Getting Medicare? Do You Qualify for Help Paying for Prescriptions?

Extra Help? Part D? Low-Income Subsidy? Prescriptions?

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Medicare prescription coverage is called Part D and if you are enrolling in Medicare, you have to enroll in Part D to get prescription coverage. Medicare can help you pay for some or all of your out of pocket prescription costs through a program called Extra Help or the Part D Low-Income Subsidy.

What is Extra Help?

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Extra Help provides a Low-Income Subsidy to help pay for out of pocket costs for Part D prescription plans. Extra Help will help pay for monthly premiums, annual deductibles and prescription co-payments. Extra Help can save you up to $4900 a year depending on your medications and on your income and assets. If you have low assets and are working, you may qualify even if your income is over the limit below. If you are struggling to pay for prescriptions, apply.

To qualify for Extra Help, your income and assets must be below:

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How do I get Extra Help?

You must apply for Extra Help, it is not usually automatic. Social Security will need information about your income and assets. Assets include your savings, investments and real estate (other than your home). If you are married, you will need information for yourself and your spouse.

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You may have received an Extra Help application in the mail when you first received information about starting Medicare. If you filled it out and mailed it back, you have already applied. If not, you can apply online at SocialSecurity.gov.

Some people automatically qualify for Extra Help and will receive a notice from Medicare. The notice will be purple, yellow or green or possibly orange. The purple notice says you qualify for Medicaid and Medicare and will receive the maximum Extra Help benefit. The yellow notice indicates you qualify for Extra Help and have been auto-enrolled unless you are already enrolled in a Part D plan. The orange notice states your Extra Help amount is changing for the coming year.

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How do I know if I already have Extra Help?

You can call Medicare at 1-800-633-4227 or log in to your account at medicare.gov.

In addition to Extra Help with Part D, you may also be eligible for help paying your Part B premium or be eligible for Medicaid with your Medicare.

At the WHP office, we help people who have Medicare apply for Medicaid. We can help you get an appointment with a Medicare Medicaid Assistance Program (MMAP) counselor to choose your Part D prescription plan. If you have questions, call us at 734-544-3030.


Resources:

Medicare 1-800-MEDICARE (1-800-633-4227)

Social Security Administration 1-800-772-1213

Find your Level of Extra Help (Part D) from Medicare.gov.

Understanding the Extra Help With Your Medicare Prescription Drug Plan from Social Security.

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Measles Outbreak - Washtenaw County

Confirmed Cases of Measles in Washtenaw County

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YPSILANTI, Mich., April 9, 2019 – The Michigan Department of Health and Human Services has confirmed measles in Washtenaw County as of April 8, 2019. Washtenaw County Health Department is providing additional information to local residents because of potential exposure to measles in public areas. Measles is very contagious, potentially serious and vaccine preventable.

Check and Update Your Measles Vaccination

Everyone is encouraged to check and update their measles vaccination, if needed. Anyone at any of the following Washtenaw County locations during the dates and times provided should monitor themselves for rash with fever or other symptoms consistent with measles for 21 days. If you suspect measles, seek immediate medical treatment. Residents are urged to call their doctor or emergency room before arriving so they can take precautions to prevent exposure to other individuals.

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 Vaccine Information

The MMR vaccine is available through primary health care providers and at some local pharmacies. Individuals should contact their health care provider for advice.

Washtenaw County Health Department is offering the MMR vaccine. Call 734-544-6700 to schedule an appointment. Visit www.washtenaw.org/health for any updates.

Vaccine given within 72 hours of exposure can prevent illness. Immune globulin (Ig) treatment is effective within six days of exposure for high-risk individuals. Talk to your healthcare provider to determine if immune globulin is right for you. You cannot get measles from the vaccine.

Because measles can be spread through the air by an infected person, Washtenaw County Health Department is alerting the public to the potential exposures. A person with measles is contagious for four days before and four days after the rash appears. An individual who was in the same location up to two hours after an individual contagious with measles is considered potentially exposed.

Having two doses of MMR vaccine at least 28 days apart is fully protective. Having only one dose of MMR vaccine is approximately 93 percent protective. The first dose is routinely given to children after their first birthday. Vaccination is not necessary if an individual has a prior history of measles illness. Individuals born before 1957 are assumed to have natural immunity, according to the Centers for Disease Control and Prevention (CDC).

 For updates, please visit www.washtenaw.org/health.

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Happy 50th Birthday to the AAATA. Are YOU Falling off Medicaid?

Happy 50th Birthday to  The Ride ! Cake picture from  sayitwithcake.ca .

Happy 50th Birthday to The Ride! Cake picture from sayitwithcake.ca.

The Ann Arbor Area Transit Authority, also known as The Ride, is celebrating its 50th birthday in 2019! People who ride the bus come from all over the county and have all kinds of insurance. But some bus riders may be losing Medicaid, and not know it.

That is why we are so excited to be partnering with The Ride on our Are You Falling off Medicaid? Campaign.

Through their generosity, we have placed posters in all buses starting March 1, 2019! We have timed this campaign to coincide with the mid-March increase in the minimum wage. Our hope is that we will be able to get people to visit or call us before their special enrollment period runs out. If done in time, people who lose Medicaid can get Marketplace or employer insurance.

Want a prize?

Snap a selfie of yourself with our poster and tag @coveragecounts on twitter, @healthcarecounts on facebook or @healthcarecounts on instagram!

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John Dingell and the Pursuit of Healthcare for All

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This photo shows former President Obama signing the Affordable Care Act. What you might not notice is the gentleman sitting in the right-hand corner of this photo. That was former Congressman John Dingell Jr., who represented much of Washtenaw County for many years. Dingell--who died yesterday--introduced a health care bill into Congress every year from his start as a legislator until the passage of the ACA, and he served for 59 years. Thank you, Congressman Dingell, for your devotion to healthcare for all.

A Little Bit of History

John Dingell’s father (also John Dingell!) was in Congress before John Dingell. John Dingell Sr. began cosponsoring a national health insurance bill (what we would now call “single-payer” legislation) and fighting for universal health care when the issue was less about cost and more about health care as a right. John Dingell Sr. was also active in the fight for social security.

John Dingell Jr. enjoyed the world of twitter, and here is a bit of history—in Dingell’s own words.

John Dingell Sr. is at the back wtih the mustache as President Franklin Delano Roosevelt signs the Social Security Act into law.

John Dingell Sr. is at the back wtih the mustache as President Franklin Delano Roosevelt signs the Social Security Act into law.

When John Dingell Sr. died, John Dingell Jr. ran for his congressional seat and took up the mantle, introducing a single-payer bill into Congress every year. But John Dingell Jr. was practical, and also worked for extending health care incrementally when the opportunities arose.

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John Dingell Jr. said the honor was given to him because the speaker had been great friends with Dingell’s father, and Dingell’s father had worked hard to make Medicare a reality. Note the gavel at bottom left.

John Dingell Jr. said the honor was given to him because the speaker had been great friends with Dingell’s father, and Dingell’s father had worked hard to make Medicare a reality. Note the gavel at bottom left.

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John Dingell Jr., July 8, 1926 – February 7, 2019

We thank John Dingell for his relentless support of health care through his entire career and for his dedication to working for the people of the United States.

Read more details about John Dingell’s role in fighting to extend health care to all here.

John Dingell’s NYTimes Obituary

From the Detroit Free Press:

John Dingell: In love with his life, in awe of his luck

Barack Obama: John Dingell made life better for Americans

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Get (Free) Help With Your Taxes!

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Don't pay to have your taxes prepared!  

You can get free help if you are low income (less than 54,000/year for in person help or less than $66,000/year for online help).  

People need help filing their taxes for many reasons. Whatever the reason, there are some great resources.  Scroll down for a complete list of help in Washtenaw County. For anywhere else in the country, go to myfreetaxes.com and look for assistance from a local United Way—or do-it-yourself online!

What About the Health Insurance Requirement?

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The Affordable Care Act required that most people have health care in 2018 or pay a penalty (shared responsibility payment) unless you qualify for an exemption.  If you had health care through the Marketplace (healthcare.gov) make sure you bring your 1095-A with you when you go to file your taxes.  Your 1095-A is available in the Messages section of your Marketplace (healthcare.gov) account.  You can also call the Marketplace (1-800-318-2596) and they can give the account holder the information over the phone.

For 2019, there is still a mandate requiring people to have health insurance but there is no longer a penalty. When filing taxes in 2020 for the 2019 year, there would be no penalty for not having health insurance.

EXEMPTIONS from the Shared Responsibility Payment

If you are an undocumented immigrant filing taxes using an ITIN number, or if your income is very low, or if your employer insurance was too expensive, you may not have to pay a penalty.  If you are not sure you qualify for an exemption, use the Health Coverage Exemptions tool.  The Exemptions Tool uses your answers to find exemptions that may work for you. It helps you see if you may qualify and tells you how to apply.  If you do qualify, talk to your tax preparer about receiving an exemption.  No tax preparer should ever collect money from you for not having health insurance, only the IRS can collect the shared responsibility payment.  [You can also read about the exemptions on the IRS web site.]

What Information Do You Need To File Taxes?

Here is a list of documents to bring with you to any tax preparation appointment or gather before you start your tax return online.  Make sure to contact your preparer about any specific requirements for receiving help.

  • Social Security or ITIN numbers for all family members, photo ID

  • W-2 forms for all jobs worked in the previous year

  • Proof of rent or mortgage and property tax payments

  • Childcare provider's name, address and federal tax ID number

  • Blank, voided check or deposit slip to set up direct deposit of refund

  • 1099 forms for other income, including unemployment, retirement, contract work

  • Social Security Letter(s) or W-2s

  • 1095-A, if you had health care from the Marketplace (healthcare.gov)

  • Copy of your last year's return (if available)

  • A heating bill from November 2015 - February 2016 or access to your energy bill online

  • Any other tax-related letters or documents

WHERE Can You go for Free Help? 

VITA - UNITED WAY OF WASHTENAW COUNTY

FREE income tax preparation assistance from the United Way of Washtenaw County for residents making up to $54,000 in 2018.

To schedule an appointment call 734-677-7235 or schedule online here.   Multiple locations can be scheduled online including the agencies below.

  • United Way, 2305 Platt Rd. Ann Arbor, 48104. 734-677-7235

  • Manchester Community Resource Center 710 East Main St., Manchester, 48158. 734-428-7722

  • Michigan Works! 304 Harriet St., Ypsilanti, 48197.

  • EMU College of Business 300 W. Michigan Ave. Ypsilanti, 48197.

Many other areas in Michigan have VITA or other tax assistance--use this link to find help in your area.

MYFREETAXES.COM

Do you use a computer?  Do you have access to the computer?  Does your family make $66,000 or less? Myfreetaxes.com is a free online service for tax preparation and filing from United Way and H&R Block.  

Myfreetaxes.com provides email, live chat and telephone support in English and Spanish. 80% of people who filed using this service finished in less than one hour.  If you do not have a computer or would prefer in-person help, computers are available during open VITA clinic hours at the United Way. Computers and volunteer assistance available on a first come, first served basis.

AARP Foundation Tax-Aide

AARP serves adults (55+) with low incomes. Call to make an appointment or inquire about walk-in times.

  • Housing Bureau for Seniors @ the Turner Center 2401 Plymouth Rd., Ann Arbor, 48105. Call 734-998-9341.

  • Milan Senior Center 45 Neckel Ct., Milan, 48160. Call 734-508-6229.

  • Saline Area Senior Center 7190 N. Maple Rd., Saline, 48176. Call 734-429-9274.

  • Ypsilanti District Library 229 W. Michigan Ave., Ypsilanti, 48197. Call 734-482-4110 Ext. 1385.

  • Chelsea Senior Center 512 E. Washington St., Chelsea, 48118. Call 734-475-9242 for Jennifer Smith.

Ann Arbor Senior Center

Ann Arbor Senior Center serves adults (55+) with low incomes. 1320 Baldwin Ave., Ann Arbor, 48104. Call 734-998-9341.

St. Francis

Adults and families with low incomes who have non-complex returns to file. 2150 Frieze Ave., Ann Arbor, 48104. Call 734-769-2550 and ask for Scott Wright.

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HELP! I got cut off of Medicaid!

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ASK: Why did I get cut off Medicaid?

Remember that you can get cut off of Medicaid because your income has risen, because the number of dependents has changed, or because you didn’t fill out an annual renewal (redetermination) form.

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So first, figure out whether the cancellation was correct.

Should Medicaid Have Been Cancelled?

Let’s take a few examples:

  1. You failed to fill out an annual redetermination form, but nothing else in your life has changed. Medicaid is renewed annually, and sometimes people in a household are on different cycles, so you may need to fill out renewals more than once a year. If nothing has changed, you should still be eligible for Medicaid, and should reapply at MI Bridges.

  2. Your income and/or household size has changed. Even a small increase in hours or pay/hour (minimum wage is going up!) can make a big difference. Especially if there are multiple earners in a household, things can get complicated. Here’s how to figure out if your income is still eligible. Income limits for Medicaid.

    Your household size also may have changed. Perhaps a child has grown up and is now on their own; perhaps you got a divorce; perhaps someone in your family died; perhaps parents or grandparents have moved into your household. While you are looking at income, don’t forget to look at household size.

    Remember that eligibility is a combination of both household size and income. If you feel the determination was made incorrectly, you can reapply, or file a hearing (Part 1 and Part 2).

But What If the Determination Was Correct, And You’re Not Eligible For Medicaid?

Good News: You Qualify for a Special Enrollment Period

Employer Insurance

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If your employer offers affordable health insurance, you generally are required to enroll. When your Medicaid ends, it opens a Special Enrollment Period for you to enroll in your employer health care.

It could be that the employer insurance is offered to someone else in the household, but you are eligible. With a Medicaid denial letter, you can get on their employer insurance with a Special Enrollment Period.

For an employer special enrollment period, you only have 30 days to take advantage of the offer, so don’t delay!

Marketplace (Healthcare.gov)

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If your employer does not offer you insurance, you can apply on the Marketplace (healthcare.gov), and you will likely qualify for good tax credits. [If you don’t, please give us a call. You may have fallen into a “family glitch” or answered a question incorrectly.]

For the Marketplace, you have 60 days from the day your insurance ends for the special enrollment period. You will need to prove that you have lost your Medicaid insurance with a denial letter.

 

Questions? We Help People.

Call us at 734-544-3030

Walk in to our office at 555 Towner in Ypsilanti,

Monday-Friday 9 a.m. to 4 p.m.

 

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Public Charge and Public Benefits

If public charge rules changes happen, there will be a notification period. DON'T end any public benefits now. #AllAreWelcomeHere

Want more information? Read the post, Welcome Immigrants—Opposing Public Charge Rules Changes, from December 2018.

#AllAreWelcomeHere

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What Are Special Enrollment Periods? (Or "I Missed Open Enrollment, Can I Still Get Marketplace Insurance?")

If you missed Open Enrollment on the Marketplace, you may be wondering if you can still get healthcare.

The answer is a Definite Maybe.

Are you eligible for Medicaid? Medicaid enrollment is always open, you can apply anytime.

Check to see if you are income eligible by clicking here. If you are not sure about your tax household size or how to calculate your income, give us a call (734-544-3030) and we can help you. There are also many blog posts on this website about eligibility and special circumstances. Search for self-employment, college/teens, income, or your circumstance. There may be a blog post specifically for you!

If not, here are the most common reasons people qualify for a Special Enrollment Period.

NOTE: Generally, Marketplace special enrollments last 60 days (not quite two months) from the change in status. Most employer special enrollments only last 30 days.

Loss of Health Care/Medicaid Denial

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If you are losing your health care, there are options. If your income is decreasing (loss of job, job change, adding a new member to your household), you maybe eligible for Medicaid. If you are losing your healthcare from your job but are over income for Medicaid, you will be eligible for a 60 day Special Enrollment Period on the Marketplace.

If you are losing Medicaid because your income is now higher, you probably have two choices. First, if your employer offers affordable health insurance, you need to enroll in your employer plan. Loss of coverage creates a 30 day Special Enrollment Period with your employer. Employers are not always aware that you qualify for a Special Enrollment Period when you lose other health coverage. This US Department of Labor document clarifies the policy.

You and your spouse may be be eligible for employer insurance but your children may stay eligible for Medicaid/MIChild, which has higher income limits for children. If your employer insurance is not affordable (official explanation of affordable), the second option is a 60 day Special Enrollment Period on the Marketplace. The 60 day period starts the day you lose your coverage.

Change of Immigration Status

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If you are lawfully present in the US, you may qualify for Medicaid or Marketplace insurance. If you are income eligible for Medicaid and have been here for 5 years, you are now eligible for full Medicaid. Apply for Medicaid and cancel the Marketplace. If your immigration status has changed, for instance if you had a work permit renewed or you got a permanent residence card, you qualify for a 60 day Special Enrollment Period on the Marketplace.

Divorce, Birth and Death

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Divorce, Birth and Death all create special enrollment periods and may change your tax household and income. For the Marketplace, any of these events creates a 60 day Special Enrollment Period from the date of the event.

Moving

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When you move from one county or state to another, you qualify for a Special Enrollment Period if you had health care at your previous address. You can apply for the special enrollment period before your move date.

Turning 26

If you are covered under your parent’s health care, when you turn 26 you will lose that coverage. Some employer plans will cancel you on the day of your birthday and some cancel you at the end of your birthday month. Occasionally they will continue your coverage until the end of the year. You can use the “loss of coverage” special enrollment period starting from 60 days before you lose coverage until 60 days after you lose coverage. Enrollment can start as early as the day after your coverage has been lost.

I was auto-enrolled in last year’s plan. What do I do?

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If you failed to update your application on the Marketplace and were auto-enrolled into your 2018 plan, you should still go in and update your application. To update your application, click on the 2019 application and select “report a life change” from the menu on the left side of the page. Update your application and your tax credit will be accurate for 2019. Unless you qualify for a Special Enrollment Period, you will not be able to change your plan, but at least you will have health care for 2019.


If you have questions, call us. We Help People figure it out. 734-544-3030.

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Welcome Immigrants—Opposing Public Charge Rules Changes

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UPDATE: Over 200,000 comments were received while the public comment period was open. No changes can be made until the regulating body (Department of Homeland Security) responds to every comment. Then they can publish a final rule, which could incorporate changes based on comments received—or they could decide not to publish a rule. After the rule is published there is a waiting period before it takes effect.

Today—in fact—any day—is a good day to tell the world that you welcome immigrants to the United States. The Washtenaw Health Plan and Washtenaw County Health Department have submitted comments opposing the changes in "public charge" regulations. Comments could be submitted until December 10th, 2018.

What Is The Issue?

The Trump administration has published a proposed rule that would force many immigrants and their families to choose between accessing essential public services and keeping their families together. 

There are many reasons why immigrants may be denied permanent residence (aka a “green card”) or not be allowed to enter the United States. Public charge is one of those reasons. Under current laws, the government considers someone a public charge if they are found likely to become primarily dependent on government programs.

Currently, “public charge” is considered very narrowly—an immigrant can only be found to be a public charge if they use cash assistance (like TANF or SSI), or institutionalized long-term care (like living in a nursing home) through Medicaid.

The government is considering changes that would dramatically expand who is considered a public charge. making it much harder to get a green card or visa. These changes include:

  • Expanding the benefits that could classify you as being a “public charge” and

  • Assessing your income differently—meaning that your income would only be viewed positively if you made at least 250% of the poverty level (nearly $63,000 for a family of 4).

  • Adding assessments of age, health, education and skills. Children and seniors could be assessed negatively.

In addition to what the public charge proposed rule actually says (and at this point it is only a proposal), it can also have a “chilling effect,” and make people afraid to access any services, even ones that are not included in the rule. If the “public charge” rule is ­finalized in its proposed form, this would mark a significant and harmful departure from long standing immigration policy. The proposal would make -- and has already made -- immigrant families afraid to seek programs that support their basic needs. These programs help them stay strong and productive, and raise children who thrive. With about one in four children having at least one immigrant parent, this issue touches millions and is critical now and for our nation’s future. And that’s why taking action is so important!

According to the Michigan Immigrant Rights Center, at this point, “If you are applying for a green card within the U.S., the rules have not changed, and there is no reason for you or anyone in your family to stop receiving non-cash benefits (like Medicaid and food stamps) that they are eligible for.”

What Can I Do To Make A Difference?

When the federal government proposes a rule, they have to request comments. We have until December 10, 2018 to submit comments. Your voice matters!

The best way to comment is to go online to the federal public charge comment portal at regulations.gov. Click on “comment now” and either enter your comment in the text box (must be fewer than 5000 characters) or upload your comments as a PDF.

Any comments are good, but it’s best if:

  1. You write comments in your own words.

  2. You share research, experiences, and/or the stories of people you know (friends, relatives, community members). You can even include web links or upload supporting materials (research, or your resume, if you are a content expert).

  3. Look to the Michigan League for Public Policy for some great information about the positive economic impact of immigrants in our communities; use that information in your comments. Talk about why we value immigrants in Michigan!

  4. Talk about the role that access to benefits has played in your life, or the lives of people you know.

More details about comments can be found here.

In fact, there’s even a toolkit with specific comment suggestions. However, don’t worry too much about it, short comments are ok too!

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What Else Can I Do?

Use email, phone calls, and social media to get your friends and family to submit comments. (Hint: Share this post!)

You Are In Good Company

If you comment, you are in good company. Not only did the Washtenaw Health Plan submit a comment, but:

And special, special thanks to our partners at the Michigan Immigrant Rights Center for their knowledge, support, and advocacy. Read more about their campaign to Protect Immigrant Families here!

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A Word Of Advice: Don't Auto-Renew

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The new plans are out, and Open Enrollment is upon us! People who have been enrolled in Marketplace plans in the past may be getting notices offering for them to auto-renew their plans. That sounds easy, but it may not be in your best (financial, or health coverage) interests!

Provider Changes

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First, a plan may sound the same, but providers may decide to affiliate or disaffiliate from year to year. So you always to want to make sure that your doctors take your health insurance.

Financial Changes

The plans that are offered may change also. For instance, in Washtenaw County in 2019, there will be a new health insurance provider—Oscar—that has not previously been in the Michigan health insurance market. And even without that new insurer, some insurers may decide to charge less or more for their plans.

The pricing of these plans matters, because tax credits are based on the actual cost of the second lowest silver plan. That is the benchmark from which all tax credits get calculated.

Let’s say that your income is exactly the same between 2018 and 2019, and you qualify for tax credits. If you auto-renew, you could find yourself paying a whole lot more. Even if the plan has not changed, and the full cost of the plan doesn’t have a big difference, there could still be a big difference in tax credits.

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In this case, in 2018 the Pacesetter A plan was the lowest-cost plan, and in 2019 it is the third-lowest-cost plan. Even though the full cost of the plan only went up by $20, the subsidized cost went up a lot more. In this example, for the same exact plan, and with the same exact income, you could end up paying $70 more per month ($840 more per year), more than double what you paid the year before!

The Moral Of The Story?

Do not Auto-Renew.

Instead, give us a call at 734-544-3030; walk in to our Ypsilanti office M-F 9-4; or find local help at this link.

Remember, Open Enrollment on the Marketplace runs from November 1-December 15, 2018.

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