Charlotte Center for Legal Advocacy’s health insurance navigators help families and individuals choose plans that are best for them within the Health Insurance Marketplace implemented under the Affordable Care Act (ACA). During the Open Enrollment Period, navigators receive calls and questions from Cabarrus, Mecklenburg and Union County residents who are concerned about making common errors that could jeopardize their ability to maximize coverage and minimize cost. More frequently asked questions are available at Charlotte Advocacy website.
Below are the “Top Four Mistakes” and how to avoid them
1. Missing the Deadline
The Open Enrollment Period is Nov. 1 through Dec. 15, 2020. During this timeframe, participants will be able to select a health insurance plan for coverage that will start on January 1, 2021. It is very difficult to qualify to sign up for health insurance on the Marketplace beyond the designated timeframe. Usually, adjustments or new enrollments are allowed only as a result of a major life event, such as marriage, divorce, job loss or a new child.
2. Misunderstanding Costs
During Open Enrollment, some people only look at the cost of premiums and don’t take into consideration the deductibles, copays, coinsurance and out-of-pocket maximums. These are all important factors that will help determine your overall health care costs in 2021.
3. Over- or Under-Insuring
A basic high-deductible plan generally has the lowest monthly premium, but it requires the policy holder to spend more before full coverage kicks in. Some people mistakenly select this option because they think it will be cheapest, but they ultimately pay more out of pocket. Navigators suggest a quick assessment of your health care spending over the last couple of years. If you tend to undershoot your deductible, you might be better off moving to a high-deductible plan. If you usually hit your deductible before it resets, you could come out ahead by paying a higher premium for a heartier plan. Remember: The cost of many preventive measures, such as mammograms, colonoscopies and cholesterol screenings, are covered 100% before you meet your deductible and require no copay.
4. Opting Out
A few years ago, not buying health insurance meant facing a potentially costly penalty. While that penalty no longer exists, forgoing coverage is a big mistake. A single illness or injury could total thousands of dollars out of pocket.
As a member of the North Carolina Navigator Consortium, Charlotte Center for Legal Advocacy navigators are available to provide free, unbiased advice to residents of Cabarrus, Mecklenburg and Union County. Navigators are federally certified and extensively trained in the insurance plan options offered by the Health Insurance Marketplace, in addition to cost-sharing reductions and premium tax credits eligibility. Navigators can also help with Medicaid and the Children’s Health Insurance Program (CHIP). Additional assistance is provided to consumers who are disabled, do not speak English or are unfamiliar with health insurance.
Free appointments with a local navigator can be made using the statewide appointment hotline at 1-855-733-3711, or online.