Some things to consider when picking a plan in 2020
The landscape of health
coverage is constantly evolving, but the time has come to prepare for
2020. But people all over California have likely been pondering their
health choices for months already.
Open enrollment periods
are starting soon for next year's health insurance decisions, whether
for Medicare, employer-provided plans or Covered California. You've
probably received brochures and postcards touting one plan or another.
There are so many choices, it can be overwhelming.
"I sometimes think
of it as going to buy laundry detergent, and find that there are 40
different types of laundry detergent on the shelves," said Jill Selby,
vice-president of product development for the Long Beach-based SCAN
Health Plan, a Health Maintenance Organization (HMO) for seniors serving
several California counties. "So, how do you choose the detergent
that's right for you, much less which health plan will give you the best
coverage?"
There are some major considerations when choosing a health insurance plan.
First, what health issues do you need covered in 2020? A lot of plans
offer benefits you may not use, so why pay for extras you don't need?
Second, where do you live and work?
Most people want health care that is conveniently close to home or their job.
That includes the offices of primary care physicians, labs and hospitals.
Third, what is your health care budget?
Would
you be content to have a onestop shop for lower cost health care with a
HMO? Or does it make more sense to pay more in premiums and copays to
have access to a wide range of health care networks?
And finally, what's new for 2020? Here's a summary of the most relevant changes:
I Covered
California has reinstated a previous Affordable Care Act requirement
that everyone must either carry essential health insurance or pay a tax
penalty: $695, or 2.5% of their income, whichever is higher.
I
Insurance premium subsidies that have been available to lower income
people will be expanded to include more young adults and middle-class
families enrolled in the state's insurance marketplace. Individuals and
families with household incomes within stated guidelines may apply for
this assistance.
I Original Medicare is phasing out some of the plans
it has required participating insurers to offer. Among them, the
popular (and most expensive) Plan F, which covers copays, the Medicare
deductible and charges by health care providers that exceed Medicare
limits.
Luckily, there are other plans that have similar benefits, and Plan F will remain available to those already subscribed.
I
Medicare Advantage HMO plans have been given the OK to offer a range of
new supplemental benefits that haven't previously been considered
medically necessary for people with chronic conditions. These include
long-term care issues like asthma or diabetes, and more coverage for
those using wheelchairs.
Of course, there are many more
considerations beyond this summary. The specific details of plans and
eligibility are or will soon be posted on Medicare and Covered
California websites, as well as those of insurance companies
participating in the programs. Need answers?
Now is the perfect time
to talk to your doctor, health care provider or research Medicare's or
Covered California's website information.
It's time to do your homework.
– CATHERINE GAUGH
Custom Publishing Writer
