What to know ahead of open enrollment with health premiums set to rise

Around 24 million Americans get health insurance through the Affordable Care Act, and the marketplace to pick a plan opens on Nov. 1.

Rising health care costs are at the center of the shutdown. Democrats have rejected bills to fund the government because they did not include an extension of health insurance subsidies that expire at the end of the year. Without those subsidies, premiums for people who purchase their health care on the Affordable Care Act exchanges will in some cases double. Republicans say they won't negotiate health care costs until the government reopens.

All of the uncertainty as many on edge.

Listeners sent in some questions as they navigate this open enrollment period. Insurance experts Hannah Frigand — senior director of the HelpLine for the advocacy group Health Care for All in Massachusetts — and Emilie Fauchet, an Affordable Care Act navigator at the nonprofit Family & Children's Service in Tennessee, share some tips.

5 questions with Hannah Frigand and Emiie Fauchet

Are there ways to buy prescription medications without insurance?

Emilie Fauchet: "The first thing I would do is check your insurance options first. For prescriptions, it's always good to check GoodRx. That's available nationwide, and usually you can just ask right at your local pharmacy.

"They have a website that you can go to, or you can just ask your pharmacy to check what your prescription would cost with GoodRx, and they can usually apply it right there at the pharmacy."

If you're in an accident, can you go to the emergency room without accumulating massive amounts of debt?

Hannah Frigand: "This does get to the importance of health insurance and why we have it, because it's there when you need it. And unfortunately, ER visits we know can be extremely expensive.

"There's ways of getting lower cost care for more preventive services. But if you have an emergency, there's not a lot of planning you can do for an emergency outside of finding the enrollment assistance at the hospital to see if there's any financial assistance that's available through the hospital."

If you can't afford insurance, is crowdfunding a viable option?

Fauchet: "That's a common thing that we hear from people is they feel like they can't afford insurance and want to take the risk. And it goes back to what we talked about with the previous listener, first checking what your options are.

"Crowdfunding sometimes can work for some people, but it's not a reliable source of money for a healthcare event."

For plans with lower monthly premiums but higher deductibles, how do you manage the financial stress of meeting that deductible?

Frigand: "I would start with your plan documents, understanding what services are available before your deductible, because there's many preventive services that are available before you have to pay medical bills towards the deductible.

"I would also look at lower-cost options of locations. So, say you need an MRI, you can actually price that out to see where it's going to be less expensive, and that could save you some money.

"There can be quite a big difference between locations, so it is worth it if you're in a situation where you can shop around. It might be worth it to call a few locations to find out how much it would cost you."

Are people generally hesitant to shop around for insurance during this open enrollment period?

Frigand: "We're seeing a lot of just general fear in the community. One, people are hearing about the rising costs of healthcare. People might not take action where they usually would.

"We know that we've, on our HelpLine, we've been hearing from less lawfully present immigrants who are qualified for coverage because they're scared to get coverage."

Fauchet: "We're really trying to encourage people, make an informed decision, know what your options are for your family. We're also seeing that barrier of fear of enrolling."

This interview was edited for clarity.

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Ashley Locke produced and edited this interview for broadcast with Catherine Welch. Grace Griffin produced it for the web.

This article was originally published on WBUR.org.

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