SCRANTON, LACKAWANNA COUNTY (WBRE/WYOU) — It’s more than holiday shopping that’s on the minds of many this time of year. It’s open enrollment time for 2020 healthcare insurance.
It’s not only the uninsured who should be doing the shopping. As Eyewitness News Healthbeat Reporter Mark Hiller explains, there are changes in the healthcare marketplace those currently insured also need to know to save money and get the care they need.
Working in his downtown Scranton office, Senior Healthcare Advisor John Jernigan told a couple from Lake Ariel, “There are some programs available where you have a zero premium. You don’t have to pay anything.” That sounds good to Roxanne and Frank Mills who are shopping for healthcare insurance.
Explaining one option, Mr. Jernigan said, “Now, it’s still $90 for emergency room, still $50 for urgent care.” Mrs. Mills asked, “$90 for emergency room?” Mr. Jernigan replied, “Emergency room unless you get admitted to the hospital.”
Finding the right balance between affordability and adequate coverage can be tricky.
“You have to weigh your options and I couldn’t do it on my own and I’m very intelligent but yet it’s so difficult,” said Mrs. Rossi-Mills.
Mr. Jernigan added, “We help people navigate through it and we also help them find any… there’s programs they’re eligible for based on their income.”
You heard him right. The federal government may actually help pay toward purchasing your healthcare coverage.
“Usually something’s available for most people that make less than $80,000 a year,” said Mr. Jernigan.
It’s not the only good news when it comes to affording health insurance.
“In Pennsylvania, we’re seeing premiums go down by an average of six percent so we’re really excited about that,” said CMS Deputy Administrator Randy Pate who is also Director of the Center for Consumer Information and Insurance Oversight.
An increased number of insurance carriers is available on healthcare.gov which gives consumers greater choice. Since plans can change from year to year, you need to make sure you do your homework while on the website.
Mr. Pate said, “You can enter in any prescription drugs you’re taking to see if they’re covered. You can enter in any doctor or hospital or other provider to see if you’re covered.”
Coverage often comes down to age. Younger people can often go with a higher deductible for a cheaper premium. It’s just the opposite if you’re managing several conditions.
Mr. Jernigan said, “If they’re seeing doctors and specialists often I would probably have them pick something with a lower or even no deductible.”
Mr. Jernigan is among the many free advisors you’ll find through healthcare.gov. The Mills are glad they turned to him for help. When reviewing her healthcare choice, Mrs. Rossi-Mills asked, “Least expensive, right?” Mr. Jernigan said, “Yeah, that would be the least expensive.”
Something to keep in mind. The open enrollment period ends December 15th. If you don’t sign-up for healthcare insurance by then, you may have to wait until late next year.
Besides visiting healthcare.gov, you can call the healthcare marketplace at 1-800-318-2596.