ACA 2019 Offers Lower Premiums But Less Coverage

Healthcare consumers and agents should be aware of significant changes in the plans offered on the ACA Marketplace this year. Among the most important changes is that short-term, limited duration health plans are now available, along with the “fully qualified” plans that were one of the original hallmarks of Obamacare.

So, it is more important than ever for people to carefully review plan coverage details this year.

For the first time since the ACA was passed, premiums will go down, according to the department of Health and Human Services. The average monthly premium for a silver plan for a 27-year-old has decreased by 2% from 2018 ($412) to $405 this year. That said, premium costs vary widely across states. In New Jersey, for example, the monthly premium for a benchmark policy is $289 for 2019. In Wyoming, the benchmark policy costs $709 a month.

Consumers should be aware that premiums for the short-term plans may be as more than 50% lower than the fully-qualified plans. These plans may better meet the financial needs of those who do not qualify for subsidies. But consumers who assume all plans on the Marketplace offer similar coverage may be confused by short-term plans, and with the cutbacks in healthcare navigators, some may find it difficult to evaluate what the short-term plans do and do not cover.

In general, assume that short-term plans will not (or will strictly limit) coverage for prescription drugs, maternity care, mental health, and substance use treatment.

Other ACA Enrollment Tips:

• Don’t wait until the last minute to enroll, or to check the details of your current plan. Signup activity tends to peak in the first and last two weeks of Open Enrollment. Increased activity can result in long delays, or problems in registering for new coverage. The deadline to sign up for new insurance, or change existing coverage, on Healthcare.gov is December 15. But some states, including California, have enrollment periods that extend into January.
• Don’t count on getting help navigating the Healthcare Market this year—federal funding for the “Navigator” programs that help individuals sign up for ACA coverage has been sharply reduced.
• People who are self-employed and who don’t qualify for subsidies can review short-term plan coverage on the Marketplace, or explore the private insurance market’s options. Speak with a broker or conduct research online to better understand what types of plans are available now.
• Self-employed people may also wish to look at the ACA’s qualifications for small business plans. In some cases, a small business with just two employees may meet the requirements for ACA coverage, which may be lower than the costs for individual insurance without subsidies.
• Dental insurance coverage under the ACA continues to be extremely weak for adults. Consider joining a dental savings plans to reduce the costs of dental care by 10%-60%.

Affordable Dental Care Options:

The ACA does not consider dental care to be an essential benefit for adults. And while it does list dental for children as essential, the law does not require dental to be included in family plans—only that dental insurance must be available for purchase.

Since dental insurance is not required, investigating alternatives such as dental savings plans may save people money on the cost of coverage as well as the cost of their dental care. Dental savings plans are typically priced at half-the-cost of traditional dental insurance and can save members 10%-60% on most dental procedures, including crowns, root canals, braces and more. And many dental savings plans also include discounts on vision care, hearing care and prescription drugs—which may fill in coverage gaps for those who choose short-term coverage.

“We have helped more than a million people access quality, affordable dental care since we launched our online marketplace in 1999. Our mission continues to be centered around empowering consumers to live happier, healthier lives through affordable dental care,” said Bill Chase, senior vice president of marketing at DentalPlans.com, a leading online provider of dental savings plans and other cost-reducing healthcare options.

“ACA plans do not always include adult dental insurance, but the good news is that there are affordable options you can couple with an ACA plan,” Chase added. “Dental savings plans are a cost-effective alternative to purchasing a separate, stand-alone dental insurance plan, which would come with a separate premium. With a dental savings plans, you just pay a low annual fee and receive discounts every time you visit the dentist.”