CEO Jeff Smedsrud talked with Maria Bartiromo, host of Mornings With Maria about the advantages and pitfalls of the open enrollment season
Updated September 2, 2020
During a recent segment on Mornings With Maria, HealthCare.com co-founder and CEO of Pivot Health Jeff Smedsrud laid out his top tips for FOX viewers to consider during the current health insurance open enrollment period, which runs until December 15 in most states.
The story of this open enrollment season is an absence of the individual mandate. Consumers who are responsible for purchasing their own health insurance are no longer penalized for not carrying an essential benefits plan that meets the requirements of the Affordable Care Act (ACA). Coupled with extended coverage durations periods on budget-friendly short-term health insurance that was enacted by the Trump administration, consumers have more freedom to purchase any type of coverage they desire without the risk of a fine.
Summarizing his interview, Smedsrud said, “Obamacare has proven one size doesn’t fit all. Those who don’t qualify for a subsidy because they earn too much (about $90,000 for a family of 4) or earn too little (less than the federal poverty level) are finding less-costly alternatives such as expanded short-term medical plans that can be purchased for up to 36-months in some states.”
The health insurance landscape is changing for a reason. More than 57% of Americans participate in some part of the gig economy. People are changing jobs more often because they are more mobile, more tech-savvy, more responsible for their own health and financial wellbeing compared to holding a traditional job with employer-sponsored benefits. The best advice for consumers Smedsrud contends – shop at places like eHealthInsurance, HealthSherpa or HealthCare.com. Think about the monthly budget and tailor a plan to fit health insurance needs for right now.
“This open enrollment season, consumers are in charge of their health care because we are all different, with unique needs. Individuals should feel empowered by their consumer freedoms and do more to unleash markets, even if it is from time-to-time a bit messy,” said Smedsrud.
Top 10 Tips Summarized on FOX Business Network
- Don’t assume your current plan will automatically be the best choice. Costs change, networks change and circumstances change.
- If you are subsidy-eligible, be truthful about your taxable household income. If you estimate it is lower than it really is, you will likely have to pay back any premium credits the following year during tax time.
- Understand the true cost of health insurance. Monthly premium and deductibles equal true cost. If you know you will be using your health plan often, pick a plan with a lower deductible, even though your monthly premium might be higher.
- If your income is below 250% of the federal poverty level, you are eligible for lower deductibles, in addition to premium tax subsidies. Work with an expert like an insurance agent to help you obtain the right plan type.
- There currently is no penalty for not buying health insurance at healthcare.gov. You can buy what you want to buy. But if you qualify for a subsidy, an Obamacare plan is very often the best choice.
- If you earn too much to qualify for premium tax credits (a subsidy) be sure to look at other, less expensive options, such as short-term medical. But only buy a plan for the length of time you need it. Try to keep the plan at least until the next open enrollment period. That way, you’re guaranteed not to have a gap in coverage.
- Although short-term medical plans and other alternatives can offer good coverage, you need to be in generally good health to apply. If you consider what is called faith-based or health cost-sharing ministries, remember these memberships are not insurance, are not regulated in any manner and do not have regulated protections that health insurance does.
- This year, several online companies have been allowed to use what is called enhanced direct enrollment (EDE). In short, you can apply on the site of a private company and still get premium tax credits from healthcare.gov or your state exchange.
- States are creating new options and new regulations. Become educated and informed about options in your state.
- If you are a small business owner, learn about the new health reimbursement arrangements (HRA) rules which could save your employees money and you, the business owner, as well.
Smedsrud wants to leave everyone applying for health insurance during the ACA open enrollment with one final thought. “Consumers really can’t go wrong this open enrollment period if they look at all of their options. The only bad choice is not to be covered. It’s like clothes. You decide what you want to wear. Just don’t run around naked.”
View the entire FOX Business Network segment.