Mon
Nov 6 2017
06:19 am
Open enrollment for health insurance through the Affordable Care Act is available now.
This is a shorter enrollment period than previous years, so it’s important to act quickly.
If you don’t act by December 15, you can’t get 2018 coverage unless you qualify for a Special Enrollment Period. Plans sold during Open Enrollment start January 1, 2018.
You can go here to preview plans offered for 2018.
Knox County had 19,338 enrolled in 2017. Blount County had 4,788 enrolled. In these counties, there was one insurer (Humana) offering plans in 2017 and there is one insurer (Blue Cross Blue Shield) offering plans in 2018.
Don't wait. With the shortened enrollment period it could get very busy.
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It's expensive
I went through the process to see what it would cost. First the whole process is kind of difficult. Lot's of questions and they seem to repeat several times during the process. Second, there are only a few BCBS choices with the cheapest for me at about $950 per month. It really was not a good deal. The one plan that most closely matched my current health care through my employer was about $2K a month. I would not qualify for any help from the gov't to pay for it. So now I guess I have to work for a few more years.
It would be nice if we
(in reply to xmd)
It would be nice if we weren't dependent on employers for health insurance. Being limited to employers for good health plans limits your choices of employers.
It also limits your choice of
(in reply to bizgrrl)
It also limits your choice of plans to the one your employer offers.
Pardon my naivete' Does a
Pardon my naivete'
Does a Tennessee or North Carolina small business have access to the DC Link exchange? If not, why?
What are their options to offer health insurance to their employees?
DC Link
Don't think so. Don't know
(in reply to jbr)
Don't think so. Don't know why. Why would they? Looking for a loophole because DC isn't a state?
Definition of "out of pocket maximums".
I understand this to mean that once you hit this threshold, all other expenses are covered by the insurer. I looked at the FAQ's on BCBS and they confirm this but with then under a sample question "What is not covered?" it says "Amounts you pay for health care services that aren’t included in your plan’s benefits".
I travel extensively as a tradesman and recognize that my most likely health risk at this point is an ER visit for stitches or other trama. If I go to (or in the case of incapacitation, am taken to) an ER that is not "in plan", how does that relate to OOPM?
The marketplace offers me four BCBS choices this year: GO6S, SO4S, SO1S, BO7S. I am also curious if others are offered different BCBS plans?
I think BC BS is only
(in reply to earlnemo)
I think BC BS is only offering S plans in this area.
Those are the same plans I
(in reply to earlnemo)
Those are the same plans I was offered.
The ACA enrollments process for this year
Hi, and since I have been involved in Enrollments for the ACA, a volunteer who helps register applicants, I would like to answer a few questions, and refer you to our advocate, Dr. Mary Headrick, whose article in Tuesday, Nov 7th paper,yesterday's paper: "Don't Miss Deadline to Sign Up For Obamacare". Dr. Mary explains, IN DETAIL, about the plans offered this year. And YES, Blue Cross is the ONLY insurer in the marketplace here in Eastern Tennessee. She stresses s that over 87% will be eligible, based on income, age, and tobacco use, will qualify for some premium tax credits and 67% will have other types of cost savings in the plans offered.
ALSO, if you already enrolled and have a plan now, you need to re-enroll NOW. If you fail to re-enroll, your plan will end on its renewal date.
And a short explanation of why only Blue Cross is an insurance provider HERE: About a year ago, ALL insurance carriers here DROPPED OUT of the ACA...even Blue Cross. BUT due to the protests, BC decided once again to be a provider. And of course the rates have changed, increased somewhat. But if you enroll or re-enroll in this current Enrollment period, you will have coverage for ALL of 2018! Here in this area, we began enrollments on November 1st with our kick-off at OBC church...we have 3 area locations you can easily access here in the Knoxville area. And we have phone numbers to call for information, or to make an appointment to see our Navigators and/or CACs, ALL of whom are trained professionals and who WANT TO HELP.
The reason y'all may not have heard about this current enrollment is that tRUMP cut our Budget over $1 million which we needed to do PR about our continuing enrollments. OBAMACARE IS NOT ENDED. (IN FACT, new enrollments are surging across the country: In Minnesota, over 200,000 new enrollees got coverage SINCE NOV. 1st. We still have funding to cover all current and future enrollments, BUT the DEADLINE is December 15th.
The 3 locations are: Mt. Calvary Baptist Church on Dandridge Ave, Cherokee Health on Western and the South Knox Community Center on Maryville Pike. The phone numbers are: 844-644-5443 if you have questions or to get FREE HELP in the enrollment process. Or to enroll by phone, call: 800-318-2596 or TTY:855-889-4325
And there will be a program on CTV, channel 12, with members of our team proving information and answering questions. (Not sure about the date or time for that event.)
THE BEST WAY TO LEARN ABOUT THE ACA is to visit one of our enrollment sessions IN PERSON. We want to stress that even enrollment for one year will be a savings for you and your family, especially if you do not have health insurance through your employer.
Hope this clears up some of the confusion !
Mary
Knox County TN ACA 2018 Reality
After researching the ACA 2018 options on Healthcare.gov, I have come to the following conclusions:
1) If you make more than $48,240 as a single taxpayer, or more than $64,960 as married filing jointly, then the lowest cost BCBS Bronze plan for an individual will cost over $11,500 in premiums. The only service not subject to the $5,650 individual deductible is ONE physical per year. So, an individual in either of these situations will pay over $17,000 for anything other than that physical before the BCBS starts to cover office visits/ER visits/doctor services/RX at 50% - up to the $6,650 max out of pocket. At that point the individual would have spent over $18,000 for health coverage in 2018.
2) Per Healthcare.gov, a married filing jointly taxpayer making more than $64,960 but less than $143,006 will NOT owe the individual mandate tax penalty for not having ACA coverage in 2018. The reason given for this exemption - "Will I pay a penalty if I don’t get insurance? No, you are likely exempt from the penalty because the lowest cost plan in your area is unaffordable."
It appears that only one insurance provider in Knox County (Farm Bureau) is offering 'non-qualified' traditional plans, and those require evaluation of pre-existing conditions before coverage & rate can be determined. For anyone within the income ranges discussed above, especially those who do not have severe 'pre-existing conditions', then a traditional 'non-qualifying' plan might be a viable option, and would not incur the tax penalty.
You are basically correct.
(in reply to (Anonymous) Dick H.)
You are basically correct. Individual health insurance is expensive. The majority of people get their health insurance through their employer.
Prior to the ACA, if you had a pre-existing condition, you could not get individual health insurance in Tennessee, except maybe a real crummy policy.
Of the $18,000 you mentioned, $11,500 is for the health insurance premiums ($958/month). With this type of health insurance there is no maximum amount the insurance company pays. Thus, if you get real sick or hurt real bad, you are covered. This was not the case prior to the ACA.
Also, there are some additional benefits to the ACA policies you didn't mention, however small. Beside the preventive health care exam once a year (annual physical), the BCBS policies that follow the ACA guidelines cover mammograms, colonoscopies, and other screening, flu shots, and other immunizations. In addition, you get good discounts on prescriptions and doctor visits, etc.
The ACA policies are definitely limited in Tennessee and have gotten more expensive. The individual mandate was meant to help keep down costs for people who actually do have to pay for individual policies. If everyone able to pay paid at least something for healthcare it would help bring down health insurance costs. However, that is not the case in this country.
Keep in mind, I don't believe the BCBS S plans now available through the ACA are accepted by UT Hospital or their related physicians. Don't know how that would work if you had to go to the ER.