Your Comprehensive Guide
As the annual health insurance Open Enrollment Period approaches, individuals and families are gearing up to make crucial decisions about their healthcare coverage. During this period, people will actively shop for health insurance plans, evaluating options available on the federal Marketplace Healthcare.gov or their respective state exchanges. Understanding the intricacies of Open Enrollment, subsidies, and the array of choices on and outside these platforms is essential for making informed decisions that align with personal health needs and financial considerations. This blog will dig into the complexities of health insurance Open Enrollment, shedding light on subsidies, potential repayment scenarios, network choices, and share a surprising alternative option that might be the solution you have been looking for.
What is Open Enrollment?
Open Enrollment is a specific period during which individuals can enroll in a health insurance plan or change their existing coverage. This period typically occurs from November 1st through December 15th once a year, allowing people to explore various insurance options. Open Enrollment will enable individuals and families to secure health insurance coverage without worrying about pre-existing conditions, qualifying events, or medical underwriting.
What is a Subsidy?
In health insurance, a subsidy is a financial assistance the government provides to help eligible individuals and families afford health coverage. The subsidy amount is based on many factors, such as income, family size, and geographic location. It substantially reduces the monthly premiums for those who qualify, making health insurance more affordable for those with limited financial resources. You can apply for a subsidy at healthcare.gov or your state Marketplace. Your subsidy amount will be determined once your application is complete but before you choose your insurance plan.
What If I Do Not Qualify for a Subsidy?
If you do not qualify for a subsidy, don’t worry! You still have options. Start by exploring different health insurance plans and compare their benefits, premiums, and coverage options. While subsidies can significantly lower costs, some plans without a subsidy can be rather expensive. These monthly payments can be the equivalent of a mortgage payment for many families, often forcing them to go without insurance altogether. This can have grave repercussions when unexpected medical needs arise. Fortunately, there are alternative options available that cost significantly less, which we’ll get into in a moment.
A Word of Caution About Your Subsidy
Individuals who receive subsidies are required to estimate their annual income accurately for the upcoming year. If your income exceeds the estimate provided during enrollment, you’ll pay a portion of the subsidy back when you file your taxes the following year. Whether your estimate was incorrect, you got a pay raise, or you came into some unexpected income, your subsidy qualification or amount will change, too. It’s crucial to report any income changes promptly to avoid unexpected repayments.
The Problem With Cost-Effective HMO and POS Plans
Health Maintenance Organization (HMO) and Point-of-Service (POS) plans are often the more cost-effective options when compared to a Preferred Provider Organization (PPO) plan. However, they come with a drawback. HMO and POS plans will often have a restricted network of healthcare providers. They typically require individuals to choose doctors and specialists within the designated network. Limited network choices might impact your ability to see specific healthcare providers, making it essential to consider this factor when selecting a plan. When shopping on the healthcare exchanges, very few remaining PPO options give out-of-network flexibility, and the cost of existing plans has skyrocketed over the years. For many people, this kind of cost-effective plan is too restrictive. Fortunately, there is a great alternative.
A Promising Alternative During Open Enrollment
Knew Health is an excellent alternative solution. While it is not health insurance, Knew Health is an innovative healthcare choice that prioritizes the needs of individuals and families in the form of a monthly Membership. It is a community-driven approach to healthcare centered around medical cost sharing, which can alleviate the financial strain of healthcare costs. Memberships are designed to be accessible, transparent, and user-friending, ensuring you get the healthcare you need without breaking the bank. Best of all, you can enroll and become a Knew Health Member any time of year, not just during Open Enrollment.
Knew Health Advantages
Affordability: Knew Health provides a cost-effective alternative to health insurance suitable for various budgets, making quality healthcare more accessible. Memberships start as low as $142/month.
Comprehensive Membership: Memberships offer extensive services, including general wellness costs, lab services, telehealth services, health and life coaching, health and wellness allowances, and so much more. When you enroll in Knew Health, you’ll become part of a model that limits the financial impact of costs that result from illness, injuries, and pregnancies, ensuring you have peace of mind in the event of unexpected medical expenses.
No Networks: Unlike insurance plans, Knew Health offers the ability to choose any provider, allowing you to select from a broad range of healthcare providers and specialists, giving you total freedom to manage your healthcare effectively. Members can choose conventional, integrative, or holistic providers.
Community-Driven Approach: The community of like-minded Members adopts the idea of shared responsibility. They share in each other’s medical expenses, which helps create a sense of community and encourages members to maintain healthy lifestyles.
Enroll Any Time of Year: Knew Health is always enrolling, so there is no need to worry about Open Enrollment windows. Whether November 1st or March 1st, you’ll get the same Member advantages no matter the time of year.
Final Thoughts
Open Enrollment is an excellent time to assess your healthcare needs and choose a path that fits your requirements and budget. It is also the perfect time to explore innovative alternatives like Knew Health, which can provide a pathway to affordable and comprehensive healthcare with unique advantages you won’t find with a health insurance plan.
Whether you’re tired of paying for a high-cost insurance plan each year, prefer to see doctors who aren’t covered by your insurance network, or simply love the distinctive perks of a Knew Health Membership, now is the ideal time to consider making the switch. By staying informed and exploring the available options, you can make confident decisions about your healthcare, ensuring you and your family are protected in times of need.
If you’d like to learn more about enrolling in Knew Health and all the tools available to you as a Member, call us today at 855-542-0050 or schedule a virtual appointment with our knowledgeable Care Team.
As a reminder, Knew Health is not Health Insurance. Please visit our website for a description of our services.
Resources:
Andrews, Michelle. “A Raise Can Wreak Havoc With Your Health Insurance Subsidy.” NPR, January 10, 2017, www.npr.org/sections/health-shots/2017/01/10/509012824/a-raise-can-wreak-havoc-with-your-health-insurance-subsidy.
