Things to know about open enrollment for individual health insurance in Arizona
Open enrollment for the second phase of President Barack Obama's health care law opened over the weekend with less fanfare than the original rollout that was plagued by computer glitches. But this enrollment period will bring about many changes for Arizona residents, including the prospect of lower prices but shifting insurance providers.
Here is a look at some of the key facts, changes and issues:
FEWER UNINSURED
Arizona began its second open enrollment under the Affordable Care Act with an estimated 780,000 uninsured residents out of 6.5 million people in the state, based on estimates done by the Kaiser Family Foundation and the number who gained insurance this year.
About 422,000 Arizonans gained insurance in the past year, 302,000 through an expanded state Medicaid program and 120,000 through the federal health insurance marketplace created by Obama's health care overhaul law.
Arizona chose to let the federal government run its insurance marketplace. Residents purchase policies through the federal website, www.healthcare.gov .
FALLING PREMIUMS, MORE CHOICES
Three new insurance companies are entering the individual market in Arizona on Jan. 1, including the nation's largest health insurer, United Healthcare. That brings to 13 the number of insurers in the market.
Premiums for a mid-range plan in Phoenix, called a silver-level plan, dropped 10 percent this year, making Arizona one of the least expensive states for individual health insurance.
Prices in rural areas may be higher, but a 40-year-old nonsmoker can get a plan in Phoenix for $170 a month — before a subsidy that people earning less than 400 percent of the poverty line can receive. There are seven network pricing zones in the state.
DIFFICULT, BUT HELP'S AVAILABLE
With more than 100 plans in Phoenix alone, picking an insurance plan can be incredibly complicated.
Besides premium price, people need to consider maximum out-of-pocket costs, whether their doctor or hospital is a preferred provider, and what kind of prescription coverage is included.
But don't worry: Help is available.
Two large community groups have received grants to provide "navigator" services, essentially education and handholding to help people figure out how to apply and what plan to choose.
And it's easier to find help than in the last enrollment period. A group called Covered Arizona has upgraded its website to link navigators with those who need help. If you don't have access to a computer, dial 211 and they'll do it for you.
ALREADY INSURED?
If you signed up for health insurance for 2014 during the first open enrollment period, that doesn't mean you should ignore this enrollment period.
A large number of the 120,000 Arizonans who bought insurance this year get subsidies based on their income, so it is important that they update their information at www.healthcare.gov . That will update people's subsidy amount, avoiding a potential repayment.
Also, because so many plans are changing next year and premiums have changed, now's the time to shop around.
ODDS AND ENDS
— Those in the country illegally don't qualify to buy a plan through the healthcare exchanges and don't qualify for Medicaid.
— Expect to hear about this more as the federal government, Covered Arizona, and nonprofit groups conduct ad campaigns and outreach on social media. The Hispanic community in particular can expect a bigger effort, since enrollment among Latinos fell short last year, and that is a key market for insurers.
— The last day to pick a new plan for it to take effect on Jan. 1 is Dec. 15. Open enrollment ends Feb. 15, locking most people out of the market for another year.
— Penalties for those without insurance in 2015 go to $325 per person or 2 percent of income, whichever is higher. In 2014, it is 1 percent or $95. The penalty must be paid when you file your taxes.