 soon, and you’re still working with health insurance from your job, talk to your company’s benefits office or person about your options. 

The official Medicare hotline is 1-800-MEDICARE (1-800-633-4227) or you can use Medicare's online chat service. Both are available 24/7 every day except federal holidays.

If you live in Michigan and are covered by Medicare or will be eligible soon, or you are trying to help a loved one who lives in Michigan navigate their Medicare choices, you have another great resource you can try. The nonprofit organization called the Michigan Medicare Assistance Program can help. MMAP can connect you with a certified counselor who can give free, unbiased help. Visit mmapinc.org or call 1-800-803-7174.

Watch this recording of a talk about Medicare enrollment, by a U-M health insurance expert and a person who helps older adults with Medicare enrollment at a Michigan Area Agency on Aging.

 

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

5. No matter what your situation, don’t procrastinate and don’t try to go without coverage to save money.

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

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

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

Another thing not to procrastinate on: scheduling preventive care like vaccinations, mammograms, colonoscopies and Pap smears. If you’re in the right age group, these are free to you no matter what kind of insurance you have.

Also, getting a shot or a scan now could keep you from getting much sicker later. Read about the vaccines adults should get at different ages.

Note: Washtenaw County residents who do not qualify for insurance can also get help in connecting to health care from the Washtenaw Health Project. Call 734-544-3030 or email [email protected], or visit WashtenawHealthProject.org

 

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