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Special? Open? Medicaid? Medicare? FPL?

Sometimes it makes my head spin, this whole health insurance coverage thing. The big news today is the federal government is RE-OPENING healthcare.gov for a 90-day Special Enrollment Period (SEP), taking-all-comers, starting on Feb. 15 and ending May 15!

Need to Get Healthcare Coverage? Now’s the Time

If you are one of the more than 400,000 people in Louisiana who are STILL uninsured, this SEP will be a great time to get some protection against unexpected healthcare needs or perhaps go ahead and take care of that existing healthcare problem you’ve just ignored. Putting off care is always dangerous, so look into your coverage options.

With all the different healthcare options available in Louisiana, it’s no surprise that people are confused about their health insurance. There are lots of different government agencies involved in providing health insurance to us nowadays, and those programs can be tricky to navigate. Our insurance safety net in Louisiana, with the combination of the state Medicaid program and coverage available through healthcare.gov, is the strongest it’s ever been. And, we want to make sure you can get the best coverage for your situation. We want to help you burn through all the complexity. This is why you have us, at Straight Talk.

Keep in mind, there is ALWAYS free assistance to hold your hand through the enrollment process. State-licensed agents are available for you at 1-844-GET-BLUE or www.GetPlanOptions.com. I’ve used their expertise myself to arrange coverage for my older kids and other family members, and they do an amazing job at no cost to you.

The Different Paths to Coverage

If you want to handle signing up for coverage yourself, or you want to do some research before you call, here are the steps you should take:

1) If you are offered coverage through your job, like around 1.6 million people in Louisiana are, that’s typically your best bet. You’re going to want to check that out first through your company’s human resources department, to see what kind of coverage is available through your job and what it will cost.

2) If your income is relatively low, Medicaid may be a better fit for you. Here are the income limits by household size to qualify for Medicaid in Louisiana this year. If your income is at or below these amounts, you can apply for Medicaid coverage at ldh.la.gov:

This chart shows 2021 Medicaid annual income limits for a single wage earner with a 1-8 member household.

3) If your income exceeds the amounts above, you can apply at healthcare.gov for individual coverage, often complete with federal help. The insurance plans sold there come in a wide variety of coverage levels and prices. As with all insurance you might purchase, make SURE your doctors, hospitals, and prescription drugs are covered in the plan you sign up for.

Premium assistance starts to kick in above the amounts in the table in bullet 2, and subsidies are available all the way until your income hits 400% of Federal Poverty Level (FPL), which is almost $100,000 a year for a family of four. There is a helpful calculator on healthcare.gov that can help you determine if you might qualify for assistance.

Healthcare.gov is typically a limited-access market February through May, but in 2021, it will be wide open from Feb. 15 through May 15! This is a unique opportunity, so take advantage of it if you qualify.

4) If none of these options works for you, or you are sure you’ll only need health insurance for a short time, you can reach an agent at 1-844-GET-BLUE to ask about Bridge Blue. This is a high-quality short-term medical plan that’s available to people who are relatively healthy. The coverage is not as full as other, longer-term plans, but it’s an option that can save you money if you qualify.

When I look across the spectrum of Louisianians who are uninsured today, a large swath of them remain uninsured due to a lack of awareness about what’s out there, what’s available and what kind of financial help is really in place.

Straight Talk is, we all have an obligation to spread the word to our friends and neighbors about the power of the health insurance coverage in Louisiana today. Almost 2 million of us are getting health insurance coverage at $0 premiums right now through healthcare.gov and Medicaid plans. Millions more are getting insurance with heavy employer or federal subsidies to reduce what they pay. It’s a unique time to join the group.

Don’t miss it!

Posted on: February 10, 2021

2 comments on “Special? Open? Medicaid? Medicare? FPL?

  1. Derek

    What are the cut-off dates for enrollment? Normally it has to be by the 15th. Is this still the case, meaning they need to select a plan on Feb 15th to be effective for March 1st?

    Reply
    • Michael R Bertaut

      Derek!
      Thanks for your question!
      In this Federal Order for an Open Enrollment Period, they violate the standard PPACA enrollment schedule by requiring the following:
      Any enrollment in February must be active on 3/1/2021; and
      Any enrollment in March must be active on 4/1/2021; and
      Any enrollment in April must be active on 5/1/2021; and
      Any enrollment in May (by 5/15 at the latest) must be active by 6/1/2021.

      It’s different from regular enrollment or even normal special enrollment requirements.
      thanks!…mrb

      Reply

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