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14 last-minute tips for enrollees in the Obamacare marketplace

Jeanie Ahn
Senior Producer/Reporter

You have one week left to enroll for health care coverage through the federal exchange on Healthcare.gov before it closes on December 15, 2017. If you haven’t already signed up, we’re here to help you find the right plan. Earlier this week, Yahoo Finance invited Sara Collins, vice president for health care coverage and access at the Commonwealth Fund, and Elisabeth Benjamin, vice president of health initiatives at the Community Service Society of New York, to answer audience questions.

Below are 14 viewer questions they answered during the 35-minute Q&A session.

1) “I’ve been using the marketplace for my insurance since its inception, and every year have the same problem: calculating my income for the upcoming year. My income has varied wildly each year and continues to do so. What advice do you have for doing this? What happens if I overstate my expected income for 2018?” —Barb [This question was answered at timecode 1:30 on the video player above]

It can be a tough task to estimate your income for the next year, but you have to give it your best guess, says Collins. “What you can do during the year, if your income changes, is call the marketplace and tell them your income went up or down, and they’ll adjust your tax credit for each month. So, that’s a way of avoiding a big fine or payment at the end of the year.” There’s no limit to how many times you can call the marketplace to update your income, she says.

If you underestimate your income for 2018, when you file your taxes in 2019, you may owe a little more to the government, but if the reverse is true — you overestimate and don’t get enough monthly financial assistance—then you’ll get a greater refund from the federal government, adds Benjamin.

2) “I’m uninsured, and I heard the new tax bill might have changed the penalty that I would get if I go without coverage? Is this true?” —Barry [Watch at timecode 3:42 on the video above]

The tax bill has not yet been enacted, so there is no clear answer to this yet. “But even if they get rid of the fine, they’re not getting rid of the requirement to have health coverage,” says Benjamin. Many people this year will qualify for lower premiums that could be even lower than their possible penalty, so it’s worth shopping around to see if you’re eligible for financial assistance.

Collins adds: “The only thing that would go away under the new tax bill is the mandate penalty, and that would only start in 2019 … For 2018 nothing changes. So if you don’t get covered by Dec 15, in most states you’re still subject to the penalty.”

3) “I’m unemployed. What is the cheapest, most basic minimal amount I have to pay to keep from being devastated on my taxes?” —Aimee [Watch at timecode 5:54 on the video above]

First, if you’re unemployed and you have no other income except for unemployment, you could be eligible for Medicaid, which is free coverage with no cost-sharing and great health benefits, so make sure to look there first, advises Benjamin. If your partner or spouse has income and makes more than enough to qualify for Medicaid, you still may be eligible for a bronze plan or your spouse’s plan.

Benjamin strongly recommends talking with a marketplace navigator to get free counseling about your financial situation and all your health care options so you can figure out the best plan for your family.

“Premiums went up quite a bit because of an action taken by the Trump administration in terms of how they reimburse insurance companies,” explains Collins. But most people aren’t going to see these increases because the tax credits also went up, making some people’s gold plans even cheaper than lower level plans.

4) “I am 22 years old, and I’m on my parents insurance do I need to do anything right now?” —Ann [Watch at timecode 8:30 on the video above]

Probably not, but it’s always a good idea to check to see what your parents plan on doing for the following year, says Collins. “If they have coverage through their employers, they might be signing up for family plans for the new year. If they have a marketplace plan and you’re on their marketplace plan, you may want to remind your parents about the enrollment period as they may want to renew their policy.”

4) “Can I just purchase dental insurance from the ACA marketplace? My current plan doesn’t include it.” —Reggie [Watch at timecode 9:42 on the video above]

You cannot buy a dental plan on its own, you have to buy a marketplace plan first and then add dental coverage on top of it, says Benjamin. “The one thing I would caution people about dental coverage, it often doesn’t pay as you’re spending more on your premium than you’re actually getting in coverage. And a lot of people are surprised that it’s not the most robust network of dentists that participate in-network so you really need to look carefully.”

Both experts on the panel encourage consumers to negotiate your medical costs as providers are often willing to work with you. [Related video: 9 ways to lower your medical bills]

5) “I’ve been told that if my son, who is 21, is not in college or submits his own taxes, cannot be on my policy even though he lives in my home. How long can dependents stay on my plan?” —Denise [Watch at timecode 11:38 on the video above]

Under the Affordable Care Act, if you get coverage through your employer and your employer offers dependent coverage, your son (or daughter) is allowed to stay on your plan until they are 26 years old. In some states like New York, the age goes up to 29.  Filing his own taxes, being married and having children, doesn’t disqualify him from being on your plan, says Collins.

If you have a marketplace plan and your son is filing his own taxes, make sure he checks to see if he’s eligible for any tax credits that he can apply to your policy, reducing the cost overall. And it’s worth having him compare how much he would save by getting his own for health coverage through the marketplace independently from you.

6) “Is there an office I can go to that will review my ACA application? Similar to the DMV covering autos?” —Angela [Watch at timecode 13:55 on the video above]

There are in-person assisters, or certified health-care navigators, that have been intensively trained and are impartial because they don’t work for health insurance companies who are there just for you. To get an appointment, either go to GetCoveredAmerica.org or Healthcare.gov on the marketplace to find local help. “All the call centers have extra staff for this crush period,” says Benjamin.

7) “Can a non-US citizen in the U.S. on a tourist visa without a Green Card or Social Security number buy a policy and just use a foreign passport as an ID?  Obviously, no subsidy/tax incentive, but can such a person simply purchase a policy on the exchange?” —Sungjin [Watch at timecode 16:32 on the video above]

“On the exchange you have to be lawfully present in the United States to buy a plan on the marketplace and be potentially eligible for tax credits,” says Collins. But Sungjin might be able to buy a plan off the exchange but needs to make sure the coverage is ACA compliant. Benjamin adds that depending on his situation, Sungjin might be eligible for Medicaid, but needs to check with a health-care navigator to learn more about all options.

8) “I have a plan from last year I still like. Do I need to sign up again? I received my re-enrollment letter from my health insurance company pretty late in the game, and I’d like to skip having to go through the entire process if I can just keep my plan from last year.” —Mikey [Watch at timecode 18:41 on the video above]

If you get financial assistance or tax credits through a plan on the exchange, it’s really important to double check and make sure your eligibility hasn’t changed for 2018, says Benjamin. “Tax credits are going a lot farther next year, and your plan may or may not know that your income has changed. At the very least, call the plan make sure you know what your premium is so you’re not getting any surprises,” she says.

9) “I own a regional paper company with four full-time employees. I offer health care coverage through the Affordable Care Act to my full-time workers, but the increasing premiums are crippling my bottom line.  Should I reduce my employees’ hours to make them part-time and avoid the cost or offer that the employees can keep their coverage, but have to contribute to the cost of their health care?” —Brian [Watch at timecode 21:38 on the video above]

It might be time to have a staff meeting to talk about the different choices that face the employees. But before you do, Benjamin recommends first talking to a marketplace broker or someone who’s an expert in small business marketplace coverage because there might be better deals and creative solutions like health reimbursement arrangements and product pairings that might work for your employees.

10) “Why was there such a large increase in the cost of insurance from year to year?” —June [Watch at timecode 23:55 on the video above]

Premiums went up because the government used to provide cost-sharing reimbursements to insurers to help offer lower deductible plans for enrollees, but the Trump administration discontinued this and it’s resulted in a rise in costs as insurers had to adjust their premiums significantly. Some states were allowed to increase premiums for all levels of plans, but most states worked to manage the cost increases to silver-only plans and shield consumers with tax credits that help make up for the increase entirely.

Related: Open enrollment for 2018 marketplace has begun: 6 changes you can expect

11)  “I signed up for a catastrophic bronze plan, but I want to up my coverage to a better one,  maybe silver. Can I pick another one or is it too late? Whom would I call or email?” —Nicole [Watch at timecode 26:32 on the video above]

You still have until December 15 to change your decision, unless you reside in one of the 15 states that have their own exchanges and deadlines like California, Rhode Island, and Washington. You might even be able to find a gold plan that’s more affordable than a silver plan, so it’s definitely worth taking a look beyond just the lower-level bronze plans, says Benjamin.

12) “I am retiring at end of this year. I am not yet eligible for Medicare. I have a monthly pension of $3,200 from my retirement package. If I sign up for ACA coverage in January 2018, how do I report my income?” —Cam [Watch at timecode 29:20 on the video above]

You need to estimate your income for 2018. Benjamin recommends checking your eligibility for tax credits as you might be eligible for Medicare depending on how many people you have in your household, etc., but you can always adjust your income month to month, and call the marketplace as many times as you want to update your income information. “But don’t forget! When it is time to sign up for medicare, sign up for it, because there can be a penalty if you wait and don’t sign up on time,” says Benjamin.

13) “With the threat of the new health care bill, is it even worth signing up when I could lose it just as fast?” —Michael [Watch at timecode 30:56 on the video above]

Nothing has changed for 2018. “There’s always a chance that something may happen to you during the year. You could get into an accident or get really sick, so you should look for a plan,” recommends Collins.

“But if you are uninsured throughout the year you can negotiate with providers. Many hospitals are required to have a financial assistance or charity care program to work out deals with their patients,” adds Benjamin.

14) “I may have a job opportunity in the spring that will offer health insurance.  If the job works out, am I stuck with Obamacare until the next open enrollment period when I can opt out?” —Martin [Watch at timecode 33:04 on the video above]  

“Once your employer’s coverage kicks in, notify the marketplace that you no longer need the plan and your policy will be terminated,” says Collin. It’s important to sign up now though, so you don’t have a gap in your coverage.

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