Open Enrollment for 2019 health plans starts November 1, 2018.
Important dates to note:
November 1, 2018: Open Enrollment starts — first day you can enroll, re-enroll, or change a 2019 insurance plan through the Health Insurance Marketplace. Coverage can start as soon as January 1, 2019.
December 15, 2018: Last day to enroll in or change plans for coverage to start January 1, 2019.
Need 2018 coverage outside of open enrollment?
You can still get health coverage if you qualify for a Special Enrollment Period due to a qualifying life event — like getting married, losing other coverage, or having a baby. Find out if you qualify.
Apply for a short-term plan for the part of the rest of the year. These plans are less expensive than many individual ACA plans but do not cover some of the essential health benefits such as maternity coverage. These plans are your best option if you don't currently qualify for a special enrollment period.
Medicaid & CHIP – apply any time
There’s no limited enrollment period for Medicaid or the Children’s Health Insurance Program (CHIP). You can apply any time.
Upcoming 2019 Changes
Health Insurance Exemptions For 2019
The individual mandate was repealed for 2019. Meaning, Americans without health coverage in 2019 will not be subject to a tax penalty. However, up until Monday, anyone without health insurance in 2018 would still have to pay up come tax season.
The new CMS rules, titled in true Trump fashion, “Final 2019 Payment Notice Rule To Increase Access To Affordable Health Plans For Americans Suffering From High Obamacare Premiums,” could potentially save you from paying a tax penalty this year. The new rule provides exemptions to residents living in counties where no health insurance companies offer coverage, or only one insurer offers coverage. The rule also states that those living in counties where the only available health insurance plans cover abortion can also be exempt from a tax penalty for 2018 if it goes against their religious beliefs.
Verification For Premium Tax Credits
The final CMS rule is also going to attempt to improve the integrity of the Advanced Premium Tax Credits (APTC) program. It hopes to do this by “implementing stronger checks” that would take tougher measures to verify anyone applying for Advanced Premium Tax Credits earn the income they claim. The new measure is also going to disqualify any applicant who fails to file taxes or reconcile prior APTCs.
Bring Stability To The Marketplace
The Medical Loss Ratio (MLR) was put in place under the Affordable Care Act, with the purpose of ensuring health providers offer value to their members. The Medical Loss Ratio is scored from 0% to 100%, and measures the amount of money from member premiums spent by health insurers on members’ claims rather than overhead costs. For example, if a health insurance company allocates $0.90 of every dollar to cover medical claims, and the remaining $0.10 to cover overhead costs, the MLR score for that insurer would be 90%.
Obamacare had what it known as the 80/20 rule, which meant health insurance companies were required to have an MLR score of at least 80%. For health insurance companies offering group large group coverage (usually to 50 or more people), that minimum score jumped to 85%. The new CMS rule is going to loosen the Obama era MLR regulations, helping “ease the burden” for health insurance companies. This would allow more companies to enter the marketplace, and create more competition in an attempt to drive down costs.
Changes To Rate Review
The last major takeaway from the new CMS rule is the change to Rate Review. Under the Affordable Care Act, insurance companies had to justify any premium increase of 10% or more, but that number will jump to 15% in 2019. Also, the CMS final rule will get state regulators involved in the Rate Review process, and exempt student health insurance plans from federal Rate Review requirements.