As deadline approaches, state insurance chief warns that limited care plans are luring consumers

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The open enrollment period for the Health Insurance Marketplace ends on January 31, 2017.

In previous years there has been a surge in website traffic and phone calls to sign up in the final days of the open enrollment period, sometimes causing the federal government to issue extensions.

No extensions are expected to be issued this year as efforts to repeal and replace the Affordable Care Act continue.

“Eight out of ten uninsured Delawareans who were eligible for a Marketplace plan qualified for some level of financial assistance to help offset the cost of monthly premiums,” said Insurance Commissioner Trinidad Navarro.

Those not qualifying for the subsidies, often small business or professional  people with higher incomes, have seen soaring rates. 

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Consumers can find more details about the various plans and their related premiums and deductibles, as well as any potential premium subsidies they may be eligible for www.healthcare.gov.

 Federal application counselors are also available to help with enrollment by calling 1-800-318-2596.

All of the plans sold on the federal marketplace meet the coverage standards and consumer protections mandated by the Affordable Care Act (ACA).

“It is important for consumers to be cautious when shopping for health insurance coverage outside of the Marketplace, especially when looking for plans online,” said  Navarro.

The Department of Insurance’s Consumer Services Division has received numerous complaints from members of the public who thought they had enrolled in an ACA-compliant plan only to learn that they had actually purchased a limited benefit plan.

A limited benefit medical plan is not a comprehensive major medical plan, nor is it intended to replace a major medical plan. The plans receive numerous complaints about never paying claims. 

After January 31, 2017, you cannot buy a health insurance plan for the rest of 2017 unless you have a qualifying life event—a change in your situation like having a baby, getting married, or losing other health coverage — which makes you eligible for a Special Enrollment Period.

If you fail to pay your monthly premiums then your insurance company can eventually cancel your policy. If your policy is canceled due to non-payment you will likely not qualify for any other coverage until January 1, 2018.

“When you are shopping for health insurance coverage it is important to consider more than just the cost of the monthly premium alone,” said Navarro. “Before you enroll in a plan make sure you know how much the deductible will be since deductibles on different plans can vary by thousands of dollars. It is also important to see what the plan will require you to contribute for co-pays or co-insurance,” he said.

Small businesses can apply for SHOP coverage for their employees any time, all year. Simply click on the Small Business tab at the top of Healthcare.gov to get started.

 

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